Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
Eur J Cancer. 2014 May;50(8):1446-61. doi: 10.1016/j.ejca.2014.01.019. Epub 2014 Feb 20.
The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association.
The pooled HPV prevalence was estimated using a random effects model and the I(2) statistic was used to describe the amount of heterogeneity. Potential sources of heterogeneity were evaluated by meta-regression and stratified analyses. For the studies on adenocarcinomas including control tissue, random effects estimates of odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
Thirty-seven studies were included. Among the 2630 adenocarcinomas, the pooled HPV prevalence was 11.2% (95% CI, 4.9-19.6%) with substantial between-study heterogeneity (I(2)=97.2%). The HPV prevalence varied by geographical region with highest prevalence in South America (45.1%, 95% CI, 21.9-69.4%), Asia (39.2%, 95% CI, 20.3-60.0%) and the Middle East (32.2%, 95% CI, 1.1-79.3%), and by detection method with the highest HPV prevalence in PCR-based studies. In the eight case-control studies, the pooled HPV prevalence was 36.8% (95% CI, 21.3-53.8%) in adenocarcinomas and 1.6% (95% CI, 0.0-9.6%) in controls giving an OR of 6.0 (95% CI, 2.0-17.9%) for the association between HPV and colorectal cancer. Among the 415 adenomas, the pooled HPV prevalence was 5.1% (95% CI, 0.0-17.8%; I(2)=93.7%).
HPV may be associated with a subset of colorectal cancers. Future large-scale multicenter case-control studies with data on risk factors such as lifestyle and sexual behaviour are needed.
人乳头瘤病毒（HPV）在结直肠癌中的作用已得到广泛研究，但结果存在争议。我们进行了系统评价和荟萃分析，以估计结直肠腺癌和腺瘤中 HPV 的流行率，并检验其潜在关联。
使用随机效应模型估计 HPV 总流行率，并使用 I(2)统计量描述异质性程度。通过 meta 回归和分层分析评估潜在的异质性来源。对于包含对照组织的腺癌研究，计算了比值比（OR）和 95%置信区间（CI）的随机效应估计值。
共纳入 37 项研究。在 2630 例腺癌中，HPV 总流行率为 11.2%（95%CI，4.9-19.6%），研究间存在较大异质性（I(2)=97.2%）。HPV 流行率因地理位置而异，南美洲（45.1%，95%CI，21.9-69.4%）、亚洲（39.2%，95%CI，20.3-60.0%）和中东（32.2%，95%CI，1.1-79.3%）的流行率最高，且因检测方法而异，基于 PCR 的研究中 HPV 流行率最高。在 8 项病例对照研究中，腺癌中 HPV 流行率为 36.8%（95%CI，21.3-53.8%），对照组为 1.6%（95%CI，0.0-9.6%），HPV 与结直肠癌之间的 OR 为 6.0（95%CI，2.0-17.9%）。在 415 例腺瘤中，HPV 总流行率为 5.1%（95%CI，0.0-17.8%；I(2)=93.7%）。
HPV 可能与结直肠癌的一部分有关。需要未来开展大规模多中心病例对照研究，并纳入生活方式和性行为等危险因素的数据。
