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直接抗病毒药物改善HCV相关肝细胞癌患者远期预后效果的Meta分析

周荃 杨丽晖 蒋芳清

周荃,杨丽晖,蒋芳清. 直接抗病毒药物改善HCV相关肝细胞癌患者远期预后效果的Meta分析[J]. 临床肝胆病杂志, 2021, 37(8): 1836-1840. DOI: 10.3969/j.issn.1001-5256.2021.08.018
引用本文: 周荃,杨丽晖,蒋芳清. 直接抗病毒药物改善HCV相关肝细胞癌患者远期预后效果的Meta分析[J]. 临床肝胆病杂志, 2021, 37(8): 1836-1840. DOI: 10.3969/j.issn.1001-5256.2021.08.018
ZHOU Q, YANG LH, JIANG FQ. Long-term prognosis of patients with hepatitis C virus-related hepatocellular carcinoma receiving direct-acting antiviral: A Meta-analysis[J]. J Clin Hepatol, 2021, 37(8): 1836-1840. DOI: 10.3969/j.issn.1001-5256.2021.08.018
Citation: ZHOU Q, YANG LH, JIANG FQ. Long-term prognosis of patients with hepatitis C virus-related hepatocellular carcinoma receiving direct-acting antiviral: A Meta-analysis[J]. J Clin Hepatol, 2021, 37(8): 1836-1840. DOI: 10.3969/j.issn.1001-5256.2021.08.018

直接抗病毒药物改善HCV相关肝细胞癌患者远期预后效果的Meta分析

DOI: 10.3969/j.issn.1001-5256.2021.08.018
详细信息
    通讯作者:

    蒋芳清,478772806@qq.com

  • 中图分类号: R512.63;R735.7

Long-term prognosis of patients with hepatitis C virus-related hepatocellular carcinoma receiving direct-acting antiviral: A Meta-analysis

  • 摘要:   目的  系统的评价全口服直接抗病毒药物(DAA)与无DAA(NDAA)方案对于丙型肝炎相关肝细胞癌(HCC)患者在无复发生存率、HCC复发率、全因死亡率、肝脏相关病死率方面的差异。  方法  检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、Pubmed、Embase、Cochrane Library七大数据库于2020年12月之前公开发表的DAA治疗丙型肝炎相关HCC患者的临床队列研究,并进行质量评价与Meta分析。  结果  本研究共纳入10个临床队列研究,共计3108例患者。Meta分析结果显示:与NDAA方案相比,DAA治疗能够显著提高丙型肝炎相关HCC患者的无复发生存率(RR=1.38,95%CI:1.10~1.72,P=0.005),降低HCC复发率(RR=0.52,95%CI:0.42~0.63,P<0.000 01)、全因死亡率(RR=0.42,95%CI:0.32~0.55,P<0.000 01)及肝脏相关病死率(RR=0.37,95%CI:0.18~0.76,P=0.007)。  结论  对于丙型肝炎相关HCC患者使用DAA治疗是有益且安全的。

     

  • 图  1  文献筛选流程图

    图  2  无复发生存率的Meta分析

    图  3  无复发生存率不同年龄的亚组分析

    图  4  HCC复发率的Meta分析

    图  5  全因死亡率的Meta分析

    图  6  肝脏相关病死率的Meta分析

    图  7  无复发生存率漏斗图

    表  1  纳入研究的基本情况

    第一作者 年份 总样本量 例数(E/C) 男/女(例) 种族 国籍 年龄(岁) 随访时间 结局指标 NOS评分
    Warzyszyńska等[11] 2017 51 19/32 33/18 波兰 58.5(36~67) 4年 ①② 8
    Singal等[12] 2019 797 383/414 E: 276/107
    C: 320/94
    非西班牙裔白人 美国、加拿大 E: 62.1(58.6~66.1)
    C: 61.2(57.0~65.0)
    4年 ①②③④ 7
    Cabibbo等[13] 2019 204 102/102 E: 63/39
    C: 65/37
    意大利 E: 71.3±9.5
    C: 71.9±8.8
    3年 ①②③ 6
    Kamp等[14] 2019 368 123/245 E: 99/24
    C: 202/43
    62.8±10.2 11年 5
    Preda等[15] 2019 44 22/22 E: 13/12
    C: 9/10
    64(51~77) 44个月 7
    Dang等[16] 2020 642 321/321 E: 197/124
    C: 194/127
    美国、日本、韩国、中国台湾 E: 66.39±9.09
    C: 65.92±9.13
    5年 ①③④ 6
    Kuo等[17] 2019 240 80/160 E: 51/29
    C: 102/58
    中国台湾 E: 66
    C: 66
    12年 ①② 6
    The ANRS collaborativestudy group[18] 2016 267 189/78 E: 147/42
    C: 57/21
    法国 E: 62±9
    C: 66±10
    3年 5
    Ikeda等[19] 2017 178 89/89 E: 52/37
    C: 52/37
    日本 E: 71(39~85)
    C: 71(45~85)
    2年 7
    Ochi等[20] 2020 317 56/261 E: 31/25
    C: 157/104
    日本 E: 71(56~87)
    C: 75(46~91)
    2年 ①②③ 7
    注:E,试验组,C,对照组;①无复发生存率;②HCC复发率;③全因死亡率;④肝脏相关病死率;—,未提及。
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  • 收稿日期:  2020-12-01
  • 修回日期:  2021-02-03
  • 刊出日期:  2021-08-16
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