A systematic review and Meta-analysis on the carcinogenic risk difference of HBV subtypes
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摘要:
目的 探究不同基因型的HBV引发肝细胞癌(简称“肝癌”)风险差异及其潜在机制。 方法 通过检索数据库PubMed、Web of Science、Embase、中国知网(China national knowledge infrastructure, CNKI)及万方数据获取相关数据,利用Meta分析的方法进行数据整合。从National Center for Biotechnology Information(NCBI)Genbank数据库获取HBV的DNA序列,并分析不同基因型的HBV危险突变发生频率。 结果 共检出相关文献1 066篇,经筛检纳入符合要求文献17篇。总调查人数为16 288例,其中肝癌患者3 613例。Meta分析结果显示,感染HBV C基因型患者罹患肝癌风险较A、B及D基因型高,而感染A、B及D基因型的患者发生肝癌风险差异无统计学意义(均有P>0.05)。HBV DNA突变频率分析结果显示,C基因型中危险突变发生频率高于其他基因型。 结论 HBV C基因型与其他主要基因型相比,发生肝癌的风险更高,这可能归因于C基因型发生危险突变的频率更高。 Abstract:Objective To explore the risk difference and potential mechanisms on the hepatocellular carcinogenesis of different HBV genotypes. Methods Literatures were retrieved from PubMed, Web of Science, Embase databases Wanfang data and CNKI. Data were synthesized by meta-analysis methods. HBV sequences were obtained from NCBI-GenBank and the mutation frequency of different HBV genotypes were calculated. Results A total of 1 066 studies were retrieved via literature search. Finally, 17 studies were included in the Meta-analysis after eligibility screening. The total number of study subjects was 16 288, including 3 613 liver cancer patients. Patients with HBV C genotype had a higher risk of liver cancer than genotypes A, B, and D. While no significant difference in the risk of liver cancer across genotypes A, B and D was observed. The frequency of mutations indicated that most mutations were more frequently occurred in genotype C compared with other genotypes. Conclusions HBV genotype C is associated with a higher risk of hepatocellular carcinoma than other genotypes, which might due to more risk mutations genotype C HBV possessed. -
Key words:
- HBV /
- Genotype /
- Liver cancer /
- Meta-analysis
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表 1 纳入文献基本情况
Table 1. Characteristic of included studies
作者及年份 地区 研究人数 肝癌人数 研究的基因型 研究设计 质量评分 杨家红2013[9] 中国大陆 1 152 112 B、C 横断面研究 A-6 郑丹2015[10] 中国大陆 123 53 B、C 病例对照研究 N-6 Chen 2012[11] 中国大陆 466 156 B、C 病例对照研究 N-6 Kao 2000[12] 中国台湾 270 80 A、B、C、D、 横断面研究 A-7 Fujie 2001[13] 日本 109 58 B、C 病例对照研究 N-5 陈岳明2009[14] 中国大陆 175 86 B、C 横断面研究 A-5 Asim 2010[15] 印度 189 88 A、D 病例对照研究 N-7 Chen 2014[16] 中国大陆 328 97 B、C 病例对照研究 N-7 Sumi 2003[7] 日本 585 74 A、B、C 横断面研究 A-8 Sung 2008[17] 中国香港 200 100 B、C 病例对照研究 N-6 Toan 2006[18] 越南 375 84 A、B、C、D 横断面研究 A-8 Wen 2015[19] 中国大陆 3 067 1 507 B、C、D 病例对照研究 N-7 Yang 2008[6] 中国台湾 2 762 153 B、C 横断面研究 A-9 Yin 2008[20] 中国大陆 1 121 462 A、B、C、D 横断面研究 A-7 Yu 2005[21] 中国台湾 470 154 A、B、C 病例对照研究 N-7 Yuen 2004[22] 中国香港 270 90 B、C 病例对照研究 N-6 Li 2010[23] 中国大陆 4 300 203 B、C、D 病例对照研究 N-5 注:A:AHRQ,横断面文献质量评价工具;N:NOS,病例对照文献质量评价工具。 表 2 亚组分析
Table 2. Subgroup analysis
分组 研究数量 样本量 OR(95% CI)值 I2值(%) P值 研究类型 横断面研究 7 6 013 2.18(1.34~3.52) 84 0.002 病例对照研究 9 8 656 3.22(1.78~5.83) 92 < 0.001 地区 中国大陆 8 10 071 3.24(1.76~5.97) 94 < 0.001 其他 8 4 598 2.19(1.34~3.58) 82 0.002 -
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