Abstract：
OBJECTIVE: High-risk human papillomaviruses (HPV) are an established cause of oropharyngeal cancer. Their relationship with oral cancer remains unclear with detection ranging from 0% to 100%. HPV DNA detection or evidence of exposure alone is insufficient to conclude causality. This systematic review assesses the extent of bias in studies of HPV detection in cancers of the oral cavity.
METHODS: PubMed, Ovid MEDLINE, EMBASE, and PsycInfo databases were searched for observational studies reporting the effect of HPV in oral cavity specific cancers.
RESULTS: All 15 included studies presented HPV DNA detection or serum HPV-antibodies, none included mRNA E6/E7 analysis. Cases with oral cancer had 5.36 times (95% CI 3.29-8.72) higher odds of having HPV detected compared to controls. The odds of HPV detection were higher in cell-based (OR 6.93; 95% CI 0.82-58.55) and tissue samples (OR 5.28; 95% CI 3.41-8.18) than blood-based samples (OR 3.36; 95% CI 1.53-7.40).
CONCLUSIONS: When cancer site is clearly differentiated between oropharynx and oral cavity, 12 studies showed strong association between HPV and oral cancer, but the available estimates lack internal validity due to inconsistent measurements, high confounding, and lack of gold standard testing. There is not high-quality evidence to conclude a causal relationship of HPV with oral cancer.
METHODS: PubMed, Ovid MEDLINE, EMBASE, and PsycInfo databases were searched for observational studies reporting the effect of HPV in oral cavity specific cancers.
RESULTS: All 15 included studies presented HPV DNA detection or serum HPV-antibodies, none included mRNA E6/E7 analysis. Cases with oral cancer had 5.36 times (95% CI 3.29-8.72) higher odds of having HPV detected compared to controls. The odds of HPV detection were higher in cell-based (OR 6.93; 95% CI 0.82-58.55) and tissue samples (OR 5.28; 95% CI 3.41-8.18) than blood-based samples (OR 3.36; 95% CI 1.53-7.40).
CONCLUSIONS: When cancer site is clearly differentiated between oropharynx and oral cavity, 12 studies showed strong association between HPV and oral cancer, but the available estimates lack internal validity due to inconsistent measurements, high confounding, and lack of gold standard testing. There is not high-quality evidence to conclude a causal relationship of HPV with oral cancer.
摘要：
目的：高危型人乳头瘤病毒（HPV）是口咽癌的确定原因。它们与口腔癌的关系尚不清楚，检测范围为0％至100％。HPVDNA检测或单独暴露的证据不足以得出结论因果关系。本系统综述评估了口腔癌中HPV检测研究中的偏倚程度。
方法：PubMed，OvidMEDLINE,EMBASE,在PsycInfo数据库中搜索了报告HPV在口腔特异性癌症中的作用的观察性研究。
结果：所有15项纳入的研究均显示HPVDNA检测或血清HPV抗体，无mRNAE6/E7分析。与对照组相比，口腔癌患者检测到HPV的几率是对照组的5.36倍（95％CI3.29-8.72）。基于细胞的样本（OR6.93;95％CI0.82-58.55）和组织样本（OR5.28;95％CI3.41-8.18）的HPV检测几率高于基于血液的样本（OR3.36;95％CI1.53-7.40）。
结论：当癌症部位在口咽和口腔之间有明显区别时，12项研究显示HPV与口腔癌之间有很强的关联，但是由于测量不一致，现有的估计缺乏内部有效性，高度混杂，缺乏黄金标准测试。没有高质量的证据来推断HPV与口腔癌的因果关系。
方法：PubMed，OvidMEDLINE,EMBASE,在PsycInfo数据库中搜索了报告HPV在口腔特异性癌症中的作用的观察性研究。
结果：所有15项纳入的研究均显示HPVDNA检测或血清HPV抗体，无mRNAE6/E7分析。与对照组相比，口腔癌患者检测到HPV的几率是对照组的5.36倍（95％CI3.29-8.72）。基于细胞的样本（OR6.93;95％CI0.82-58.55）和组织样本（OR5.28;95％CI3.41-8.18）的HPV检测几率高于基于血液的样本（OR3.36;95％CI1.53-7.40）。
结论：当癌症部位在口咽和口腔之间有明显区别时，12项研究显示HPV与口腔癌之间有很强的关联，但是由于测量不一致，现有的估计缺乏内部有效性，高度混杂，缺乏黄金标准测试。没有高质量的证据来推断HPV与口腔癌的因果关系。
