中国人群HBV感染与原发性肝癌关系病例对照研究的Meta分析

目的探讨中国人群乙型肝炎病毒(HBV)感染状态与原发性肝癌的关联程度，为预防决策提供依据。方法采用Meta分析法，对51篇关于HBV感染与原发性肝癌关系的病例对照研究进行定量综合分析。结果HBV感染与原发性肝癌呈高度关联(OR=11．34)，其中HBsAg、Anti．HBc-IgM与原发性肝癌的关联程度最高(OR分别为13．15和12．37)，其次为Anti—HBc(OR=8．50)，HBeAg与原发性肝癌的关联程度高于Anti—HBe(OR=4．36 vs 2．49)，Anti—HBs与原发性肝癌关系的合并OR值小于1(OR=0．24)。结论HBV感染是原发性肝癌的危险因素，HBV现正感染、病毒复制活跃者发生原发性肝癌的危险性较大。慢性HBV感染者出现Anti-HBc—IgM阳性要警惕原发性肝癌的发生，Anti-HBs是降低原发性肝癌发生风险的保护性因素。

Meta-analysis of Relationship between Infectious Status of Hepatitis B Virus and Primary Liver Carcinoma in Chinese Population

Objective To evaluate the relationship between infectious status of hepatitis B virus (HBV) and primary liver carcinoma in Chinese population and provide basis for setting the preventive measurements. Methods Fifty-one case-control studies on the relationship between hepatitis B virus (HBV) and primary liver carcinoma were included according to the standards for inclusion and exclusion. The included studies were analyzed synthetically by Meta-analysis. Results HBV was highly related with primary liver carcinoma (OR= 11.34). The relationship between HBsAg level and primary liver carcinoma was very strong (OR=13.15), so were Anti-HBc-IgM (OR=12.37) and Anti-HBc (OR=8.50). The correlation between HBeAg level and primary liver carcinoma was stronger than that of Anti-HBe level (OR=4.36 vs 2.49). The combined OR of relationship between Anti-HBs level and primary liver carcinoma was less than 1 (OR=0.24). Conclusions HBV infection was a risk factor of primary liver carcinoma. Patient with current infection and active replication of HBV could have high risk of primary liver carcinoma. More attention should be paid to the development of primary liver carcinoma once diagnosed as positive for Anti-HBc-IgM of patients with chronic HBV infection. Anti-HB antibodies demonstrated a protective effect against primary liver carcinoma.