Despite several recent meta-analyses on the topic, the comparative risk of hepatocellular carcinoma in patients with chronic hepatitis B (CHB) receiving entecavir (ETV) or tenofovir disoproxil fumarate (TDF) remains controversial. The controversy partly results from the arbitrary nature of significance levels leading to contradictory conclusions from very similar datasets. However, the use of observational data, which is prone to both within- and between-study heterogeneity of patient characteristics, also lends additional uncertainty. The asynchronous introduction of ETV and TDF in East Asia, where the majority of these studies have been conducted, further complicates analyses, as does the ensuing difference in follow-up time between ETV and TDF cohorts. Researchers conducting meta-analyses in this area must make many methodological decisions to mitigate bias but are ultimately limited to the methodologies of the included studies. It is therefore important for researchers, as well as the audience of published meta-analyses, to be aware of the quality of observational studies and meta-analyses in terms of patient characteristics, study design and statistical methodologies. In this review, we aim to help clinicians navigate the published meta-analyses on this topic and to provide researchers with recommendations for future work.

尽管最近对该主题进行了几项荟萃分析，但接受恩替卡韦 (ETV) 或富马酸替诺福韦二吡呋酯 (TDF) 的慢性乙型肝炎 (CHB) 患者发生肝细胞癌的比较风险仍存在争议。争议的部分原因是显着性水平的任意性导致来自非常相似的数据集的相互矛盾的结论。然而，观察数据的使用容易出现患者特征的研究内部和研究之间的异质性，也带来了额外的不确定性。ETV 和 TDF 在东亚的异步引入（其中大部分研究已在东亚进行）使分析进一步复杂化，随之而来的 ETV 和 TDF 队列之间的随访时间差异也是如此。在该领域进行荟萃分析的研究人员必须做出许多方法决定以减轻偏见，但最终仅限于纳入研究的方法。因此，研究人员以及已发表荟萃分析的受众了解观察性研究和荟萃分析在患者特征、研究设计和统计方法方面的质量非常重要。在这篇综述中，我们旨在帮助临床医生浏览已发表的关于该主题的荟萃分析，并为研究人员提供未来工作的建议。了解观察性研究和荟萃分析在患者特征、研究设计和统计方法方面的质量。在这篇综述中，我们旨在帮助临床医生浏览已发表的关于该主题的荟萃分析，并为研究人员提供未来工作的建议。了解观察性研究和荟萃分析在患者特征、研究设计和统计方法方面的质量。在这篇综述中，我们旨在帮助临床医生浏览已发表的关于该主题的荟萃分析，并为研究人员提供未来工作的建议。