人乳头瘤病毒感染与膀胱癌风险：荟萃分析。
Human papillomavirus infection and bladder cancer risk: a meta-analysis.
机构信息
National Office for Cancer Prevention and Control, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
J Infect Dis. 2011 Jul 15;204(2):217-23. doi: 10.1093/infdis/jir248.
BACKGROUND
Despite an increase in the number of molecular epidemiological studies conducted in recent years to evaluate the association between human papillomavirus (HPV) infection and risk of bladder cancer, the studies remain inconclusive.
METHODS
The prevalence of HPV in bladder cancer was estimated by pooling data from 52 studies, taking into consideration the heterogeneity from major related parameters including study region, histological type, HPV DNA specimen, publication calendar period, and detection method. Moreover, the association of HPV infection with bladder cancer was tested by a meta-analysis with 19 case-control studies.
RESULTS
An HPV prevalence of 16.88% (95% confidence interval [CI], 15.53%-18.31%) among the bladder cancer cases was revealed, most of whom were high-risk HPV types (15.82% [95% CI, 14.37%-17.36%]). The prevalence varied by region, types of HPV DNA specimen, and polymerase chain reaction primers used. A significantly increased risk of bladder cancer was shown for the positivity of overall HPV (odds ratio, 2.84 [95% CI, 1.39-5.80]), which was also infuenced by HPV type, study region, HPV DNA specimen, and detection method.
CONCLUSIONS
Infection of high-risk HPV types, especially HPV16, may play a role in bladder carcinogenesis.
背景
尽管近年来进行了大量的分子流行病学研究来评估人乳头瘤病毒（HPV）感染与膀胱癌风险之间的关联，但这些研究仍然存在争议。
方法
通过汇总 52 项研究的数据，考虑到与研究区域、组织学类型、HPV DNA 样本、出版时间和检测方法等主要相关参数的异质性，估计膀胱癌中 HPV 的流行率。此外，通过对 19 项病例对照研究进行荟萃分析，检验 HPV 感染与膀胱癌之间的关联。
结果
膀胱癌病例中 HPV 的流行率为 16.88%（95%置信区间[CI]，15.53%-18.31%），其中大多数为高危 HPV 型（15.82%[95%CI，14.37%-17.36%]）。流行率因地区、HPV DNA 样本类型和聚合酶链反应引物的使用而有所不同。总体 HPV 阳性的膀胱癌风险显著增加（比值比，2.84[95%CI，1.39-5.80]），这也受到 HPV 类型、研究区域、HPV DNA 样本和检测方法的影响。
结论
高危 HPV 型（尤其是 HPV16）的感染可能在膀胱癌的发生中起作用。
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