核苷(酸)类似物治疗与乙型肝炎病毒相关肝癌术后生存的meta分析

Effect of Nucleos(t)ide analogues(NAs) therapy on the postoperative survival in patients with hepatitis B virus related hepatocellular carcinoma-a meta analysis

目的 系统性分析核苷(酸)类似物(nucleos(t)ideanalogues, NAs)抗病毒治疗与乙型肝炎病毒(Hepatitis B virus, HBV)相关肝细胞癌(hepatocellular carcinoma, HCC)肝切除术后患者的生存预后。方法 采用计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、CBM、万方、维普数据库,检索时间截至到2021年12月。2位评价员根据纳入标准和排除标准独立筛选文献,提取数据并评价其偏倚风险后,使用Stata16软件进行meta分析。结果 最终纳入25篇文献,包括6项随机对照试验(randomized controlled trial, RCT),20项队列研究,其中一篇是两阶段纵向临床研究,包括了一项RCT和一项队列研究[1]。共计8197人。meta分析结果显示,第1、3、5年接受NAs和肝切除术的HBV-HCC实验组的总生存率(overall survival, OS)和无复发生存率(recurrence free survival, RFS)均优于单纯肝切除对照组。结论 与单纯肝切除术对照组相比,接受NAs和肝切除术的HBV-HCC患者,可获得更好的总生存率和无复发生存率。

Objective To investigate the effect of Nucleos(t)ide analogues(NAs) on postoperative survival and prognosis of patients with hepatitis B virus(HBV) related hepatocellular carcinoma(HCC). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, Wan fang, and Wei pu databases were used for searching, and the deadline was December 2021. Two reviewers screened the literatures independently according to the inclusion and exclusion criteria, then extracted and assessed the data. The meta-analysis was conducted through Stata16. Results A total of 25 studies including 6 randomized controlled trial(RCT) studies and 20 cohort studies were included. Among them, there was a two-stage longitudinal clinical study, which including both a RCT and a cohort study. Our meta-analysis showed that the overall survival(OS) and recurrence free survival(RFS) of the patients in the experimental treated by NAs and hepatic resection, were superior to the patients in control group treated by hepatic resection at the 1st, 3rd, 5th year. Conclusion Compared with the control group, the patients with HBV-HCC who were treated by NAs and hepatic resection could achieve a better OS and RFS.