Liang LB, Zhang HJ, Liu F, Su QL. Hepatitis B core-related antigen as a predictive biomarker for recurrence in primary hepatocellular carcinoma: A meta-analysis. World J Gastrointest Oncol 2025; 17(5): 105148 [DOI: 10.4251/wjgo.v17.i5.105148]
Corresponding Author of This Article
Qiao-Li Su, MD, General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. cuxf27@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. May 15, 2025; 17(5): 105148 Published online May 15, 2025. doi: 10.4251/wjgo.v17.i5.105148
Hepatitis B core-related antigen as a predictive biomarker for recurrence in primary hepatocellular carcinoma: A meta-analysis
Ling-Bo Liang, Hai-Jun Zhang, Feng Liu, Qiao-Li Su
Ling-Bo Liang, Feng Liu, Qiao-Li Su, General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Hai-Jun Zhang, General Practice Ward/International Medical Center Ward, West China Healthcare Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Liang LB and Su QL contributed to the conception of the study; Liang LB contributed significantly to literature search, data extraction, quality assessment, data analyses, and manuscript preparation; Liang LB and Zhang HJ contributed improving the article for language and style and protocol preparation; Liang LB and Liu F helped perform the analysis with constructive discussions; Su QL revised the manuscript and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiao-Li Su, MD, General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. cuxf27@163.com
Received: January 13, 2025 Revised: February 24, 2025 Accepted: April 11, 2025 Published online: May 15, 2025 Processing time: 122 Days and 19.5 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) is one of the most common malignancies, with high recurrence rates after treatment. Identifying reliable biomarkers for predicting recurrence is essential for improving patient outcomes. Hepatitis B core-related antigen (HBcrAg) has shown potential as a predictive marker for HCC recurrence.
AIM
To evaluate the association between HBcrAg levels and the risk of HCC recurrence.
METHODS
A systematic review was conducted following PRISMA guidelines. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched without restrictions on date or language. Observational studies reporting hazard ratios (HRs) for HBcrAg as a predictor of HCC recurrence were included. Data extraction and quality assessment were performed independently by two reviewers. Statistical analyses used a random-effects model to account for heterogeneity (I² ≥ 50%), and sensitivity analysis was performed to ensure the robustness of the results.
RESULTS
A total of 1339 articles were initially identified, and 17 studies were included in the final meta-analysis after screening. The pooled analysis showed a significant association between elevated HBcrAg levels and HCC recurrence (HR = 4.42, 95% confidence interval: 3.43-5.41) with substantial heterogeneity (I² = 92.6%). Subgroup analysis revealed higher pooled HRs in studies with ≥ 500 participants (HR = 4.18) and HBcrAg cut-offs ≥ 4.0 LogU/mL (HR = 5.29). Studies with ≥ 10 years of follow-up showed a lower HR (2.89) compared to those with < 10 years (3.27). Patients treated with nucleos(t)ide analogs had a pooled HR of 1.98, while those without nucleos(t)ide analog had a higher HR of 3.87. Sensitivity analysis confirmed the robustness of the results, with no significant publication bias detected.
CONCLUSION
This meta-analysis provides strong evidence that elevated HBcrAg levels are associated with an increased risk of HCC recurrence. HBcrAg may serve as a valuable biomarker for predicting recurrence, aiding personalized management and surveillance strategies for HCC patients.
Core Tip: Our research compiles robust data from various studies to assess the prognostic significance of hepatitis B core-related antigen in predicting recurrence in hepatocellular carcinoma patients. This meta-analysis synthesizes evidence from 17 studies encompassing diverse populations and methodologies to offer a comprehensive understanding of hepatitis B core-related antigen’s role as a predictive biomarker. Given the high heterogeneity and recurrence rate of hepatocellular carcinoma, our findings are crucial for clinicians in tailoring patient-specific management strategies, potentially revolutionizing current surveillance and treatment protocols.
