论文部分内容阅读
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Pub Med,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=8 2.6%);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<0.0 0 1)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。
Objective: To evaluate the relationship between human papillomavirus (HPV) infection and clinicopathological features of lung cancer in China by Meta-analysis. Methods: The English and Chinese literatures which were collected in databases such as Pub Med, CBM, CNKI and Wanfang Medical Database before April 2017 were searched. The documents were screened and extracted according to inclusion and exclusion criteria. OR and 95% CI were used as Effect, the use of Review Manager5.3 software Meta analysis. Results: 9 literatures were included in the literature, with a total of 1 364 cases of lung cancer and 533 cases of normal control group. The subgroup analysis showed that HPV16 / 18 specific primers were used to detect the HPV group (P <0.001) (P = 0.0002). The HPV infection in lung cancer was higher than that of the normal control group. Although the results of the two subgroups were consistent, there was statistical heterogeneity among the groups (P = 0.02, I2 (OR = 0.43; 95% CI 0.29-0.64; P <0.001) and pathological type (OR = 2.91; 95% CI 2.16-3.91, P <0.0 01) HPV infection was not associated with gender, age, smoking, lymph node metastasis and clinical stage; the HPV infection rate was higher in squamous cell carcinoma than in adenocarcinoma; 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 <0.001). Conclusion: HPV infection may be one of the risk factors of lung cancer in Chinese patients, which is related to the occurrence and differentiation of lung cancer. HPV-associated lung cancer induces its development by p53 mutation at least partly.