背景:宫颈癌(CC)是全世界女性中最常见的妇科肿瘤之一。尽管人乳头瘤病毒(HPV)在CC中的病因学作用已得到证实,CC癌变的其他因素尚不清楚.这里,我们进行了系统评价和荟萃分析,以探讨人类疱疹病毒(HHVs)感染与CC风险之间的关系.
方法:利用Embase和PubMed数据库检索相关研究。修订后的JBI关键评估工具用于评估纳入研究的质量。计算患病率和比值比(ORs)和95%置信区间(CI),以评估病毒感染与CC或癌前宫颈病变(PCL)之间的关联。
结果:共有67项符合条件的研究纳入荟萃分析,涉及7种不同的HHV。我们发现CC或PCL的风险增加,这与HHV的整体感染有关(CC,OR=2.74,95%CI2.13-3.53;PCL,OR=1.95,95%CI1.58-2.41)。亚组分析显示2型单纯疱疹病毒(HSV-2)感染与CC(OR=3.01,95%CI2.24至4.04)或PCL(OR=2.14,95%CI1.55至2.96)之间呈正相关。EB病毒(EBV)感染与CC(OR=4.89,95%CI2.18至10.96)或PCL(OR=3.55,95%CI2.52至5.00)之间也是如此。然而,对于HSV-1和巨细胞病毒(HCMV),病毒感染与CC或PCL无相关性.相比之下,由于研究数量有限,HHV-6,HHV-7和卡波西肉瘤相关疱疹病毒(KSHV)在宫颈病变中的作用尚不清楚.
结论:这项研究提供了证据,表明HHV感染作为一个整体会增加CC发病率的风险。此外,某些类型的HHV,如EBV和HSV-2,可能成为宫颈病变新干预措施或治疗策略开发的潜在靶点.
Cervical cancer (CC) is one of the most common gynecologic tumors among women around the world. Although the etiological role of human papillomavirus (HPV) in CC is well established, other factors in CC carcinogenesis remains unclear. Here, we performed a systematic review and meta-analysis to explore the association between infections of human herpesvirus (HHVs) and CC risk.
Embase and PubMed databases were utilized to search the relevant studies. The revised JBI Critical Appraisal Tool was used to assess the quality of the included studies. Prevalence and odds ratios (ORs) with 95% confidence intervals (CI) were calculated to evaluate the association between viral infection and CC or precancerous cervical lesions (PCL).
Totally 67 eligible studies involving 7 different HHVs were included in meta-analysis. We found an increased risk of CC or PCL that was associated with the overall infection of HHVs (CC, OR = 2.74, 95% CI 2.13-3.53; PCL, OR = 1.95, 95% CI 1.58-2.41). Subgroup analysis showed a trend towards positive correlations between herpes simplex virus type 2 (HSV-2) infection and CC (OR = 3.01, 95% CI 2.24 to 4.04) or PCL (OR = 2.14, 95% CI 1.55 to 2.96), and the same is true between Epstein-Barr virus (EBV) infection and CC (OR = 4.89, 95% CI 2.18 to 10.96) or PCL (OR = 3.55, 95% CI 2.52 to 5.00). However, for HSV-1 and cytomegalovirus (HCMV), there was no association between viral infection and CC or PCL. By contrast, the roles of HHV-6, HHV-7, and Kaposi sarcoma-associated herpesvirus (KSHV) in cervical lesions were unclear due to the limited number of studies.
This study provided evidence that HHVs infection as a whole increase the risk of CC incidence. In addition, some types of HHVs such as EBV and HSV-2 may serve as potential targets in the development of new interventions or therapeutic strategies for cervical lesions.