Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Oral Oncol. 2024 Dec;159:107057. doi: 10.1016/j.oraloncology.2024.107057. Epub 2024 Oct 8.
Human papillomavirus (HPV) is known to affect head and neck sites beyond the oropharynx, including the nasopharynx. Unlike HPV-associated oropharyngeal squamous cell carcinoma (HPV+OPSCC), HPV-associated nasopharyngeal carcinoma (HPV+NPC) is not well characterized and the true prevalence in non-endemic regions is poorly described. Here, we sought to obtain a global point prevalence of HPV in NPC, stratified by geographic region.
EMBASE, OVID Medline, and Web of Science were systematically searched for available evidence on September 21, 2022 for articles published between January 1, 1990 and September 21, 2022.
We reviewed the literature for all studies examining NPC and HPV status in adult patients that provided a quantitative HPV prevalence. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Main outcome and measures included HPV+NPC prevalence estimates stratified by geographic region, along with other clinical and demographic features.
Of the 1567 citations retrieved, 46 studies encompassing 6314 NPC patients were eligible for statistical analysis. The global prevalence of HPV+NPC was 0.18 (95% CI 0.14-0.23). When stratified by geographic region, prevalence was highest in North America (0.25, 95% CI 0.17-0.36), which is a non-endemic region for NPC and also has highest prevalence for HPV+OPSCC. Asia, an endemic area, had the lowest HPV prevalence estimate (0.13, 95% CI 0.08-0.22). HPV 16 (44%) and 18 (33%) were the predominant genotypes in HPV+NPC, dissimilar to HPV+OPSCC.
This systematic review and meta-analysis provides a global point prevalence of HPV+NPC stratified by geographic region and suggests that HPV is a significant etiological factor of NPC in North America.
人乳头瘤病毒（HPV）已知会影响口咽以外的头颈部部位，包括鼻咽部。与 HPV 相关的口咽鳞状细胞癌（HPV+OPSCC）不同，HPV 相关的鼻咽癌（HPV+NPC）尚未得到很好的描述，在非流行地区的真实流行率也描述不足。在这里，我们试图获得 HPV 在 NPC 中的全球点流行率，并按地理位置进行分层。
2022 年 9 月 21 日，系统地在 EMBASE、OVID Medline 和 Web of Science 上搜索了 1990 年 1 月 1 日至 2022 年 9 月 21 日期间发表的关于 NPC 和 HPV 状况的可用证据的文章。
我们回顾了所有检查 NPC 和 HPV 状态的文献，这些文献提供了 HPV 阳性率的定量数据。该研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。主要结果和措施包括按地理位置分层的 HPV+NPC 流行率估计，以及其他临床和人口统计学特征。
在 1567 条引用中，有 46 项研究共纳入 6314 例 NPC 患者，符合统计分析的条件。全球 HPV+NPC 的流行率为 0.18（95%CI 0.14-0.23）。按地理位置分层，北美（0.25，95%CI 0.17-0.36）的流行率最高，北美是非 NPC 的流行地区，也是 HPV+OPSCC 流行率最高的地区。亚洲是一个流行地区，HPV 流行率估计最低（0.13，95%CI 0.08-0.22）。HPV+NPC 中主要的 HPV 基因型为 16（44%）和 18（33%），与 HPV+OPSCC 不同。
这项系统评价和荟萃分析提供了 HPV+NPC 的全球点流行率，按地理位置进行了分层，并表明 HPV 是北美的 NPC 的一个重要病因因素。
