Usman Muhammad, Hameed Yasir, Ahmad Mukhtiar
Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan.
Ecancermedicalscience. 2020 Sep 21;14:1107. doi: 10.3332/ecancer.2020.1107. eCollection 2020.
The role of human papillomavirus (HPV) in human colorectal cancer (CRC) has already been widely investigated worldwide with conflicting results. Although researchers have tried to establish the link between HPV and CRC through a statistical meta-analysis of the previous studies associating HPV with CRC, they failed to establish a more reliable link due to the shortcomings of the statistical meta-analysis. In the present study, we identified population-wide studies relating HPV with CRC through the PubMed search engine. Then, we examined the available data of HPV prevalence in CRC and normal/benign samples and applied the postulates of Bradford Hill criteria on the available evidence to investigate the association between HPV and CRC. The Bradford Hill criteria are very old, reliable and widely accepted for establishing a link between the cause and disease. In addition, to further enhance the reliability of the outcomes, we have also evaluated the methodologies of the previous studies to address the possibility of false-negative and false-positive results. After a careful evaluation of the extracted data against the postulates of Bradford Hill criteria, it was observed that none of the studies fulfil all the major postulates of Bradford Hill criteria for causation including temporality, consistency, biological gradient, experiment, coherence, specificity and analogy. Hence, no causal relationship has been suggested between HPV and CRC patients of the any included population. The results failed to prove the causal relationship between HPV and CRC and suggested HPV as a coparticipant in the pathogenesis of CRC.
人乳头瘤病毒（HPV）在人类结直肠癌（CRC）中的作用已在全球范围内得到广泛研究，但结果相互矛盾。尽管研究人员试图通过对先前将HPV与CRC相关联的研究进行统计荟萃分析来建立HPV与CRC之间的联系，但由于统计荟萃分析的局限性，他们未能建立更可靠的联系。在本研究中，我们通过PubMed搜索引擎确定了全人群范围内将HPV与CRC相关联的研究。然后，我们检查了CRC以及正常/良性样本中HPV流行率的现有数据，并根据布拉德福德·希尔标准的假设对现有证据进行分析，以研究HPV与CRC之间的关联。布拉德福德·希尔标准历史悠久、可靠且被广泛接受，用于建立病因与疾病之间的联系。此外，为了进一步提高结果的可靠性，我们还评估了先前研究的方法，以解决假阴性和假阳性结果的可能性。在根据布拉德福德·希尔标准的假设对提取的数据进行仔细评估后，发现没有一项研究满足布拉德福德·希尔因果关系标准的所有主要假设，包括时间顺序、一致性、生物学梯度、实验、连贯性、特异性和类推性。因此，在任何纳入人群的CRC患者中，均未发现HPV与CRC之间存在因果关系。研究结果未能证明HPV与CRC之间存在因果关系，并提示HPV是CRC发病机制中的一个共同参与者。
