人乳头瘤病毒在中国喉癌中的感染率及其与喉癌相关性的荟萃分析

Infection rate of human papillomavirus and its association with laryngeal cancer in Chinese： a meta-analysis

目的 分析中国喉癌患者中人乳头瘤病毒（HPV）的感染率以及HPV感染与喉癌发病风险的相关性.方法 检索中英文数据库,纳入符合条件的文献,采用R3.0软件进行荟萃分析喉癌患者中HPV的感染率,并按研究年份以及标本保存方法进行亚组分析.进一步筛选病例-对照研究,完成HPV感染与喉癌发病风险的荟萃分析.结果 喉癌患者中HPV总感染率为32％（95％CI：22％ ～44％）,HPV-16/18感染率为30％（95％ CI：24％～37％）,HPV-6/11感染率为12％ （95％ CI：9％ ～ 17％）;1992-2000年和2001-2012年发表的文献中喉癌HPV-16/18感染率分别为24％（95％CI：15％ ～35％）和32％（95％CI：24％ ～41％）,差异无统计学意义（P=0.07）.新鲜冻存标本和石蜡保存标本中HPV-16/18感染率分别为28％（95％ CI：18％ ～ 42％）和31％（95％ CI：24％ ～ 39％）,差异无统计学意义（p=0.06）.两组患者HPV总感染率的风险效应的荟萃分析,OR（odds ratio,优势比）=15.87 （95％ CI：9.25～27.24）,差异有统计学意义（P＜0.01）;高危型HPV-16/18感染的风险效应的荟萃分析,OR =8.07 （95％ CI：5.67～11.48）,差异有统计学意义（P＜0.01）.结论 中国喉癌患者中HPV感染率保持在较高的水平,并且有随时间增高的趋势.HPV感染可能增加了中国人喉癌发生的危险性.

Objective To systematically explore the prevalence of human papillomavirus （HPV） in laryngeal cancer （LC） in Chinese and evaluate the association between HPV infection and laryngeal cancer risk.Methods The databases both in English and Chinese were searched.And the studies met the inclusion criteria were included.The prevalence of HPV in LC group and in subgroups,stratified by publishing years and sample storage methods,were analyzed by the R 3.0 software respectively.The cancer risk of HPV infection was estimated by odds ratio （OR） generated by comparisons with the control group.Results The overall prevalence of HPV was 32％ [95％ confidence interval （CI）：22％-44％] and the prevalence of high-risk HPV-16/18 and low-risk HPV-6/11 was 30％ （95％ CI：24％-37％） and 12％ （95％ CI：9％-17％） respectively in Chinese LC patients.The HPV-16/18 infection rate was 24％ （95％ CI：15％-35％） in the subgroup between 1992 and 2000 and 32％ （95％ CI：24％-41％） in the subgroup from 2001 to 2012 respectively.And no significant difference existed between two subgroups （P =0.07）.The HPV-16/18 infection rate in formalin-fixed paraffin-embedded sample cohort was not significantly different from the fresh-frozen sample cohort [31％ （95％ CI：24％-39％） and 28％ （95％ CI：18％-42％）; P =0.06].Meta-analysis showed the overall HPV infection rate in the LC group was significantly higher than in the control group （OR =15.87 （95％ CI：9.25-27.24） ; P ＜ 0.01）.Moreover,as compared with the control group,the patients in the LC group had a higher infection rate of HPV-16/18 （OR=8.07 （95％ CI：5.67-11.48）; P＜0.01）.Conclusions HPV infection rates in Chinese LC patients stay at a relatively high level and tend to increase over time.And HPV infection may increase LC risk in Chinese.