Shaikh Mushfiq Hassan, McMillan Nigel A J, Johnson Newell W
School of Dentistry & Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia; School of Medical Science, Griffith University, Gold Coast Campus, Queensland, Australia; Cancer Research Centre, Molecular Basis of Disease program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
School of Medical Science, Griffith University, Gold Coast Campus, Queensland, Australia; Cancer Research Centre, Molecular Basis of Disease program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
Cancer Epidemiol. 2015 Dec;39(6):923-38. doi: 10.1016/j.canep.2015.09.013. Epub 2015 Nov 9.
Malignancies of the upper aero-digestive tract are a major public health problem, especially in the Asia Pacific. Certain Human papillomaviruses (HPVs) are well-established risk factors for carcinoma of the uterine cervix and for a subset of head and neck carcinomata: however their true importance in different populations and anatomical subsites remains unclear. The major risk factors in Asia Pacific remain smoked/smokeless tobacco, areca nut, alcohol abuse and poor diet, with limited evidence for HPVs. We review published studies of association of HPV with anatomical site-specific Head & Neck Squamous Cell Carcinoma (HNSCC) in these populations and attempt a meta-analysis.
From MEDLINE/PubMed/WEB-of SCIENCE/EMBASE/Scopus databases we found 67 relevant studies with a total of 7280 cases: 15 case-control studies met our inclusion criteria for meta-analysis, totaling 1106 cases & 638 controls. HPV detection rates, sample site and size, and methods of tissue preservation and HPV detection were tabulated for each study.
Studies were heterogeneous in terms of sample selection and method of detection of HPVs. Most were of limited quality. Averaging data from 67 studies of HNSCC, the prevalence of HPV of any subtype is approximately 36%. PCR (polymerase chain reaction) was the most used detection method and HPV16 the most common genotype reported. Meta-analyses of case-control studies from this region reveal significant heterogeneity but suggest higher HPV prevalence in oropharyngeal cancer (OR: 14.66; 95%CI: 6.09-35.26) compared to oral cavity cancer and laryngeal cancer; (OR: 4.06; 95%CI: 3.05-5.39 & OR: 3.23; 95%CI: 1.37-7.61) respectively.
In view of the significant association of HPV with HNSCC, studies with accurate subsite classification and more sensitive detection methods are necessary. Accurate data from this geographical region are essential to inform public health policies and treatment decisions, especially as studies from Europe and North America reveal HPV-driven cancers to be less aggressive, permitting treatment de-intensification.
上呼吸道消化道恶性肿瘤是一个重大的公共卫生问题，在亚太地区尤为如此。某些人乳头瘤病毒（HPV）是子宫颈癌以及一部分头颈癌的确立危险因素：然而，它们在不同人群和解剖亚部位中的真正重要性仍不清楚。亚太地区的主要危险因素仍然是吸烟/无烟烟草、槟榔、酗酒和不良饮食，HPV的证据有限。我们回顾了这些人群中HPV与解剖部位特异性头颈鳞状细胞癌（HNSCC）关联的已发表研究，并尝试进行荟萃分析。
从MEDLINE/PubMed/科学网/EMBASE/Scopus数据库中，我们找到了67项相关研究，共7280例病例：15项病例对照研究符合我们荟萃分析的纳入标准，共计1106例病例和638例对照。为每项研究列出了HPV检测率、样本部位和大小以及组织保存和HPV检测方法。
研究在样本选择和HPV检测方法方面存在异质性。大多数研究质量有限。对67项HNSCC研究的数据进行平均，任何亚型HPV的患病率约为36%。聚合酶链反应（PCR）是最常用的检测方法，HPV16是报告中最常见的基因型。该地区病例对照研究的荟萃分析显示存在显著异质性，但与口腔癌和喉癌相比，口咽癌中HPV患病率更高（比值比：14.66；95%置信区间：6.09 - 35.26）；（比值比分别为：4.06；95%置信区间：3.05 - 5.39和3.23；95%置信区间：1.37 - 7.61）。
鉴于HPV与HNSCC之间存在显著关联，有必要开展具有准确亚部位分类和更敏感检测方法的研究。该地理区域的准确数据对于为公共卫生政策和治疗决策提供信息至关重要，特别是因为来自欧洲和北美的研究表明HPV驱动的癌症侵袭性较小，允许降低治疗强度。
