拉米夫定联合TACE治疗HBV相关性中晚期肝癌的Meta分析

目的探讨拉米夫定(LAM)联合经皮肝动脉化疗栓塞术(TACE)治疗慢性乙型肝炎病毒(HBV)相关性中晚期肝癌的效果。方法检索中文数据库万方(Wanfang Data)、维普(VIP)、中国期刊全文数据库(CNKI),英文数据库Pubmed、Embase、Cochrane Library、CBM自建库至2019年11月发表的有关LAM联合TACE治疗HBV相关性中晚期肝癌的临床研究。采用RevMan5.3软件对符合标准的文献进行Meta分析,并使用漏斗图评估发表偏倚。结果本研究共纳入12篇文献,共752例患者,均具有一定的偏倚风险。试验组的1、2年生存率均高于对照组(P<0.05)。治疗后3个月、6个月、1年、2年,试验组的HBV-DNA转阴率均高于对照组(P<0.05)。治疗后及治疗后3个月,试验组的HBV-DNA水平低于对照组(P<0.05)。治疗后1、2年,试验组的Child-Pugh评分低于对照组(P<0.05)。两组的瘤体大小变化、HBV再激活率无显著差异(P>0.05)。结论 LAM联合TACE治疗HBV相关性中晚期肝癌有效率更高,患者生存期更长,预后更好。

Meta analysis of lamivudine combined with TACE in the treatment of HBV related advanced hepatocellular carcinoma

Objective To explore the effect of lamivudine(LAM)combined with transhepatica arterial chemoembolization(TACE)in the treatment of Hepatitis B virus(HBV)related advanced hepatocellular carcinoma.Methods Clinical studies on LAM combined with TACE in the treatment of HBV related advanced hepatocellular carcinoma published from establishment to November 2019 were retrieved in the Chinese databases of Wanfang Data,VIP and CNKI,the English databases of PubMed,Embase,Cochrane Library and CBM.RevMan5.3 software was used to perform a Meta-analysis of the literatures met the criteria and funnel plot was used to assess the publication bias.Results A total of 12 articles and 752 patients were included in this study,all of which had a certain risk of bias.The 1 and 2 year survival rates of the experimental group were higher than those of the control group(P<0.05).At 3 months,6 months,1 year and 2 years after treatment,the negative conversion rates of HBV-DNA in the experimental group were higher than those in the control group(P<0.05).After treatment and 3 months after treatment,the HBV-DNA levels of the experimental group were lower than those of the control group(P<0.05).One and two years after treatment,the Child-Pugh scores of the experimental group were lower than those of the control group(P<0.05).There were no significant differences in tumor size and HBV reactivation rate between the two groups(P>0.05).Conclusion LAM combined with TACE in the treatment of HBV related advanced hepatocellular carcinoma has a higher effective rate,longer survival time and better prognosis.