背景：有资料显示乙型肝炎病毒（HBV）感染可增加患胰腺癌风险（PAC），但对于两者是否有直接关系仍有争议。另外，至目前为止还不知道HBV感染阶段是否增加PAC感染风险的。因此，我们进行了一项分析，更深入探讨HBV感染与PAC之间的关联。

    方法：我们分析和检索了2012年8月前的PubMed和其他相关数据库，在综合分析汇总相对危险（RR），95％可信区间（CI），采用随机效应和固定效应模型，并采用Cochrane协作网的应用Revman 5.1。

    结果：9个研究，其中包括6病例对照研究和队列研究均符合标准。分析表明，PAC风险与乙肝病毒感染呈正相关，“而从来没有接触到乙肝病毒的人群，RR为1.39（95％CI 1.22-1.59，P <0.00001），慢性乙肝病毒携带者中为1.41（ 95％CI 1.06-1.87，P = 0.02），在HBV感染活跃期为3.83（95％CI 1.76-8.36，P = 0.0007）。使用分层分析，我们也发现，吸烟，饮酒，糖尿病也能增加PAC的风险。

    结论：这一分析结果强烈支持HBV感染与PAC密切相关，即乙型肝炎病毒（HBV）感染可增加患胰腺癌风险（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