Aspirin in Patients with Viral Hepatitis: Systematic Review and Meta-Analysis of Observational Studies.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI:10.1007/s12029-024-01027-5

Wentao Bian, Wenkai Bian, Qingyu Li, Yulian Li

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引用次数: 0

Abstract

Background: Hepatocellular carcinoma (HCC) is a disease demonstrating increasing morbidity and mortality, especially in patients with chronic viral hepatitis. Studies have shown that aspirin can reduce the incidence of liver cancer; however, the degree of benefit in patients with viral hepatitis is unclear. This study focused on the association between aspirin use and HCC risk in patients with chronic viral hepatitis.

Methods: A systematic search of the PubMed, Embase, Web of Science, and Cochrane Library databases was performed from the earliest available date to December 16, 2023. The primary outcome was HCC incidence, and the secondary outcome was gastrointestinal bleeding. The results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). Meta-analyses were performed by using random or fixed-effects models based on the heterogeneity assessed via the I² statistic.

Results: A total of 13 articles (303,414 participants and 14,423 HCC patients) were included in the analysis. The incidence of HCC in aspirin users was lower than that in non-aspirin users (HR 0.75; 95% CI, 0.68-0.83; P < 0.001; I² = 90.0%). Subgroup analysis further showed that this effect may be more obvious in HCV patients, non-cirrhotic patients, patients with statins, and long-term aspirin users, but it may have the risk of gastrointestinal bleeding (HR 1.13; 95% CI, 1.07-1.20; P = 0.906; I² = 0.0%).

Conclusions: Our meta-analysis shows that in patients with chronic viral hepatitis, aspirin use is associated with a significantly reduced risk of liver cancer, but attention should be paid to the possible risk of gastrointestinal bleeding, and this conclusion needs further validation in the future.

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病毒性肝炎患者服用阿司匹林：观察性研究的系统回顾和元分析》。

背景：肝细胞癌（HCC）是一种发病率和死亡率不断上升的疾病，尤其是在慢性病毒性肝炎患者中。研究表明，阿司匹林可降低肝癌的发病率；然而，病毒性肝炎患者的获益程度尚不明确。本研究的重点是慢性病毒性肝炎患者服用阿司匹林与 HCC 风险之间的关系：方法：对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了系统检索，检索时间从最早可用日期起至 2023 年 12 月 16 日。主要结果是HCC发病率，次要结果是消化道出血。研究结果以危险比（HRs）和95%置信区间（CIs）表示。根据通过 I2 统计量评估的异质性，采用随机或固定效应模型进行 Meta 分析：共有13篇文章（303414名参与者和14423名HCC患者）被纳入分析。阿司匹林使用者的HCC发病率低于非阿司匹林使用者（HR 0.75；95% CI，0.68-0.83；P 2 = 90.0%）。亚组分析进一步显示，这种效应在HCV患者、非肝硬化患者、使用他汀类药物的患者和长期服用阿司匹林的患者中可能更明显，但可能有胃肠道出血的风险（HR 1.13；95% CI，1.07-1.20；P = 0.906；I2 = 0.0%）：我们的荟萃分析表明，慢性病毒性肝炎患者服用阿司匹林与肝癌风险的显著降低有关，但应注意可能存在胃肠道出血的风险，这一结论需要在未来进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.