Effects of hepatitis B e-antigen on recurrence of hepatitis B-related hepatocellular carcinoma after curative resection: A meta-analysis.

AIM   The impact of hepatitis B e-antigen (HBeAg) on recurrence of hepatocellular carcinoma (HCC) after curative resection remains controversial. This meta-analysis aimed to determine whether the presence of HBeAg influenced the recurrence of HCC after curative resection. METHODS   We performed a meta-analysis including six studies (a total of 865 patients) to assess the effect of HBeAg on recurrence of HCC after curative resection. The pooled odds ratios (OR) were calculated using a random or fixed effects model. PUBMED, MEDLINE, EMBASE and the Cochrane Database were searched for articles published from 1990 to March 2012. Sensitivity analysis and publication bias estimate were also performed to evaluate the potential risk bias in the overall results of pooled analysis. RESULTS   Our results showed that the presence of HBeAg significantly increased the overall HCC recurrence risk after curative resection (OR = 1.63, 95% confidence interval (CI) = 1.11-2.40; P = 0.01). Pooled data from three studies on the risk of early recurrence among HBeAg positive patients compared with HBeAg negative patients showed an increased risk of early recurrence (OR = 1.50, 95% CI = 1.02-2.19; P = 0.04). However, there was no significant difference in late HCC recurrence between HBeAg positive and negative patients (OR = 1.17, 95% CI = 0.62-2.19; P = 0.62). CONCLUSION   The present study suggested that HBeAg positive patients had a significantly higher risk of early recurrence after curative resection of HCC.