评估术前人乳头状瘤病毒（HPV）检测结果与宫颈癌复发率、无病存活率、癌症特异生存率和总体生存率之间的关联，报告HPV与宫颈癌组织学、分期、分级、肿瘤大小、淋巴结受累和治疗反应的关系。使用与宫颈癌、HPV和预后相关的MeSH词汇和关键词，检索EMBASE和MEDLINE数据库，时限为至2022年1月27日。由于我们的研究问题的特点，未对ClinicalTrials.gov进行搜索。研究必须对20例或更多有浸润性宫颈癌患者的术前宫颈活检组织或细胞中的HPV DNA或RNA进行评估，随访时间不限，并报告HPV阳性或阴性检测结果对宫颈癌复发、无病存活、癌症特异存活或总体生存的影响。我们提取了有关HPV检测方法、患者和肿瘤特征以及临床结果的数据。使用随机效应模型汇总了风险比（HR）和95%置信区间。进行荟萃分析以探讨异质性。在检阅了11,179个标题或摘要和474篇全文文章后，共有77项研究纳入了系统综述。在这77项研究中，有30项研究报告了HPV情况与组织学的关系，39项研究报告了与癌症分期的关系，13项研究报告了与肿瘤分级的关系，17项研究报告了与肿瘤大小的关系，23项研究报告了与淋巴结受累的关系，4项研究报告了与治疗反应的关系。 HPV阳性检测与较好的无病存活（HR 0.38，95% CI 0.25-0.57，15项研究，2,564例）、癌症特异存活（HR 0.56，95% CI 0.44-0.71，9项研究，1,398例）和总体生存（HR 0.59，95% CI 0.47-0.74，36项研究，9,169例）相关，但与复发率无关（HR 0.59，95% CI 0.33-1.07，8项研究，1,313例）。荟萃分析显示，研究案例数、肿瘤分级、样本类型、基因靶向以及HPV感染率共解释了73.8%的研究间异质性。该综述表明，HPV在宫颈癌中的检测与更好的临床预后有关。https://osf.io/dtyeb。版权所有2023年，美国妇产科学院。由Wolters Kluwer Health, Inc.发表，保留所有权利。

To evaluate whether testing positive for human papillomavirus (HPV) before treatment is associated with cervical cancer recurrence and disease-free, cancer-specific, and overall survival and to report the relationship of HPV to cervical cancer histology, stage, grade, tumor size, lymph node involvement, and treatment response.EMBASE and MEDLINE were searched from inception to January 27, 2022, with the use of MeSH terms and keywords relating to cervical cancer, HPV, and prognosis. ClinicalTrials.gov was not searched because of the nature of our review question.Studies must have assessed HPV DNA or RNA in cervical pretreatment biopsies or cells from 20 or more patients with invasive cervical cancer followed up for any length of time and reported the effect of testing positive or negative for HPV on cervical cancer recurrence, disease-free survival, cancer-specific survival, or overall survival. We extracted data on HPV-detection methods, patient and tumor characteristics, and clinical outcomes.Hazard ratios (HRs) and 95% CIs were pooled with a random-effects model. Meta-regression was performed to explore heterogeneity. Of 11,179 titles or abstracts and 474 full-text articles reviewed, 77 studies were included in the systematic review. Among these 77 studies, 30 reported on the relationship of HPV status to histology, 39 to cancer stage, 13 to tumor grade, 17 to tumor size, 23 to lymph node involvement, and four to treatment response. Testing positive for HPV was associated with better disease-free survival (HR 0.38, 95% CI 0.25-0.57; 15 studies with 2,564 cases), cancer-specific survival (HR 0.56, 95% CI 0.44-0.71; nine studies with 1,398 cases), and overall survival (HR 0.59, 95% CI 0.47-0.74; 36 studies with 9,169 cases), but not recurrence (HR 0.59, 95% CI 0.33-1.07; eight studies with 1,313 cases). Meta-regression revealed that the number of cases, tumor grade, specimen type, gene target, and HPV prevalence together explained 73.8% of the between-study heterogeneity.This review indicates that HPV detectability in cervical cancer is associated with a better clinical prognosis.https://osf.io/dtyeb.Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.