HBV感染与放射性肝损害关系的Meta分析

Meta-analysis on Association Between Hepatitis B Virus Infection and Radiation-induced Liver Disease

目的通过Meta分析系统性评价原发性肝癌放射治疗中,HBV感染及肝功能分级与放射性肝损害相关性(radiation-induced liver disease,RILD)。方法检索国内外相关数据库,依据标准收集所有相关的临床研究,应用RevMan4.2软件对符合条件的所有研究结果进行汇总Meta分析。结果符合标准的文献共5篇,其中416例HBV阳性中63例出现RILD,200例HBV阴性中17例有RILD,差异无统计学意义,HBV感染与RILD发生无相关性[OR=1.86,95%CI(0.49,7.04),P=0.36]。肝功能Child-Pugh A观察例数541例中有45例出现RILD,而Child-Pugh B观察例数74例中30例出现RILD,差异明显[OR=0.16,95%CI(0.05,0.49),P=0.02]。结论 HBV感染并非RILD发生重要因素,而基础肝功能状态,Child-Pugh肝功能分级与RILD密切相关,是影响RILD发生主要因素。

Objective To evaluate the correlation between hepatitis B virus infection and liver function classification with radiation-induced liver disease（RILD） for primary hepatocellular carcinoma patients undergoing three-dimensional conformal radiotherapy.Methods English and Chinese literatures were searched,the relevant clinical studies were collected,and meta-analysis was performed with the software RevMan Manager 4.2.Results According to the results of meta-analysis,totally 5 trials were recruited in the study.Among 416 HBV-positive cases,RILD occurred in 63 cases;among 200 HBV-negative cases,RILD occurred in 17 cases;and the difference was not statistically significant.Hepatitis B virus infection was not correlated with the occurrence of RILD（OR=1.86,95%CI： 0.49～7.04,P=0.36）.Among 541 cases with liver function of Child-Pugh A grade,RILD occurred in 45 cases;among 74 cases with liver function of Child-Pugh B grade,RILD occurred in 30 cases;and the difference was statistically significant（OR=0.16,95%CI： 0.05～0.49,P=0.02）.Conclusions There is no significant relationship between HBV infection and RILD,but baseline liver function,Child-Pugh classification,is closely related to RILD in primary hepatocellular carcinoma patients after radiotherapy.