人乳头瘤病毒感染与中国肺癌患者临床病理特征关系的Meta分析
作者: |
1刘晓俊,
2王宏坤,
2郑绘霞
1 山西医科大学第一临床医学院,太原 030001 2 山西医科大学第一医院病理科,太原 030001 |
通讯: |
郑绘霞
Email: huixiazheng62@126.com |
DOI: | 10.3978/j.issn.2095-6959.2017.10.023 |
摘要
目的:应用Meta分析的方法评价人乳头瘤病毒(human papillomavirus,HPV)感染与中国肺癌患者及临床病理特征的关系。方法:检索2017年4月以前收录在PubMed,CBM,CNKI和万方医学数据库等数据库中的英文和中文文献,按纳入和排除标准对文献进行筛选并提取资料,以OR及95%CI作为效应量,采用Review Manager5.3软件进行Meta分析。结果:最终纳入文献9篇,共1 364例肺癌患者,533例为正常对照组;亚组分析显示应用HPV16/18特异性引物进行扩增的PCR法检测HPV组(P<0.001)及应用通用型引物进行扩增的PCR检测HPV组(P=0.0002),HPV在肺癌组织的感染较正常对照组高,虽然两亚组结果一致,但组间有统计学异质性(P=0.02,I2=82.6%);HPV感染与肺癌的分化程度(OR =0.43;95%CI 0.29~0.64;P<0.001)及病理类型(OR=2.91;95%CI 2.16~3.91,P<0.001)有相关性,中/低分化组比高分化组HPV感染率高,鳞状细胞癌组比腺癌组HPV感染率高;HPV感染与性别、年龄、吸烟、有无淋巴结转移及临床分期无关;HPV阳性组p53蛋白的表达显著高于HPV阴性组(OR=1.98;95%CI 1.46~2.67,P<0.001)。结论:HPV感染可能是中国肺癌患者的危险因素之一,与肺癌的发生及分化有关,且HPV感染相关性肺癌至少部分通过p53的突变来诱导其发生发展。
关键词:
人乳头瘤病毒
肺癌
p53
meta分析
Meta-analysis on association of human papillomavirus infection with clinicopathological features in Chinese lung cancer
CorrespondingAuthor: ZHENG Huixia Email: huixiazheng62@126.com
DOI: 10.3978/j.issn.2095-6959.2017.10.023
Abstract
Objective: To evaluate the relationship between human papillomavirus (HPV) infection and clinicopathological features of lung cancer patients in China by meta-analysis. Methods: The literatures were collected and retrieved in English literatures of PubMed and Chinese literatures of CBM, CNKI, Wanfang Medical Database before April 2017. Review Manager 5.3 was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Results: Nine studies contain 1 364 patients and 533 controls; subgroup analysis showed that HPV infection in lung cancer was higher than that in the control group of PCR using HPV16/18 specific primers (P<0.00001) and so was the group of PCR using universal primers (P=0.0002). However, there was statistical heterogeneity in subgroups (P=0.02; I2=82.6%); HPV infection was significantly correlated with the differentiation (OR =0.43; 95% CI 0.29–0.64; P<0.00001) and pathological type of lung cancer (OR =2.91; 95%CI 2.16–3.91; P<0.00001), but not correlated with sex, age, smoking, lymph node metastasis, and clinical stage; the expression of p53 protein in HPV positive group was significantly higher than that in HPV negative group(OR =1.98; 95% CI 1.46–2.67; P<0.00001). Conclusion: HPV infection may be one of the risk factors for lung cancer in China and it is correlated with the occurrence and differentiation of lung cancer. The development of HPV-associated lung cancer is partially induced by p53 mutations at least.
Keywords:
human papillomavirus
lung cancer
p53
meta-analysis