Prevalence of human papillomavirus and its prognostic value in vulvar cancer: A systematic review and meta-analysis

The purpose of this study was to estimate the prevalence of human papillomavirus (HPV) in vulvar cancer and determine whether positive HPV in vulvar cancer was associated with a better prognosis. Literature searches of Ovid EMBASE, PubMed, Web of Science and Cochrane Library were performed to identify related studies published from January 2000 to May 2017. A total of 33 studies including 7,721 subjects were selected in this meta-analysis. Overall, the HPV prevalence in vulvar cancer tissue was 34% (95% CI: 28%-39%) with 45% (95% CI: 28%-64%) in Asian populations and 34% (95% CI: 26%-42%) in Caucasian populations. The HPV-positive vulvar cancer was associated with better overall survival (hazard ratio = 0.64, 95% CI: 0.47–0.87; P = 0.004) and recurrence-free survival (hazard ratio = 0.66, 95% CI: 0.45–0.97; P = 0.03) compared with HPV-negative counterpart. HPV status may play an important role in predicting the prognosis of patients with vulvar cancer. The HPV-positive vulvar cancer women might relatively have a better survival than HPV-negative ones.

本研究旨在评估外阴癌中人乳头瘤病毒（human papillomavirus, HPV）的流行率，并明确外阴癌HPV阳性是否与更佳预后相关。研究通过检索Ovid EMBASE、PubMed、Web of Science及Cochrane图书馆，筛选2000年1月至2017年5月发表的相关文献。本次荟萃分析共纳入33项研究，涉及7721名研究对象。总体而言，外阴癌组织中HPV的检出率为34%（95%置信区间：28%~39%）；其中亚洲人群的HPV检出率为45%（95%置信区间：28%~64%），高加索人群为34%（95%置信区间：26%~42%）。与HPV阴性的外阴癌患者相比，HPV阳性患者的总生存期更优（风险比=0.64，95%置信区间：0.47~0.87；P=0.004），无复发生存期亦更优（风险比=0.66，95%置信区间：0.45~0.97；P=0.03）。HPV状态可能在外阴癌患者的预后预测中发挥重要作用，HPV阳性的外阴癌女性患者相较HPV阴性者，或可获得更优的生存结局。