HBV感染与结直肠癌肝转移关系的Meta分析

Relationship between hepatitis B virus infection and hepatic metastasis from colorectal cancer: a Meta analysis

  • 摘要:

    目的 初步探讨HBV感染与结直肠癌肝转移的关系。方法 检索19901月至2011 12PubMedCochrane图书馆、万方数据库、CNKI数据库收录的已发表文献,并辅以文献追溯、手工检索等方法收集相关杂志及会议论文中未发表的文献。采用表格提取文献资料,将样本中结直肠癌患者按照是否感染HBV分为感染组和对照组(未感染HBV患者),并对肝转移发生率进行分析。应用Review Manager 5.0 软件进行Meta分析。采用I2检测各研究的异质性,I2>50% 提示纳入的研究之间异质性强,则采用随机效应模型;反之使用固定效应模型。以效应量标准误的倒数为纵坐标,以效应量的对数为横坐标绘制散点图,评估潜在的发表偏倚。计数资料采用优势比(OR)以及95%可信区间(95%CI)表示。 结果 检索到相关文献共56篇,其中符合纳入标准的中文文献11篇,结直肠癌患者共计5622例,其中感染组患者924例,对照组患者4698例,各文献研究结果的异质性检验差异无统计学意义( I2=0df=10P>0.05);采用固定效应模型进行合并,并进一步分析结果表明:感染组结直肠癌患者肝转移发生率为10.61%(98/924),对照组为23.84%(1120/4698),两组肝转移发生率比较,差异有统计学意义(合并 OR=0.35P< 0.05)。散点图显示文献不存在明显发表偏倚。 结论 感染HBV的结肠癌患者具有较低肝转移发生率。

     

    Abstract:

    Objective To investigate the relationship between hepatitis B virus (HBV) infection and hepatic metastasis from colorectal cancer. Methods Published literatures and unpublished conference papers from January 1990 to December 2011 were searched in PubMed, Cochrane library, Wanfang Database and CNKI. Data of the literatures were extracted by a table. All the patients with colorectal cancer were divided into the infected group and the control group according to the patients whether infected by HBV or not. The hepatic metastatic rate was analyzed. The Meta analysis was carried out by using the Review Manager 5.0 software, and the heterogeneity between studies was analyzed using the I2. Random effect regression model or fixed effects regression model was used according to the P value. The funnel plot was drawn to assess the potential for publication bias. The count data were presented by odds ratio (OR) and 95% confidence intervals (95% CI). Results Fiftysix articles were retrieved, and 11 of which met the criteria. The number of patients with colorectal cancer was 5622, and 924 were in the infected group, 4698 in the control group. There was no statistical difference in the heterogeneity between all the articles (I2=0, df=10, P>0.05). The hepatic metastatic rate was 10.61% (98/924) in the infected group, which was significantly lower than 23.84% (1120/4698) of the control group (OR=0.35, P<0.05). The funnel plot showed that there was no obvious publication bias in these studies. Conclusion Patients with colorectal cancer and infected by HBV have lower incidence of hepatic metastasis.

     

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