Association between the presence of H pylori in the liver and hepatocellular carcinoma: a meta-analysis.

Aim: To evaluate the arguments for and against the possible roles of H pylori in hepatocellular carcinoma (HCC).

Methods: We performed a systematic review of all relevant studies published in the literature. A total of 103 clinical trials and reports were identified, but only 10 trials qualified under our selection criteria. A meta-analysis was carried out by a biostatistician according to the Cochrane Reviewers' Handbook recommended by The Cochrane Collaboration.

Results: Nine case-control studies and one retrospective cross sectional study were included in the final analysis. Overall the prevalence of H pylori infection was 53.3% (129 of 242) in cases and 10.4% (29 of 280) in controls, and the summary odds ratio for the association of H pylori infection with the risk for HCC (using the fixed-effects model, which accounted for the homogeneity across the 10 studies) was determined to be 13.63 (95% CI, 7.90-23.49).

Conclusion: Our analysis showed a positive association between H pylori infection and the risk of HCC, with an indication of possible publication bias and possible confounders due to study designs that showed results of less pronounced associations.