Wang Huanhuan, Zhang Yuyu, Bai Wei, Wang Bin, Wei Jinlong, Ji Rui, Xin Ying, Dong Lihua, Jiang Xin
Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.
Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun, China.
Front Oncol. 2020 Nov 25;10:524928. doi: 10.3389/fonc.2020.524928. eCollection 2020.
Human papillomavirus (HPV) is a risk factor for squamous cell carcinoma of the head and neck (HNSCC). This study aimed to investigate the feasibility of IHC- p16INK4a (p16) as an alternative modality for diagnosing HPV infection. We searched PubMed, EMBASE, Web of Science, and Cochrane library for studies that evaluated the diagnostic accuracy of IHC-p16 staining. A total of 30 studies involving 2,963 patients were included from 2007 to 2019. The combined sensitivity was 0.94 (95% CI: 0.92-0.95); specificity, 0.90 (95% CI: 0.89-0.91); positive likelihood ratio (LR), 6.80 (95% CI: 5.63-8.21); negative LR, 0.10 (95% CI: 0.07-0.16); diagnostic odds ratio, 85.98 (95% CI: 55.57-133.03); and area under the curve value, 0.9550. Subgroup analysis showed that the IHC-p16 test was more consistent with the hybridization (ISH) test and has greater diagnostic value for oropharyngeal squamous cell carcinoma. The diagnostic efficacy of IHC-p16 varied among countries. In conclusion, IHC-p16 has high sensitivity and specificity for diagnosing HPV infection in HNSCC. The consistency of IHC-p16 findings with those of ISH indicate that their combination can be used to improve the specificity of diagnosis.
人乳头瘤病毒（HPV）是头颈部鳞状细胞癌（HNSCC）的一个风险因素。本研究旨在探讨免疫组化检测p16INK4a（p16）作为诊断HPV感染替代方法的可行性。我们在PubMed、EMBASE、科学网和Cochrane图书馆中检索了评估免疫组化p16染色诊断准确性的研究。2007年至2019年共纳入30项研究，涉及2963例患者。合并敏感性为0.94（95%CI：0.92 - 0.95）；特异性为0.90（95%CI：0.89 - 0.91）；阳性似然比（LR）为6.80（95%CI：5.63 - 8.21）；阴性LR为0.10（95%CI：0.07 - 0.16）；诊断比值比为85.98（95%CI：55.57 - 133.03）；曲线下面积值为0.9550。亚组分析表明，免疫组化p16检测与杂交（ISH）检测结果更一致，对口咽鳞状细胞癌具有更大的诊断价值。免疫组化p16的诊断效能在不同国家有所差异。总之，免疫组化p16在诊断HNSCC中的HPV感染方面具有高敏感性和特异性。免疫组化p16结果与ISH结果的一致性表明，两者联合可用于提高诊断的特异性。
