Precore mutation of hepatitis B virus may contribute to hepatocellular carcinoma risk: evidence from an updated meta-analysis.
BACKGROUND
Studies focused on the correlation of mutations in the genome of Hepatitis B Virus (HBV) like Pre-S mutation, Basal Core promoter (BCP), Enhancer II (EnhII), especially Precore mutation, with the risk of hepatocellular carcinoma (HCC) have triggered stiff controversies. With an increasing number of studies in this field recently, we conducted this meta-analysis to appraise the correlations.


METHODS
We searched the commonly used databases both in English and Chinese till February 1(st), 2012. Meta-analysis was performed in fixed/random-effects models using STATA 10.0. Publication bias was examined through Egger's test and Begg's funnel plot.


RESULTS
In total, 85 case-control studies were included involving 16745 HBV-infected patients, of whom 5781 had HCC. Statistically significant correlations were observed in Precore mutation G1896A (OR = 1.46, 95% confidence interval [CI] = 1.15-1.85, P(OR) = 0.002), G1899A (OR = 3.13, 95%CI = 2.38-4.13, P(OR)<0.001) and Pre-S mutation especially Pre-S1 deletion (OR = 2.94, 95%CI = 2.22 to 3.89) and Pre-S2 deletion (OR = 3.02, 95%CI = 2.03 to 4.50). Similar correlation existed between BCP double mutation A1762T/G1764A, T1753V, C1653T and HCC. In subgroup analysis, the Asians, genotype C or HBeAg positive patients with certain above mutations may be more susceptible to HCC. Besides, the mutations like G1896A and BCP double mutation may be associated with the progression of the liver diseases.


CONCLUSIONS
Precore mutation G1896A, G1899A, deletions in Pre-S region as well as the other commonly seen mutations correlated with the increased risk of HCC, especially in Asians and may predict the progression of the liver disease.
Department of Laboratory Medicine, West China Hospital, Sichuan University, Wuhou District, Chengdu, China.
Yun
Y
Liao
Xin
X
Hu
Jie
J
Chen
Bei
B
Cai
Jiangtao
J
Tang
Binwu
B
Ying
Haiqing
H
Wang
Lanlan
L
Wang
D019943:Amino Acid Substitution / Q000235:genetics; D006528:Carcinoma, Hepatocellular / Q000235:genetics*; D016001:Confidence Intervals; D017353:Gene Deletion; D018740:Genetic Heterogeneity; D020022:Genetic Predisposition to Disease; D016679:Genome, Viral / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D016017:Odds Ratio; D017594:Publication Bias; D012307:Risk Factors