HBV BCP/PC突变对发生肝癌危险的系统评价

Systematic evaluation of HBV BCP/PC mutations on the risk of hepatocarcinogenesis

目的:系统评价BCP-A1762T/G1764A以及PC-G1896A基因突变对肝癌的发生的影响。方法:计算机检索PubMed、SCI、CNKI、VIP和WanFang Data数据库,收集突变在HBV感染相关疾病进程中作用的文献,检索时限均为建库至2021年7月1日。两位研究员独立筛选文章,提取资料,评价研究质量。采用Review Manager软件版本5.4用于Meta分析。结果:共纳入40篇文章,总共病例数为12423例,肝癌数为3710例。Meta分析结果显示,BCP-A1762T/G1764A基因突变与HBV感染的疾病进程相关,促进肝癌的发生。BCP/PC基因突变在HBV感染进程中具有重大意义,在BCP-A1762T/G1764A中HCC vs non-HCC[OR=4.05,95%CI=2.64~6.22]、CHBC[OR=3.90,95%CI=2.13~7.17]、CHB[OR=2.77,95%CI=1.78~4.32]、LC[OR=1.64,95%CI=0.95~2.84],具有统计学意义;在PC-G1896A突变中HCCvs non-HCC[OR=1.49,95%CI=1.02~2.17]、CHBC[OR=1.56,95%CI=0.89~2.72]、CHB[OR=1.80,95%CI=1.17~2.77]有统计学意义,而在与比较HCC与LC时,差异没有统计意义(P=0.4)。BCP-A1762T/G1764A突变在B基因型与C基因型[OR=0.36,95%CI=0.20~0.64],差异有统计学意义,在PC-G1896A突变时差异没有统计学意义。C基因中BCP-A1762T/G1764A突变在HCC与non-HCC[OR=3.71,95%CI=1.82~7.61],PC-G1896A突变在HCC与non-HCC[OR=2.81,95%CI=1.34~5.91],差异有显著统计学意义。结论:当前证据显示,BCP-A1762T/G1764A以及PC-G1896A基因突变与肝癌发生危险的增加具有重要效应,且与基因型相关。但由于受纳入研究数量及质量的限制,上述结论尚需更多高质量研究予以验证。

Objective:To evaluate of the effects of mutations in BCP-A1762T/G1764A and PC-G1896A genes on hepatocarcinogenesis.Methods:Computer searches for PubMed,SCI,CNKI,VIP and WanFang Data databases were conducted to collect literature on the role of mutations in the disease process associated with HBV infection from database creation to July 1,2021.Two researchers independently screened the articles,extracted information and evaluated the quality of the studies.Review Manager software version 5.4 was used for Meta-analysis.Results:A total of 40 articles were included,with a total of 12423 cases and 3710 cases of hepatocellular carcinoma.Meta-analysis showed that mutations in BCP-A1762T/G1764A gene were associated with the disease process of HBV infection and promoted hepatocellular carcinogenesis.mutations in BCP/PC gene were significant in the process of HBV infection in BCP-A1762T/G1764A in HCC vs non-HCC[OR=4.05,95%CI=2.64~6.22],CHBC[OR=3.90,95%CI=2.13~7.17],CHB[OR=2.77,95%CI=1.78~4.32],LC[OR=1.64,95%CI=0.95~2.84],which were statistically significant;in PC-G1896A mutation HCC vs non-HCC[OR=1.49,95%CI=1.02~2.17],CHBC[OR=1.56,95%CI=0.89~2.72],CHB[OR=1.80,95%CI=1.17~2.77]were statistically significant,while the difference was not statistically significant when comparing HCC with LC(P=0.4).The BCP-A1762T/G1764A mutation in the B genotypes/genotyped versus the C genotype[OR=0.36,95%CI=0.20~0.64],with a statistically significant difference,and no statistically significant difference in the PC-G1896A mutation.BCP-A1762T/G1764A mutation in the C gene in HCC versus non-HCC[OR=3.71,95%CI=1.82~7.61]and PC-G1896A mutation in HCC vs non-HCC[OR=2.81,95%CI=1.34~5.91],the differences were statistically significant.Conclusions:Current evidence suggests that mutations in the BCP-A1762T/G1764A and PC-G1896A genes have a significant effect on the increased risk of hepatocellular carcinoma and are genotype dependent.However,due to the limitation of the number and quality of included studies,these findings need to be validated by more high-quality studies.