Sun Guorui, Dong Xiaoyuan, Tang Xiaolong, Qu Hui, Zhang Hao, Zhao Ensheng
Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China.
Department of Hematology, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China.
Oncotarget. 2017 Dec 21;9(8):8081-8088. doi: 10.18632/oncotarget.23545. eCollection 2018 Jan 30.
Human papillomavirus (HPV) DNA and p16 expression have been identified to be related to the progression of anal squamous cell carcinoma (ASCC). However, the prognostic relevance of combined detection, particularly HPV-/p16+ and HPV+/p16- signatures, is unknown. A meta-analysis of epidemiologic studies was therefore conducted to address this issue. Data were collected from studies comparing overall survival (OS) and disease-free survival (DFS) / disease-specific survival (DSS) / relapse-free survival (RFS) / progression-free survival (PFS) in ASCC patients with HPV and p16 status. The electronic databases of MEDLINE and EMBASE were searched from their inception till 31 May 2017. Study-specific risk estimates were pooled using a fixed-effects model for OS and DFS/DSS/RFS/PFS. Four studies involving a total of 398 ASCC cases were included in this meta-analysis. The pooled results showed that HPV+/p16+ cancers were significantly associated with improved OS (HR = 0.30, 95% CI: 0.17-0.51) and DFS/DSS/RFS/PFS (HR = 0.23, 95% CI: 0.14-0.36). However, patients with HPV-/p16+ or HPV+/p16- do not have a comparably good prognosis compared with HPV+/p16+ patients. The meta-analysis indicated that concomitant detection of HPV-DNA and p16 expression may be of prognostic or therapeutic utility in the evaluation of factors contributing to ASCC. Testing tumor specimens for HPV-DNA and p16 expression might indirectly affect treatment decisions.
人乳头瘤病毒（HPV）DNA和p16表达已被证实与肛管鳞状细胞癌（ASCC）的进展相关。然而，联合检测，尤其是HPV-/p16+和HPV+/p16-特征的预后相关性尚不清楚。因此，开展了一项流行病学研究的荟萃分析以解决这一问题。数据收集自比较ASCC患者HPV和p16状态与总生存期（OS）、无病生存期（DFS）/疾病特异性生存期（DSS）/无复发生存期（RFS）/无进展生存期（PFS）的研究。检索MEDLINE和EMBASE电子数据库，检索时间从建库至2017年5月31日。使用固定效应模型汇总OS及DFS/DSS/RFS/PFS的研究特异性风险估计值。该荟萃分析纳入了四项研究，共398例ASCC病例。汇总结果显示，HPV+/p16+癌症与OS改善显著相关（HR = 0.30，95% CI：0.17 - 0.51）及DFS/DSS/RFS/PFS改善显著相关（HR = 0.23，95% CI：0.14 - 0.36）。然而，与HPV+/p16+患者相比，HPV-/p16+或HPV+/p16-患者的预后没有那么好。该荟萃分析表明，同时检测HPV-DNA和p16表达可能对评估ASCC的影响因素具有预后或治疗价值。检测肿瘤标本中的HPV-DNA和p16表达可能会间接影响治疗决策。
