系统回顾和荟萃分析：发展肝细胞癌的慢性乙型肝炎患者的

StephenW

J Viral Hepat. 2018 May 9. doi: 10.1111/jvh.12928. [Epub ahead of print]
Systematic review and meta-analysis: development of hepatocellular carcinoma in chronic hepatitis B patients with hepatitis e antigen seroconversion.
Zhou TC1, Lai X1, Feng MH1, Tang Y2, Zhang L1, Wei J1.
Author information

1
    Central lab, Liver disease research center, the second people's hospital of Yunnan Province (The fourth affiliated hospital of kunming medical university), Kunming, Yunnan Province, 650000, China.
2
    The first affiliated hospital of kunming medical university, Kunming, Yunnan Province, 650000, China.

Abstract

Hepatitis B e antigen (HBeAg) seroconversion is considered to have significantly favorable clinical outcomes for patients with chronic hepatitis B (CHB). However, inconsistent study results suggest that hepatocellular carcinoma (HCC) still occurs in patients with HBeAg seroconversion. We performed a systematic review and meta-analysis to determine the incidence of HCC in patients with CHB after HBeAg seroconversion. Web of Science, PubMed and EMBASE databases were searched through July 2017. The incidence of HCC in CHB patients after HBeAg seroconversion was pooled using a random-effects model or fix-effects model. Sixteen studies were finally included, involving 4910 patients with HBeAg seroconversion. The overall pooled proportion suggested that 3.33% (95% confidence interval (CI): 2.28-4.58%) of patients with CHB develop HCC despite HBeAg seroconversion. In patients with HBeAg seroconversion without cirrhosis or HCV/HDV co-infection, the pooled proportion of HCC development was 0.94% (95% CI: 0.15-2.4%). Moreover, patients with cirrhosis, active hepatitis, or aged greater than 40 years at the time of HBeAg seroconversion were at significantly higher risk for HCC development. HBeAg seroconversion was significantly associated with a reduced risk for HCC compared with persistently positive HBeAg (RR = 0.58, 95% CI: 0.35-0.97, P = 0.04). Despite the reduced risk with HBeAg seroconversion, HCC can still occur in a proportion of patients with CHB after HBeAg seroconversion. Long-term monitoring is needed for patients with established cirrhosis, active hepatitis, or those older than 40 years at the time of HBeAg seroconversion. This article is protected by copyright. All rights reserved.
KEYWORDS:

chronic hepatitis B; hepatitis e antigen; hepatocellular carcinoma; meta-analysis; seroconversion

PMID:
    29741285
DOI:
    10.1111/jvh.12928

StephenW

J Viral Hepat。 2018年5月9日doi：10.1111 / jvh.12928。 [电子版提前打印]
系统回顾和荟萃分析：发展肝细胞癌的慢性乙型肝炎患者的肝炎抗原血清转换。
周TC1，赖X1，冯MH1，唐Y2，张L1，魏1 1。
作者信息

1
    云南省第二人民医院（昆明医科大学第四附属医院）中心实验室肝病研究中心，云南昆明650000。
2
    昆明医学院附属第一医院，云南昆明650000，中国。

抽象

乙型肝炎e抗原（HBeAg）血清转换被认为对慢性乙型肝炎（CHB）患者具有显着有利的临床结果。然而，不一致的研究结果表明，肝细胞癌（HCC）仍然发生在HBeAg血清学转换的患者身上。我们进行了系统回顾和荟萃分析，以确定CHB患者HBeAg血清学转换后HCC的发生率。科学，PubMed和文摘数据库的网页是通过2017年七月肝癌的慢性乙型肝炎患者发病后搜索HBeAg血清学转换是使用随机效应模型或固定效应模型合并。最终纳入了16项研究，涉及4910例HBeAg血清学转换的患者。总体汇总比例表明，尽管HBeAg血清学转换，CHB患者的3.33％（95％可信区间（CI）：2.28-4.58％）发展为HCC。在无肝硬化或HCV / HDV共感染的HBeAg血清学转换的患者中，HCC发展的合并比例为0.94％（95％CI：0.15-2.4％）。此外，肝硬化，活动性肝炎或HBeAg血清转换时间超过40岁的患者发生HCC的风险显着更高。与持续阳性的HBeAg相比，HBeAg血清学转换与HCC发生风险降低显着相关（RR = 0.58,95％CI：0.35-0.97，P = 0.04）。尽管HBeAg血清学转换的风险降低，但HBeAg血清学转换后仍有一部分CHB患者发生HCC。在HBeAg血清学转换时，对于确诊为肝硬化，活动性肝炎或40岁以上的患者需要长期监测。本文受版权保护。版权所有。
关键词：

慢性乙型肝炎;戊型肝炎抗原;肝细胞癌;荟萃分析;血清转换

结论：
    29741285
DOI：
    10.1111 / jvh.12928