Ren Chutong, Zeng Kai, Wu Chujun, Mu Lan, Huang Jiangsheng, Wang Mingming
Department of Minimally Invasive Surgery, the Second Xiangya Hospital, Central South University, Changsha 410000, China.
Gland Surg. 2019 Oct;8(5):486-500. doi: 10.21037/gs.2019.09.04.
Breast carcinoma (BC) is a cancer with a high morbidity rate, but the mechanisms by which it develops are never clear. There has been speculation regarding the potential relationships between breast cancer and local HPV infections for some time, and although much clinical research supports this hypothesis, some research results disprove the association. Therefore, the association is still inconclusive.
We performed the data collection by searching the database PubMed, Embase, Cochrane Library and Web of science. In addition, 22 sites were added manually. After carefully selection, the pooled odds rate of 37 included case control studies was calculated. Subgroup analysis, publication bias and trim & fill analysis were conducted to make the result more reliable.
The analysis of 37 case control studies containing 3,607 BC cases and 1,728 controls showed obviously increase of BC risk with human papillomavirus (HPV) positive [summary odds ratio (SOR) =6.22, 95% confidence interval 4.25 to 9.12; P=0.0002]. Subgroup analysis proved three high risk HPV types (HPV16, 18 and 33) were positively correlated to BC.
This systemic review and meta-analysis provide the evidence for HPV infection as a potential risk factor in BC, while the mechanism of this hypothesis still needs further evaluation.
乳腺癌（BC）是一种发病率很高的癌症，但其发病机制尚不清楚。一段时间以来，人们一直在猜测乳腺癌与局部人乳头瘤病毒（HPV）感染之间的潜在关系，尽管许多临床研究支持这一假设，但一些研究结果却否定了这种关联。因此，这种关联仍无定论。
我们通过检索PubMed、Embase、Cochrane图书馆和科学网数据库来收集数据。此外，还手动添加了22个网站。经过仔细筛选，计算了37项纳入的病例对照研究的合并优势比。进行亚组分析、发表偏倚分析和修剪与填充分析以使结果更可靠。
对37项病例对照研究（包括3607例乳腺癌病例和1728例对照）的分析显示，人乳头瘤病毒（HPV）呈阳性时乳腺癌风险明显增加[汇总优势比（SOR）=6.22，95%置信区间4.25至9.12；P=0.0002]。亚组分析证明三种高危HPV类型（HPV16、18和33）与乳腺癌呈正相关。
这项系统评价和荟萃分析为HPV感染是乳腺癌的潜在危险因素提供了证据，而这一假设的机制仍需进一步评估。
