Review

人乳头瘤病毒相关的鼻咽癌：系统综述与Meta分析

Human papillomavirus-associated nasopharyngeal carcinoma: A systematic review and meta-analysis

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ORAL ONCOLOGY

影响因子:3.9

分区:医学2区 / 牙科与口腔外科2区肿瘤学3区

发表日期:2024 Dec

作者: Brian Y Zhao, Shun Hirayama, Deborah Goss, Yan Zhao, Daniel L Faden

DOI: 10.1016/j.oraloncology.2024.107057

摘要

人乳头瘤病毒（HPV）不仅影响口咽部，还涉及头颈部其他部位，包括鼻咽。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）尚未充分描述，其在非流行区的真实患病率亦不清楚。本研究旨在获得全球范围内不同地区的HPV在NPC中的点状患病率。系统检索EMBASE、OVID Medline和Web of Science数据库，截至2022年9月21日，涵盖1990年1月1日至2022年9月21日发表的相关文献。筛选所有研究成人患者NPC和HPV状态的研究，提供定量的HPV患病率。遵循系统评价和Meta分析的PRISMA指南。主要指标包括按地理区域划分的HPV+NPC的患病率估计，以及其他临床和人口统计特征。从1567篇文献中筛选出46篇，涉及6314名NPC患者，符合统计分析条件。全球HPV+NPC的患病率为0.18（95% CI 0.14-0.23）。按地区划分，北美地区患病率最高，为0.25（95% CI 0.17-0.36），该地区非流行区，亦是HPV+OPSCC的高发区。亚洲为流行区，患病率最低，为0.13（95% CI 0.08-0.22）。HPV16（44%）和18（33%）为主要基因型，与HPV+OPSCC不同。本系统综述和Meta分析提供了按地区划分的全球HPV+NPC点状患病率，提示HPV是北美地区NPC的重要病因因素。

Abstract

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.