核苷类似物治疗慢性乙型肝炎病毒相关性肝细胞癌的疗效：Me

StephenW

Dig Dis Sci. 2018 Aug 23. doi: 10.1007/s10620-018-5252-8. [Epub ahead of print]
Efficacy of Nucleoside Analogs for Chronic Hepatitis B Virus-Related Hepatocellular Carcinoma After Curative Treatment: A Meta-Analysis.
Zhang G1, Yu X2, Liu P1, Huang X1, Jiang X3.
Author information

1
    Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 43 People's Avenue, Haikou, 570028, China.
2
    Department of Gastroenterology, Zhongshan Hospital of Fudan University, 180 Fenglin Rd., Shanghai, 200032, China.
3
    Department of Gastroenterology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, 43 People's Avenue, Haikou, 570028, China. [email protected].

Abstract
BACKGROUND AND AIM:

The efficacy of nucleoside analogs (NAs) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment remains unclear. The present study aimed to evaluate the efficacy of these agents by conducting a comprehensive meta-analysis of available studies.
METHODS:

We searched several databases including Pubmed, Embase, Cochrane Library, Clinical Trials, and Web of Science, according to PRISMA guidelines. We considered all randomized controlled trials and cohort studies that met the inclusion criteria. Statistical analyses were conducted using Review Manager 5.3 and Stata 14.0.
RESULTS:

Twenty-one studies with 8752 participants were included in the final analysis. The pooled data showed that patients treated with NAs had significantly lower 1- and 3-year HCC recurrence rates (relative risk [RR] 0.76, 95% confidence interval [CI] 0.65-0.90; P = 0.001 and RR 0.79, 95% CI 0.71-0.88; P < 0.001, respectively), but there was no difference in 5-year recurrence rates (RR 0.87, 95% CI 0.74-1.03; P = 0.10). Regarding overall survival (OS), patients treated with NAs had significantly higher 1-, 3-, and 5-year OS rates (RR 1.05, 95% CI 1.02-1.08; P = 0.003; RR 1.25, 95% CI 1.16-1.34; P < 0.001; and RR 1.28, 95% CI 1.18-1.39; P < 0.001, respectively).
CONCLUSION:

NA therapy has the potential to reduce the risk of early recurrence and improve OS in patients with HBV-related HCC after curative treatment, compared with placebo or no treatment. Further research including more homogeneous studies with large sample sizes is required to improve the reliability of these conclusions.
KEYWORDS:

Curative treatment; Hepatocellular carcinoma; Meta-analysis; Nucleoside analog

PMID:
    30140982
DOI:
    10.1007/s10620-018-5252-8

StephenW

Dig Dis Sci。 2018年8月23日doi：10.1007 / s10620-018-5252-8。 [提前打印]
核苷类似物治疗慢性乙型肝炎病毒相关性肝细胞癌的疗效：Meta分析。
Zhang G1，Yu X2，Liu P1，Huang X1，Jiang X3。
作者信息

1
    中南大学湘雅医学院消化内科，海口市人民大街43号海口医院，海口570028
2
    复旦大学附属中山医院消化内科，上海市枫林路180号，邮编：200032。
3
    中南大学湘雅医学院消化内科，海口市人民大街43号海口医院，海口570028 [email protected]。

抽象
背景和目的：

核苷类似物（NAs）对治疗性治疗后乙型肝炎病毒（HBV）相关性肝细胞癌（HCC）的疗效尚不清楚。本研究旨在通过对现有研究进行全面的荟萃分析来评估这些药物的疗效。
方法：

根据PRISMA指南，我们搜索了几个数据库，包括Pubmed，Embase，Cochrane图书馆，临床试验和Web of Science。我们考虑了所有符合纳入标准的随机对照试验和队列研究。使用Review Manager 5.3和Stata 14.0进行统计分析。
结果：

最终分析纳入了21项研究，共有8752名参与者。汇总数据显示，接受NAs治疗的患者1年和3年HCC复发率显着降低（相对风险[RR] 0.76,95％置信区间[CI] 0.65-0.90; P = 0.001和RR 0.79,95％CI分别为0.71-0.88; P <0.001），但5年复发率无差异（RR 0.87,95％CI 0.74-1.03; P = 0.10）。关于总生存期（OS），接受NAs治疗的患者的1年，3年和5年OS率明显较高（RR 1.05,95％CI 1.02-1.08; P = 0.003; RR 1.25,95％CI 1.16-1.34 ; P <0.001;和RR 1.28,95％CI 1.18-1.39;分别为P <0.001）。
结论：

与安慰剂或不治疗相比，NA治疗有可能降低早期复发的风险并改善治疗后HBV相关HCC患者的OS。需要进一步研究，包括更大样本量的均匀研究，以提高这些结论的可靠性。
关键词：

治疗;肝细胞癌; Meta分析;核苷类似物

结论：
    30140982
DOI：
    10.1007 / s10620-018-5252-8