人乳头瘤病毒与食管癌病原学关系的Meta分析

摘要

目的 探讨人乳头瘤病毒(Human papiuomavirus,HPV)与我国食管癌发生的相关性.方法 汇总了国内有关HPV与食管癌相关的论文,选择采用PCR方法检测的论文对发表的数据进行Meta分析.结果 我们以检测方法为PCR、标本为石蜡包埋标本、论文中列出或提示了引物序列的15篇论文作为入选论文.15篇文献涉及蜡块标本共980份,按照只要检出一个HPV型别即为HPV阳性进行计算,检出阳性例数为460例,各地HPV检出率为8.3%～69.8%,HPV平均检出率为46.9%(95%CI:43.8%～50.0%).在以上980份样品中,检测范围包括了HPV16型的样品有556份,阳性份数为139份,各地检出率为4.4%～63.4%,平均检出率为25.0%(95%CI:21.4%～28.6%);检测范围包括HPV18型的样本有485份,阳性份数为33份,各地检出率为0%～19.0%,HPV18型的平均检出率为6.8%(95%CI:4.6%～9.0%).以上15篇论文中,使用同一引物的文献只有4篇,共检测406份石蜡包埋标本,HPV阳性率为20.3%～67.6%,平均检出率为40.2%(95%17 CI:36.0%～45.4%).结论 我国食管癌组织中有HPV存在,并且HPV感染可能食管癌发生的重要病因.%Objective To study the relationship between human papillomavirus (HPV) and esophageal cancer development in China. Methods We searched and collected the published articles in Chinese related to HPV and esophageal cancer, and selected the articles with the PCR approach to detect HPV in the esophageal cancer specimens. Results We filtered our publication collection with standards as (1) PCR as the detection approach, (2) specimens as the paraffin-embedded sections, and (3) description of the primer in the experiments, and fifteen articles were enrolled for our meta-analysis. Among the articles, totally 980 specimens were tested, and 460 were HPV positive with the average HPV prevalence was 46.9% (95% CI:43.8%-50.0% ), varied from 8.3%-69.8% in the different locations. On the other hands, among 556 specimens whose HPV detection spectrum included HPV16, 139 showed the positivity of HPV16, the average prevalence was 25.0%, (95% CI: 21.4%-28.6% ) varied from 4.4%-63.4% dependent on the locations; among 485 specimens whose HPV detection spectrum included HPV18, thirty-three specimens showed the positivity of HPV18, the average prevalence was 6.8% (95% CI: 4.6%-9.0%) varied from 0%-19.0% dependent on the locations. Third, among the fifteenarticles enrolled in the meta-analysis, four articles used the same primer set for HPV detection in totally 406 paraffin-embedded specimens with the prevalence of 40.2% (95% CI: 36.0%-45.4%) varied from 20.3%-67.6% in different locations. Conclusion Our analysis result suggested the HPV prevalence in the esophageal cancer samples of China and clued the possible etiological relationships between HPV infection and the esophageal cancer development.