关键词: 肝炎, 丙型, 慢性；肝肿瘤；糖尿病；Meta分析

Abstract: Objective  Hepatitis C virus infection can lead to liver fibrosis, liver cirrhosis, and even liver cancer. The influence of diabetes mellitus(DM)  in patients with chronic hepatitis C on the incidence of hepatocarcinoma (HCC) is not clear. The effect of chronic  hepatitis C(CHC) patients with DM on the incidence of HCC was studied. Methods  This study searched CNKI, Wanfang database, CQVIP, Pubmed, Embase and other literature retrieval platform for related studies of the effect of CHC patients with DM on the incidence of HCC.This study included the literature that was in line with  the standards of the cohort study by literature selection, quality assessment; Then, data extraction and statistical analysis were carried out. This study selected the random effects model,with the combined effect amount being relative risk(RR); the sensitivity analysis, heterogeneity and publication bias detection were also conducted. Results  A total of nine cohort studies were selected, including 11 855 CHC patients,  with 1 058 in DM group and  10 797  in nonDM group. The incidences of HCC in group DM and nonDM were of  statistical significance (RR=2.674, 95%CI=1.8003.974, P=0.000), and the heterogeneity was big (P=0.000, I2=86.2%). Subgroup analysis was conducted according to whether the subjects were complicated with cirrhosis. When the subjects were all patients with cirrhosis, the amount of combined effect was of no statistical significance (95%CI=0.6891.580, P=0.842), while the heterogeneity decreased significantly (I2=40.8%, P=0.194); When all the subjects were free from liver cirrhosis, the amount of combined effect was statistically significant (95%CI=2.3416.101, P=0.000),  and  heterogeneity also decreased significantly (I2=42.2%, P=0.188).The results of sensitivity analysis showed that the results were relatively stable, the results of publication bias were within allowed band (Harbord: 95%CI=-1.58282310.18881, P=0.130; 95%CI=-409.0079382.1317, P=0.9391). Conclusion  Among CHC patients with cirrhosis, there is no significant difference in the incidence of HCC in cirrhosis patients with DM; while in  patients with CHC, merging DM can increase the incidence of HCC. DM may affect the incidence of HCC by affecting the process of liver cirrhosis in patients with CHC.

Key words: hepatitis C, chronic, liver neoplasms, diabetes mellitus, Meta analysis