title: Hepatitis B virus and hepatitis C virus play different prognostic roles in intrahepatic cholangiocarcinoma: A meta-analysis.
abstract: OBJECTIVE
  To identify the prognostic value of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in patients with intrahepatic cholangiocarcinoma.
  
  
  METHODS
  A search was performed for relevant publications in PubMed, EMBASE and Web of Science databases. The pooled effects were calculated from the available information to identify the relationship between HBV or HCV infection and the prognosis and clinicopathological features. The χ(2) and I (2) tests were used to evaluate heterogeneity between studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated by a fixed-effects model, if no heterogeneity existed. If there was heterogeneity, a random-effects model was applied.
  
  
  RESULTS
  In total, 14 studies involving 2842 cases were enrolled in this meta-analysis. The patients with HBV infection presented better overall and disease-free survival, and the pooled HRs were significant at 0.76 (95%CI: 0.70-0.83) and 0.78 (95%CI: 0.66-0.94), respectively. Additionally, our study revealed that HCV infection was correlated with shortened overall survival in comparison with the control group (HR = 2.64, 95%CI: 1.77-3.93). We also found that HBV infection occurred more frequently in male patients [odds ratio (OR) = 1.91, 95%CI: 1.06-3.44] and was correlated with higher levels of serum aspartate transaminase (AST) and alpha-fetoprotein (AFP) (OR = 1.93, 95%CI: 1.11-3.35; OR = 3.86, 95%CI: 2.58-5.78) and a lower level of serum carbohydrate antigen 19-9 (CA19-9) (OR = 0.47, 95%CI: 0.34-0.65). Moreover, HBV infection was associated with cirrhosis (OR = 6.44, 95%CI: 4.33-9.56), a higher proportion of capsule formation (OR = 6.04, 95%CI: 3.56-10.26), and a lower rate of lymph node metastasis (OR = 0.39, 95%CI: 0.25-0.58). No significant publication bias was seen in any of the enrolled studies.
  
  
  CONCLUSIONS
  HBV infection may indicate a favorable prognosis in patients with intrahepatic cholangiocarcinoma, while HCV infection suggests a poor prognosis.
authors.affiliation: Zheng Wang, Qiong-Zhu Dong, Lun-Xiu Qin, Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Zheng Wang, Qiong-Zhu Dong, Lun-Xiu Qin, Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Sheng
authors.affiliation: Zheng Wang, Qiong-Zhu Dong, Lun-Xiu Qin, Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Qiong-Zhu
authors.initials: QZ
authors.lastname: Dong
authors.affiliation: Zheng Wang, Qiong-Zhu Dong, Lun-Xiu Qin, Department of Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Lun-Xiu
authors.initials: LX
authors.lastname: Qin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000472:pathogenicity*; D006509:Hepatitis B / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D065840:Protective Factors; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Clinical features; Hepatitis B virus; Hepatitis C virus; Intrahepatic cholangiocarcinoma; Prognosis