慢性乙型肝炎患者未经治疗的肝癌发病率的系统评价和荟萃

StephenW

Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta-analysis

    Elena Raffetti1,*, Giovanna Fattovich2 andFrancesco Donato1

DOI: 10.1111/liv.13142

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Issue
Cover image for Vol. 36 Issue 5
Liver International

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    This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.13142


Keywords:

    hepatitis B;hepatocellular carcinoma;meta-analysis;liver

Abstract
Background and Aims

In the natural history of hepatitis B virus (HBV) chronic infection the hepatocellular carcinoma (HCC) risk is unclear. We assessed incidence and predictors of hepatocellular carcinoma by a systematic review and meta-analysis .
Methods

We included longitudinal studies and randomized controlled trials assessing hepatocellular carcinoma incidence in untreated patients with HBV chronic infection. Incidence rates and their 95% confidence intervals were extracted by each study and pooled together in random effects models.
Results

Sixty six studies were included with a total of 347 859 patients. According to liver disease status, the summary incidence rates were in Europe, North America and East Asia, respectively: a) asymptomatic carriers: 0.07 (95% confidence interval: 0.05-0.09), 0.19 (0.07-0.31) and 0.42 (0.21-0.63) per 100 person-years, respectively; b) inactive carriers: 0.03 (0.0-0.10), 0.17 (0.02-0.62) and 0.06 (0.02-0.10), respectively; c) chronic hepatitis: 0.12 (0.0-0.27), 0.48 (0.22-0.91) and 0.49 (0.32-0.66), respectively; d) compensated cirrhosis (Child-Pugh A): 2.03 (1.30-2.77), 2.89 (1.23-4.55) and 3.37 (2.48-4.26), respectively. Multivariate meta-regression showed a significant increase of incidence rates for age, and for status of symptomatic carrier, chronic hepatitis and compensated cirrhosis compared to inactive carrier, but not for geographical area after adjusting for age. An increase of the incidence rates was also observed for alcohol intake ≥60 g/dl, HBV genotype C with respect to B and HBV-DNA serum levels > 2000 IU/ml, in Asian studies.
Conclusions

HCC risk in untreated subjects with HBV chronic infection is strongly related with age and liver disease status.

This article is protected by copyright. All rights reserved.

StephenW

慢性乙型肝炎患者未经治疗的肝癌发病率的系统评价和荟萃分析

    埃琳娜Raffetti1，*，焦万娜Fattovich2 andFrancesco Donato1

DOI：10.1111 / liv.13142

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问题
封面图片的卷。 36第5期
肝国际

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    这篇文章已被接受发表，并接受全面的同行评审，但经过审稿，排版，分页和校对过程中，这可能会导致这个版本和记录的版本之间的差异一直没有。请引用这篇文章的DOI：10.1111 / liv.13142


关键词：

    乙型肝炎;肝细胞癌;元数据;肝

抽象
背景和目的

在B型肝炎病毒（HBV）慢性感染的自然史的肝细胞癌（HCC）的风险是不清楚。我们通过系统回顾和荟萃分析评估，发病率和肝癌的危险因素。
方法

我们包括纵向研究和随机对照试验初治患者的HBV慢性感染评估肝癌发病率。发病率和95％的置信区间是由每个研究提取和随机效应模型汇集在一起​​。
结果

六十六项研究被列入共347 859患者。据肝病状态，总结发病率分别为欧洲，北美和东亚，：一）无症状携带者：0.07（95％可信区间：0.05-0.09），0.19（0.07-0.31）和0.42（0.21- 0.63）每100人年，分别为;二）非活动性携带者：0.03（0.0-0.10），0.17（0.02-0.62）和0.06（0.02-0.10），分别;三）慢性肝炎：0.12（0.0-0.27），0.48（0.22-0.91）和0.49（0.32-0.66），分别; D）代偿期肝硬化（Child-Pugh分级A）：2.03（1.30-2.77），2.89（1.23-4.55）和3.37（2.48-4.26）​​，分别为。多元荟萃回归分析表明发病率的年龄一个显著上升，并调整了年龄后对症载体，慢性肝炎和肝硬化的补偿相比，活性载体，但不是状态的地理区域。发病率的增加也为酒精摄取观察到≥60克/分升，对于B和HBV-DNA的血清水平> 2000国际单位/毫升，在亚洲研究HBV基因型℃。
结论

与乙肝病毒慢性感染者未经治疗肝癌的风险是随着年龄和肝脏疾病状态有关。

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hbv30year

man, u r still working hard here. 劳动节快乐

癌症这东西只能听上帝的旨意了， 我觉得喝茶可以抗癌

StephenW

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