Meta Analysis Of Helicobacter Pylori For Primary Liver Cancer

ObjectiveTo evaluate the association between H.pylori infection(H pylori)and primary liver cancer(HCC)using meta-analysis,further clarify whether H pylori is a contributing factor for HCC,and provide a reference for clinical HCC prevention and treatment.MethodFrom January 2000 to now,it has been published in CNKI,Wanfang,VIP,Pub Med Cochrane.Library To collect case-control studies on the relationship between H pylori and primary liver cancer.The age,sex and race of the patients were not limited.The experimental group met the diagnostic criteria of primary liver cancer,while the control group was normal or other non liver cancer patients.H pylori was detected in liver tissue after exposure.PCR,immunohistochemistry,special staining and other effective methods were used to detect H pylori.The positive rate of Cag A detected by PCR was calculated.In addition,case-control studies on serum Cag A HP Ig G antibody and primary liver cancer were collected for meta-analysis.Two researchers used Newcastle Ottawa scale to evaluate the quality of the literature,extracted data,and used Revman 5.4.1 software for meta-analysis.Result(1)This meta-analysis included 23 articles,including 1354 cases in case group and control group.The infection rate of H pylori was 52.2%(386 / 740)in patients with primary liver cancer.The infection rate of H pylori was 3.75%(23 / 614)in normal control group,liver cirrhosis,hepatitis and other benign liver tumors.The OR value of combined effect was 21.08,95% CI(13.83,32.15).The detection rate of H pylori in liver cancer tissue was significantly higher than that in the control group(P < 0.01).The difference was statistically significant,indicating that there was a significant correlation between H pylori and primary liver cancer.Subgroup analysis showed that they were divided into foreign literature group and domestic literature group.The results of foreign literature group showed that there was no heterogeneity in the control group: I2 = 39%,z = 7.82,OR = 11.11,95%CI(6.08,20.32),P <0.01.The domestic literature group suggested that there was no heterogeneity in the control group: I2 = 0%,Z=11.23,OR = 30.67,95%CI(16.88,55.74),the results were statistically significant,H pylori was associated with liver cancer.Subgroup analysis suggested geographically distinct effects and did not appreciably affect the results.Five of the above literatures had additional cag A gene amplification by PCR.The total number of samples was 204 and the positive rate was 17.2%.(2)In the meta-analysis of the relationship between H pylori Cag A + and liver cancer,5 articles were included,including 960 cases in case group and control group.The infection rate of H pylori was 68.6%(153 / 223)in patients with primary liver cancer,and 27.7%(204 / 737)in controls with normal and other liver tissues.The OR value of combined effect was 4.77,95% CI(1.17,15.28).The detection rate of H pylori in liver cancer tissue was significantly higher than that in the control group(P < 0.01).The difference was statistically significant,indicating that there was a significant correlation between H pylori Cag A + and primary liver cancer.Conclusion:(1)there is a correlation between Helicobacter Pylori infection and primary liver cancer.(2)CAGA + is related to primary liver cancer,but there is high heterogeneity in the inclusion experiment.The relationship between CAGA +and primary liver cancer needs to be further confirmed.