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

Digestive Diseases and Sciences

December 2018, Volume 63, Issue 12, pp 3207–3219 | Cite as
Efficacy of Nucleoside Analogs for Chronic Hepatitis B Virus-Related Hepatocellular Carcinoma After Curative Treatment: A Meta-Analysis

    Authors
    Authors and affiliations

    Guangcong ZhangXiangnan YuPeng LiuXiaoxi HuangXuemei JiangEmail author

    Guangcong Zhang
        1
    Xiangnan Yu
        2
    Peng Liu
        1
    Xiaoxi Huang
        1
    Xuemei Jiang
        1Email authorView author's OrcID profile

    1.Department of GastroenterologyCentral South University Xiangya School of Medicine Affiliated Haikou HospitalHaikouChina
    2.Department of GastroenterologyZhongshan Hospital of Fudan UniversityShanghaiChina

Review
First Online: 23 August 2018

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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
Nucleoside analog Hepatocellular carcinoma Curative treatment Meta-analysis

StephenW

消化系统疾病与科学

2018年12月，第63卷，第12期，第3207-3219页|引用为
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

    作者
    作者和附属机构

    广告张湘南余鹏刘晓曦黄雪梅江泽民作者

    张光聪
        1
    湘南玉
        2
    刘鹏
        1
    黄晓曦
        1
    姜雪梅
        1Email authorView作者的OrcID个人资料

    1.中国南方大学湘雅医学院消化内科海口医院海口中国
    2.复旦大学中山医院消化内科，上海中国

评论
首次在线：2018年8月23日

    2股98下载

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％可信区间[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
核苷类似物肝细胞癌治愈性治疗Meta分析