病毒性肝炎与肝外胆管癌发病关系的系统评价

目的 探讨病毒性肝炎与肝外胆管癌发病的相关性。方法 检索Cochrane、Medline、Embase、PubMed、中国知网及万方数据库以获得研究病毒性肝炎与肝外胆管癌发病关系的文献，对符合纳入标准的文献进行质量评价和数据提取后，采用RevMan 5.0统计学软件进行Meta分析。结果 根据纳入标准和排除标准，最终纳入了9篇文献，其中有8篇与乙型肝炎病毒（HBV）相关，有6篇与丙型肝炎病毒（HCV）相关。Meta分析结果显示：HBV感染是肝外胆管癌的危险因素（OR=1.69，95% CI：1.32～2.17，P＜0.000 1）；在美国，HCV感染是肝外胆管癌发病的危险因素（OR=5.53，95% CI：2.21～13.82，P=0.000 3）；在中国，HCV感染不是肝外胆管癌发病的危险因素（OR=0.82，95% CI：0.44～1.52，P=0.520 0）。结论 HBV感染可能是肝外胆管癌的独立致病危险因素。HCV感染可能与美国人群肝外胆管癌的发病有关，而在中国，其与肝外胆管癌的发病无直接关联。

Systematic Evaluation on Relationship Between Viral Hepatitis and Extrahepatic Cholangiocarcinoma

Objective To explore the association between viral hepatitis and extrahepatic cholangiocarcinoma （ECC）. Methods Database of Medline, Embase, PubMed, CNKI, and Wanfang were searched for the articles which were related to the relationship between viral hepatitis and ECC. After the quality evaluation and the data extraction of the literatures, statistical software of RevMan 5.0 was used to perform Meta analysis. Results According to the inclusion criteria and exclusion criteria, 9 articles were enrolled, 8 articles of them were related to hepatitis B virus （HBV） and 6 articles of them were related to hepatitis C virus （HCV）. Meta analysis results showed that the HBV infection may be the risk factor for ECC （OR=1.69, 95% CI：1.32-2.17, P〈0.000 1）. In the United States, HCV infection may be the risk factor for ECC （OR=5.53, 95% CI：2.21-13.82, P=0.000 3）, but the relationship was not found in China （OR=0.82, 95% CI：0.44-1.52, P=0.520 0）. Conclusions The present studies suggest that HBV infection may be a high risk factor for ECC. HCV in the United States can increase the incidence of ECC, but the situation can not be found in China.