人乳头瘤病毒在皮肤鳞状细胞癌中的作用：荟萃分析。
Role of human papillomavirus in cutaneous squamous cell carcinoma: a meta-analysis.
机构信息
Department of Dermatology, New York Medical College, Valhalla, New York.
Department of Dermatology, University of California, San Francisco, California.
出版信息
J Am Acad Dermatol. 2014 Apr;70(4):621-629. doi: 10.1016/j.jaad.2014.01.857.
BACKGROUND
The role of human papillomavirus (HPV) in cutaneous squamous cell carcinoma (cuSCC) is not well defined, with past studies showing conflicting results.
OBJECTIVE
We sought to determine if there is a significant association between HPV and cuSCC and whether cuSCC from immunosuppressed patients are more likely to carry HPV than cuSCC from immunocompetent patients.
METHODS
We performed a systematic review and abstracted data from articles that included: skin samples by biopsy, HPV detection by polymerase chain reaction, and a minimum of 10 cases and 10 controls. Pooled effect size and 95% confidence intervals were calculated using random effects meta-analysis using the inverse variance method.
RESULTS
cuSCC were more likely to carry HPV than normal-appearing skin (pooled effect size [ES] 3.43, 95% confidence interval 1.97-5.98, P < .0001) in all patients. An increase in HPV prevalence was found in tumors from immunosuppressed patients compared with immunocompetent patients (pooled ES 3.01, 95% confidence interval 2.00-4.52, P < .0001).
LIMITATIONS
The greatest limitation is the heterogeneity of the studies included. The association of higher HPV prevalence in squamous cell carcinoma compared with normal-appearing skin does not imply causality.
CONCLUSION
These results contribute to evidence that HPV is associated with cuSCC. Higher HPV burden in tumors from immunosuppressed patients compared with immunocompetent patients may have therapeutic implications.
背景
人乳头瘤病毒（HPV）在皮肤鳞状细胞癌（cuSCC）中的作用尚未明确，既往研究结果存在矛盾。
目的
我们旨在确定 HPV 与 cuSCC 是否存在显著相关性，以及免疫抑制患者的 cuSCC 是否比免疫功能正常患者的 cuSCC 更有可能携带 HPV。
方法
我们进行了系统评价，并从包含以下内容的文章中提取数据：活检皮肤样本、聚合酶链反应 HPV 检测，以及至少 10 例病例和 10 例对照。使用逆方差法的随机效应荟萃分析计算合并效应大小和 95%置信区间。
结果
所有患者的 cuSCC 比正常外观皮肤更有可能携带 HPV（合并效应大小 [ES] 3.43，95%置信区间 1.97-5.98，P<0.0001）。与免疫功能正常的患者相比，免疫抑制患者的肿瘤中 HPV 阳性率增加（合并 ES 3.01，95%置信区间 2.00-4.52，P<0.0001）。
局限性
最大的局限性是纳入研究的异质性。与正常外观皮肤相比，鳞状细胞癌中 HPV 阳性率较高并不意味着存在因果关系。
结论
这些结果为 HPV 与 cuSCC 相关的证据提供了补充。与免疫功能正常的患者相比，免疫抑制患者的肿瘤中 HPV 负担较高可能具有治疗意义。
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