高危型人乳头瘤病毒在宫颈腺癌中的感染状况及生存影响：系统评价和荟萃分析。
Infection status and survival impact of high-risk human papillomavirus in cervical adenocarcinomas: A systematic review and meta-analysis.
机构信息
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
出版信息
Gynecol Oncol. 2022 Oct;167(1):129-136. doi: 10.1016/j.ygyno.2022.08.007. Epub 2022 Aug 13.
OBJECTIVE
Cervical adenocarcinoma (CAC) comprises a heterogeneous group of tumors that are not universally associated with HPV infection. As has been shown in other organs, it is becoming increasingly apparent that HPV status significantly affects the prognosis of adenocarcinoma. We conducted a systematic review and meta-analysis to investigate the infection status of high-risk Human papillomavirus (hrHPV) in CAC and evaluate its impact on the survival of patients.
METHODS
PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and Clinical Trials.gov were searched from inception to May 1st, 2022. Data on HPV infection status and survival outcomes were evaluated using STATA 16.0.
RESULTS
Seventy-one studies with 11,278 participants were included in HPV infection analysis and eight studies with 1099 participants were included in prognosis analysis. The HPV infection rate (including high-risk and low-risk) and hrHPV infection rate in CAC were 75% (95% CI 0.70-0.80, 6978 participants) and 75% (95% CI 0.70-0.81, 4906 participants), respectively. HPV-16 and -18 were the most common HPVs in CAC, with pooled infection rates of 37% (95% CI 0.33-0.41, 7848 participants) and 34% (95% CI 0.30-0.38, 7730 participants), respectively. hrHPV infection was associated with better overall survival (HR 0.23, 95% CI 0.11-0.47, 1013 participants), better disease-free survival (HR 0.18, 95% CI 0.07-0.43, 292 participants), better progression-free survival (HR 0.20, 95% CI 0.08-0.47, 271 participants) and less recurrence (RR 0.30, 95% CI 0.07-0.43, 181 participants).
CONCLUSION
HPV infection rates were high in CAC. HPV-16 and -18 had the highest infection rates in CAC. However, hrHPV infection was associated with better survival and less recurrence. Future studies should clarify the relationship between hrHPV infection and other prognostic factors and make reasonable treatment strategies for CAC with different HPV status.
PROTOCOL REGISTRATION
CRD42022319390.
目的
子宫颈腺癌（CAC）包含一组异质性肿瘤，它们并非普遍与 HPV 感染相关。与其他器官一样，HPV 状态对腺癌的预后有显著影响，这一点越来越明显。我们进行了一项系统综述和荟萃分析，以研究高危型人乳头瘤病毒（hrHPV）在 CAC 中的感染状况，并评估其对患者生存的影响。
方法
从成立到 2022 年 5 月 1 日，我们在 PubMed、Embase、Cochrane 中央对照试验注册库（CENTRAL）、国际临床试验注册平台（ICTRP）和临床试验.gov 上进行了检索。使用 STATA 16.0 评估 HPV 感染状况和生存结局的数据。
结果
71 项研究（11278 名参与者）纳入 HPV 感染分析，8 项研究（1099 名参与者）纳入预后分析。CAC 中 HPV 感染率（包括高危型和低危型）和 hrHPV 感染率分别为 75%（95%CI 0.70-0.80，6978 名参与者）和 75%（95%CI 0.70-0.81，4906 名参与者）。HPV-16 和 -18 是 CAC 中最常见的 HPV，其感染率分别为 37%（95%CI 0.33-0.41，7848 名参与者）和 34%（95%CI 0.30-0.38，7730 名参与者）。hrHPV 感染与更好的总生存率（HR 0.23，95%CI 0.11-0.47，1013 名参与者）、无病生存率（HR 0.18，95%CI 0.07-0.43，292 名参与者）、无进展生存率（HR 0.20，95%CI 0.08-0.47，271 名参与者）和更少的复发（RR 0.30，95%CI 0.07-0.43，181 名参与者）相关。
结论
CAC 中 HPV 感染率较高。HPV-16 和 -18 在 CAC 中的感染率最高。然而，hrHPV 感染与更好的生存和更少的复发相关。未来的研究应阐明 hrHPV 感染与其他预后因素的关系，并为不同 HPV 状态的 CAC 制定合理的治疗策略。
方案注册
CRD42022319390。
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