人喉部肿瘤与人类乳头状瘤病毒感染的相关性研究

Meta Analysis of Relationship between Laryngeal Tumor of Chinese and Human Papillomavirus Infection

背景与目的:研究显示人类乳头状瘤病毒(humanpapillomavirus,HPV)的感染与喉部肿瘤的发生密切相关,但由于研究方法不同,结果差异较大,本研究采用Meta分析法综合评价人喉部良恶性肿瘤的发生与不同类型人类乳头状瘤病毒感染的关系。方法:通过《中国生物医学文献数据库》收集所有国内有关喉部良恶性肿瘤与HPV关系的研究文献共123篇,其中符合研究标准的以聚合酶链反应(polymerasechainreaction,PCR)法检测HPV16或HPV6/11的成组对照研究共11篇,采用Fisher法和Meta分析法对收集到的文献进行综合的定性和定量研究。结果:所有文献中正常喉组织、喉癌、喉乳头状瘤、声带息肉HPV16的平均检出率分别为:10.8%、35.2%、27.5%、5.0%,而HPV6/11的检出率分别为:8.7%、18.6%、61.6%、21.9%。Fisher法和Meta法分析结果显示:①喉癌HPV16的感染率明显高于喉乳头状瘤和声带息肉(P<0.005),其合并优势比分别是喉乳头状瘤和声带息肉的2.8(1.7～4.7)和12.7(4.2～38.8)倍,其阳性检出率分别高22.0%(12.2%～31.8%)和39.0%(19.4%～58.6%);②喉乳头状瘤HPV6/11的感染率明显高于喉癌(P<0.005),其合并优势比是喉癌的16.4(5.6～48.1)倍,其阳性检出率比喉癌高56.0%(34.4%～75.6%);③喉癌和声带息肉的HPV6/11感染率无明显差异(P>0.05)。

BACKGROUND &OBJECTIVE: Researches showed that the infection of h um an papillomavirus (HPV) was closely related to laryngeal tumor, but those result s existed great differences because of different research methods. In this study Fishers and Meta analysis were used to synthetically evaluate relationship be tween laryngeal benign and malignant tumors of Chinese and infection of differen t types of HPV. METHODS: A total of 123 references about relationship between la ryngeal benign and malignant tumors of Chinese and infection of different types of HPV were collected from CBMdisc (Chinese Biomedical Literature Analysis and R etrieval System for Compact Disc). There were 11 references accorded with resear ch criteria which were case-control study,and had detected HPV16 or HPV6/11 by polymerase chain reaction (PCR). Fisher and Meta analysis were used to quantitat ively and qualitatively analyze these references synthetically. RESULTS: Mean de tection rates of HPV16 in normal laryngeal tissue,laryngeal carcinoma (LC),laryn geal papilloma(LPa),laryngeal polyp (LPo) from all references were 10.8%,35.2% ,27.5%,5.0%,respectively;and those of HPV6/11 were 8.7%,18.6%,61.6%,21.9%, respectively. The infection of HPV16 in LC were significantly higher than those in LPa,and LPo(P< 0.005); the combined odds ratio (ORc) for HPV16 infection in LC was 2.8(1.7-4.7) times that in LPa,and 12.7(4.2-38.8) times that in LPo; m ean positive rate of HPV16 in LC was 22.0%(12.2%-31.8%) higher than that in LPa,and 39.0%(19.4%-58.6%) higher than that in Lpo. The infection of HPV6/11 in LPa was significantly higher than that in LC (P< 0.005); ORc for HPV16 inf ection in LPa was 16.4 (5.6-48.1) times that LC; mean positive rate of HPV16 in LPa was 56.0%(34.4%-75.6%) higher than that in LC. There was no significant difference of HPV6/11 infection between LC and LPo (P >0.05). CONCLUSION: The infection of HPV16 may enhance risk of development of laryngeal carcinoma; and the infection of HPV6/11 may enhance risk of development of laryngeal papilloma.