A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix

被引:108
作者
Castle, Philip E. [1 ]
Pierz, Amanda [1 ]
Stoler, Mark H. [2 ]
机构
[1] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA
[2] Univ Virginia, Dept Pathol, Charlottesville, VA 22903 USA
关键词
Cervical cancer; Human papillomavirus (HPV); Cytology; Small cell neuroendocrine; Large cell neuroendocrine; SMALL-CELL CARCINOMA; POLYMERASE-CHAIN-REACTION; UTERINE CERVIX; INTRAEPITHELIAL NEOPLASIA; ENDOCERVICAL ADENOCARCINOMA; PROTEIN EXPRESSION; ENDOCRINE TUMORS; INCIDENCE TRENDS; YOUNG-WOMEN; DNA;
D O I
10.1016/j.ygyno.2017.12.001
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta analyses. Methods. PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. Results. For SCNC, 85% (95% confidence interval [95%CI]= 71%-94%) were HPV positive, 78% (95%CI = 64%-90%) were HPV16 and/or HPV18 positive, 51% (95%CI = 39%-64%) were singly HPV18 positive, and 10% (95%CI = 4%-19%) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93% were positive for p16(INK4a) by immunohistochemistry and 100% were HPV positive. For LCNC, 88% (95%CI = 72%-99%) were HPV positive, 86% (95%CI = 70%-98%) were positive for HPV16 or HPV18, 30% were singly HPV18 positive (95%CI = 4%60%), and 29% (95%CI = 2%-64%) were singly HPV16 positive. Conclusions. In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:422 / 429
页数:8
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