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目的探讨病毒性肝炎与肝外胆管癌发病的相关性。方法检索Cochrane、Medline、Embase、PubMed、中国知网及万方数据库以获得研究病毒性肝炎与肝外胆管癌发病关系的文献,对符合纳入标准的文献进行质量评价和数据提取后,采用RevMan 5.0统计学软件进行Meta分析。结果根据纳入标准和排除标准,最终纳入了9篇文献,其中有8篇与乙型肝炎病毒(HBV)相关,有6篇与丙型肝炎病毒(HCV)相关。Meta分析结果显示:HBV感染是肝外胆管癌的危险因素(OR=1.69,95%CI:1.32~2.17,P<0.000 1);在美国,HCV感染是肝外胆管癌发病的危险因素(OR=5.53,95%CI:2.21~13.82,P=0.000 3);在中国,HCV感染不是肝外胆管癌发病的危险因素(OR=0.82,95%CI:0.44~1.52,P=0.520 0)。结论 HBV感染可能是肝外胆管癌的独立致病危险因素。HCV感染可能与美国人群肝外胆管癌的发病有关,而在中国,其与肝外胆管癌的发病无直接关联。
Objective To investigate the relationship between viral hepatitis and extrahepatic bile duct cancer. Methods Cochrane, Medline, Embase, PubMed, CNKI and Wanfang database were searched for the literature to study the relationship between viral hepatitis and the pathogenesis of extrahepatic cholangiocarcinoma. After the quality evaluation and data extraction of the accords with inclusion criteria were carried out, Statistical software Meta analysis. Results Based on inclusion criteria and exclusion criteria, nine articles were finally included, of which eight were related to Hepatitis B virus (HBV) and 6 were related to Hepatitis C virus (HCV). Meta-analysis showed that HBV infection was a risk factor for extrahepatic cholangiocarcinoma (OR = 1.69, 95% CI: 1.32-2.17, P <0.0001). In the United States, HCV infection was a risk factor for extrahepatic cholangiocarcinoma = 5.53, 95% CI: 2.21-13.82, P = 0.0003). In China, HCV infection was not a risk factor for the development of extrahepatic cholangiocarcinoma (OR = 0.82, 95% CI: 0.44-1.52, P = 0.520 0). Conclusion HBV infection may be an independent risk factor for extrahepatic cholangiocarcinoma. HCV infection may be associated with the onset of extrahepatic cholangiocarcinoma in the United States, whereas in China, it is not directly associated with the occurrence of extrahepatic cholangiocarcinoma.