摘要
Abstract
Objective To systematically evaluate the value of high-sensitivity hepatitis B virus DNA(HBV DNA)in the diagnosis and prognosis of hepatocellular carcinoma(HCC),providing evidence-based references for the clinical di-agnosis and treatment of HCC.Methods We systematically searched English databases(PubMed,Embase,and the Co-chrane Library)and Chinese databases(CNKI and Wanfang)for literature on the association between high-sensitivity HBV DNA and the diagnosis and prognosis of HCC patients,from database inception until November 1,2024.Two inde-pendent researchers screened the literature,extracted data,and assessed the quality of the included studies using the Qual-ity Assessment of Diagnostic Accuracy Studies(QUADAS)tool.We performed Meta-analysis using RevMan 5.4 software and evaluated publication bias using funnel plots and Egger's test in Stata 18.0.Results A total of 15 articles were final-ly included.The subjects of all the included studies were HCC patients.All studies mentioned randomization,and none reported blinding procedures.In our Meta-analysis of high-sensitivity HBV DNA for HCC diagnosis,we found a pooled sensitivity of 0.17(95%CI:0.11 to 0.23;Z=5.63,P<0.05)and a pooled specificity of 0.73(95%CI:0.59 to 0.86;Z=10.72,P<0.05).The analysis also showed a pooled positive predictive value of 0.83(95%CI:0.76 to 0.90;Z=23.07,P<0.05)and a pooled negative predictive value of 0.71(95%CI:0.62 to 0.81;Z=14.80,P<0.05).Our sensi-tivity analysis revealed that,after eliminating each individual study one by one,these effect estimates remained stable in direction with only minor numerical variations.For the prognostic value of high-sensitivity HBV DNA in predicting HCC re-currence,we calculated a pooled odds ratio of 1.67(95%CI:0.77 to 3.64;Z=1.30,P>0.05).After excluding stud-ies,we observed no substantial changes in the overall effect size.In assessing publication bias,the funnel plot was largely symmetrical.Using Begg's test,we detected no significant bias(all P>0.05).Conclusion High-sensitivity HBV DNA testing demonstrates significant value in the early screening and clinical diagnosis of HCC,but its application value in prog-nosis assessment,especially in predicting recurrence,is relatively low.关键词
高灵敏度乙型肝炎病毒/脱氧核糖核酸/原发性肝细胞癌/诊断/预后/系统评价/Meta分析Key words
high-sensitivity hepatitis B virus/DNA/hepatocellular carcinoma/diagnosis/prognosis/systematic review/Meta-analysis分类
医药卫生
