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    背景：有資料顯示乙型肝炎病毒（HBV）感染可增加患胰腺癌風(fēng)險(xiǎn)（PAC），但對(duì)于兩者是否有直接關(guān)系仍有爭(zhēng)議。另外，至目前為止還不知道HBV感染階段是否增加PAC感染風(fēng)險(xiǎn)的。因此，我們進(jìn)行了一項(xiàng)分析，更深入探討HBV感染與PAC之間的關(guān)聯(lián)。

    方法：我們分析和檢索了2012年8月前的PubMed和其他相關(guān)數(shù)據(jù)庫(kù)，在綜合分析匯總相對(duì)危險(xiǎn)（RR），95％可信區(qū)間（CI），采用隨機(jī)效應(yīng)和固定效應(yīng)模型，并采用Cochrane協(xié)作網(wǎng)的應(yīng)用Revman 5.1。

    結(jié)果：9個(gè)研究，其中包括6病例對(duì)照研究和隊(duì)列研究均符合標(biāo)準(zhǔn)。分析表明，PAC風(fēng)險(xiǎn)與乙肝病毒感染呈正相關(guān)，“而從來沒有接觸到乙肝病毒的人群，RR為1.39（95％CI 1.22-1.59，P <0.00001），慢性乙肝病毒攜帶者中為1.41（ 95％CI 1.06-1.87，P = 0.02），在HBV感染活躍期為3.83（95％CI 1.76-8.36，P = 0.0007）。使用分層分析，我們也發(fā)現(xiàn)，吸煙，飲酒，糖尿病也能增加PAC的風(fēng)險(xiǎn)。

    結(jié)論：這一分析結(jié)果強(qiáng)烈支持HBV感染與PAC密切相關(guān)，即乙型肝炎病毒（HBV）感染可增加患胰腺癌風(fēng)險(xiǎn)（PAC）。

   BACKGROUND:Hepatitis B virus (HBV) infection is reported to be associated with an increased risk of pancreatic cancer (PaC), but it remains controversial whether this is a causal relationship. In addition, it is unclear whether the status of HBV infection also affects PaC risk. Therefore, we conducted a meta-analysis to more closely examine the association between HBV infection and PaC.

    METHOD:The studies included in the meta-analysis were identified and retrieved from PubMed and several other databases. The literature search was conducted up until August 2012. We adopted the Cochrane Collaboration's RevMan 5.1 in a combined analysis of pooled relative risk (RR) with their corresponding 95 % confidence intervals (CIs) using a random-effects and a fixed-effects model.

    RESULTS:Nine studies including 6 case-control and 3 cohort studies met eligibility criteria. The meta-analysis showed that the PaC risk was positively correlated with HBV infection when comparing with 'never exposed to HBV' subgroup, the pooled RR was 1.39 (95 % CI 1.22-1.59, p < 0.00001) in chronic HBV carriers, 1.41 (95 % CI 1.06-1.87, p = 0.02) in past exposure to HBV, and 3.83 (95 % CI 1.76-8.36, p = 0.0007) in active HBV infection. Using a stratified analysis, we also found that the risk of PaC was independent of smoking, alcohol drinking, and diabetes.

    CONCLUSION:Findings from this meta-analysis strongly support that HBV infection is associated with an increased risk of PaC.

    查看原文：http://www.ncbi.nlm.nih.gov/pubmed/23306552