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背景:有資料顯示乙型肝炎病毒(HBV)感染可增加患胰腺癌風(fēng)險(PAC),但對于兩者是否有直接關(guān)系仍有爭議。另外,至目前為止還不知道HBV感染階段是否增加PAC感染風(fēng)險的。因此,我們進行了一項分析,更深入探討HBV感染與PAC之間的關(guān)聯(lián)。
方法:我們分析和檢索了2012年8月前的PubMed和其他相關(guān)數(shù)據(jù)庫,在綜合分析匯總相對危險(RR),95%可信區(qū)間(CI),采用隨機效應(yīng)和固定效應(yīng)模型,并采用Cochrane協(xié)作網(wǎng)的應(yīng)用Revman 5.1。
結(jié)果:9個研究,其中包括6病例對照研究和隊列研究均符合標(biāo)準(zhǔn)。分析表明,PAC風(fēng)險與乙肝病毒感染呈正相關(guān),“而從來沒有接觸到乙肝病毒的人群,RR為1.39(95%CI 1.22-1.59,P <0.00001),慢性乙肝病毒攜帶者中為1.41( 95%CI 1.06-1.87,P = 0.02),在HBV感染活躍期為3.83(95%CI 1.76-8.36,P = 0.0007)。使用分層分析,我們也發(fā)現(xiàn),吸煙,飲酒,糖尿病也能增加PAC的風(fēng)險。
結(jié)論:這一分析結(jié)果強烈支持HBV感染與PAC密切相關(guān),即乙型肝炎病毒(HBV)感染可增加患胰腺癌風(fēng)險(PAC)。
BACKGROUND:Hepatitis B virus (HBV) infection is reported to be associated with an increased risk of pancreatic cancer (PaC), but it remains controversial whether this is a causal relationship. In addition, it is unclear whether the status of HBV infection also affects PaC risk. Therefore, we conducted a meta-analysis to more closely examine the association between HBV infection and PaC.
METHOD:The studies included in the meta-analysis were identified and retrieved from PubMed and several other databases. The literature search was conducted up until August 2012. We adopted the Cochrane Collaboration's RevMan 5.1 in a combined analysis of pooled relative risk (RR) with their corresponding 95 % confidence intervals (CIs) using a random-effects and a fixed-effects model.
RESULTS:Nine studies including 6 case-control and 3 cohort studies met eligibility criteria. The meta-analysis showed that the PaC risk was positively correlated with HBV infection when comparing with 'never exposed to HBV' subgroup, the pooled RR was 1.39 (95 % CI 1.22-1.59, p < 0.00001) in chronic HBV carriers, 1.41 (95 % CI 1.06-1.87, p = 0.02) in past exposure to HBV, and 3.83 (95 % CI 1.76-8.36, p = 0.0007) in active HBV infection. Using a stratified analysis, we also found that the risk of PaC was independent of smoking, alcohol drinking, and diabetes.
CONCLUSION:Findings from this meta-analysis strongly support that HBV infection is associated with an increased risk of PaC.
查看原文:http://www.ncbi.nlm.nih.gov/pubmed/23306552
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