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Human papillomavirus as a potential risk factor for gastric cancer: a meta-analysis of 1,917 cases

Authors Zeng ZM, Luo FF, Zou LX, He RQ, Pan DH, Chen X, Xie TT, Li YQ, Peng ZG, Chen G

Received 15 June 2016

Accepted for publication 14 September 2016

Published 17 November 2016 Volume 2016:9 Pages 7105—7114


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 4

Editor who approved publication: Dr Ingrid Espinoza

Zhi-ming Zeng,1 Fei-fei Luo,2 Lin-xia Zou,3 Rong-quan He,1 Deng-hua Pan,2 Xin Chen,2 Ting-ting Xie,2 Yuan-qing Li,2 Zhi-gang Peng,1 Gang Chen2

1Department of Medical Oncology, 2Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, 3Department of Children Rehabilitation Medicine, Guangxi Maternal and Child Health Hospital, Nanning, China

Background: Human papillomaviruses (HPVs) are causally associated with the tumorigenesis of several classes of cancers. However, the prevalence of HPV in gastric cancer (GC) has not yet been systematically reviewed. Hence, a meta-analysis was conducted to estimate the HPV prevalence in patients with GC, and its potential etiologic significance was assessed.
Methods: The pooled HPV prevalence and 95% confidence intervals (CIs) were estimated among all GC patients. Heterogeneity was described by using the I2 statistic. Sources of heterogeneity were explored by meta-regression and stratified analyses. The meta-influence was applied to evaluate the influence of a single study on the pooled estimates. Odds ratios (ORs) and 95% CIs were computed for case–control studies. For research providing clinicopathological parameters of age, sex, pathological, differentiated, and clinical stages, and HPV subtypes, the corresponding pooled ORs and 95% CIs were also calculated.
Results: Thirty studies were included in the current meta-analysis, involving 1,917 patients with GC and 576 controls. The pooled HPV prevalence was 28.0% (95% CI: 23.2%, 32.7%) among all the patients with GC, and the I2 was 96.9% (P<0.001). A pooled OR of 7.388 (95% CI: 3.876, 14.082) was achieved based on 15 case–control studies (I2=56.7%, P=0.004). Moreover, the HPV prevalence was significantly higher in patients from China than in those from non-Chinese regions (31% vs 9%, I2=95.0%, P<0.001). The pooled prevalence of HPV16 was 21% in GC tissues, and the pooled prevalence of HPV18 was 7% with an OR of 3.314 (95% CI =1.617, 6.792). HPV16 was 3 times more frequently detected than HPV18.
HPV could play a potential role in the pathogenesis of GC. A causal relationship can be confirmed only by detecting HPV in the cells of GC precursor lesions (gastric dysplasia or adenoma). In addition, this study might be beneficial for expounding the potential etiologic significance of molecular mechanism of gastric tumorigenesis and providing opinions regarding precautionary measures.

Keywords: gastric dysplasia, gastric adenoma, gastric tumorigenesis, odds ratios, prevalence, subtypes

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