Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis,Clinical Gastroenterology and Hepatology

当前位置： X-MOL 学术 › Clin. Gastroenterol. Hepatol. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Hepatocellular Carcinoma Incidence in Alcohol-Associated Cirrhosis: Systematic Review and Meta-analysis
Clinical Gastroenterology and Hepatology ( IF 11.6 ) Pub Date : 2022-08-05 , DOI: 10.1016/j.cgh.2022.06.032
Daniel Q Huang ₁ , Darren J H Tan ₂ , Cheng Han Ng ₂ , Maral Amangurbanova ₃ , Nancy Sutter ₃ , Phoebe Wen Lin Tay ₂ , Wen Hui Lim ₂ , Jie Ning Yong ₂ , Ansel Tang ₂ , Nicholas Syn ₂ , Mark D Muthiah ₄ , Eunice X X Tan ₄ , Shravan Dave ₃ , Benjamin Tay ₅ , Abdul M Majzoub ₆ , Danielle Gerberi ₇ , Beom Kyung Kim ₈ , Rohit Loomba ₃

Affiliation

NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
Division of Internal Medicine, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania.
Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota.
NAFLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Yonsei Liver Center, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.

Background & Aims

Alcohol is one of the leading causes of hepatocellular carcinoma (HCC). However, pooled estimates of HCC incidence in alcohol-associated cirrhosis have not been evaluated systematically. We performed a pooled analysis of time-to-event data to provide robust estimates for the incidence of HCC in alcohol-associated cirrhosis.

MethodS

Medline, Embase, Cochrane Central Register, Scopus, and Web of Science were searched from inception to August 2021. Individual patient data were reconstructed from published Kaplan–Meier curves, and a pooled analysis of cumulative HCC incidence was performed using a random-effects model.

Results

We screened 5022 articles and included 18 studies (148,333 patients). In the pooled analysis, the cumulative incidence of HCC in alcohol-associated cirrhosis at 1, 5, and 10 years among studies that accounted for the competing risk of death without HCC was 1%, 3%, and 9%, respectively. A secondary analysis by traditional meta-analysis determined that the HCC incidence rate was higher in cohorts enrolled in a HCC surveillance program (18.6 vs 4.8 per 1000 person-years; P = .001) vs those who were not enrolled in a surveillance program. Meta-regression showed that diabetes, smoking, variceal bleeding, and hepatic decompensation were associated with a higher risk of HCC.

ConclusionS

Our analysis determined that the 5- and 10- year cumulative risk of HCC in alcohol-associated cirrhosis was 3% and 9%, respectively, with a higher incidence in cohorts that were enrolled in a HCC surveillance program. These data should be validated further in large prospective studies, and may have important implications for HCC screening and surveillance among patients with alcohol-associated cirrhosis.

中文翻译：

酒精相关性肝硬化中的肝细胞癌发病率：系统评价和荟萃分析

背景与目标

酒精是导致肝细胞癌 (HCC) 的主要原因之一。然而，酒精相关性肝硬化中 HCC 发病率的汇总估计尚未得到系统评估。我们对事件发生时间数据进行了汇总分析，为酒精相关性肝硬化中 HCC 的发病率提供可靠的估计。

方法

从开始到 2021 年 8 月，对 Medline、Embase、Cochrane Central Register、Scopus 和 Web of Science 进行了检索。根据已发表的 Kaplan-Meier 曲线重建了个体患者数据，并使用随机效应模型对累积 HCC 发病率进行了汇总分析。

结果

我们筛选了 5022 篇文章，纳入 18 项研究（148,333 名患者）。在汇总分析中，在考虑非 HCC 死亡竞争风险的研究中，酒精相关性肝硬化中 HCC 的累积发病率在 1 年、5 年和 10 年分别为 1%、3% 和 9%。传统荟萃分析的二次分析确定，与未参加监测计划的人群相比，参加 HCC 监测计划的队列的 HCC 发病率较高（每 1000 人年 18.6 例 vs 4.8 例； P = .001）。荟萃回归显示，糖尿病、吸烟、静脉曲张出血和肝功能失代偿与 HCC 风险较高相关。