The interplay of dietary mycotoxins and oncogenic viruses toward human carcinogenesis: a scoping review

Mycotoxins, fungal metabolites prevalent in many foods, are recognized for their role in carcinogenesis, especially when interacting with oncogenic viruses. This scoping review synthesizes current evidence on the human cancer risk associated with mycotoxin exposure and oncogenic virus infections. Searches were conducted on PubMed, Embase, and Web of Science. Studies were selected based on the PECOS framework. Data extraction involved narrative and qualitative presentation of findings, with meta-analysis where feasible. Risk of bias and outcome quality were assessed using the OHAT tool and GRADE approach. From 25 included studies, 18 focused on aflatoxins and hepatitis viruses in hepatocellular carcinoma (HCC). Four studies examined aflatoxin B1 (AFB1) and human papilloma virus (HPV) in cervical cancer, while three investigated AFB1 with Epstein-Barr virus (EBV) in lymphomagenesis. The review highlights a significant synergistic effect between AFB1 and hepatitis B and C viruses in HCC development. Significant interactions between AFB1 and HPV, as well as AFB1 and EBV, were observed, but further research is needed. The synergistic impact of mycotoxins and oncogenic viruses is a critical public health concern. Future research, especially prospective cohort studies and investigations into molecular mechanisms, is essential to address this complex issue.真菌毒素（Mycotoxins）是普遍存在于多种食品中的真菌代谢产物，其在致癌过程中的作用已获广泛认可，尤其当与致癌病毒发生协同作用时。本范围综述（scoping review）系统整合了当前关于真菌毒素暴露与致癌病毒感染相关的人类癌症风险的研究证据。 研究检索覆盖PubMed、Embase及Web of Science三大数据库，基于PECOS框架筛选纳入研究。数据提取环节采用叙述性与定性方式呈现研究结果，并在条件允许的情况下开展荟萃分析（meta-analysis）；偏倚风险与结局质量分别采用OHAT工具（OHAT tool）与GRADE方法（GRADE approach）进行评估。 本次纳入的25项研究中，18项聚焦于黄曲霉毒素（aflatoxins）与肝炎病毒在肝细胞癌（HCC）发生中的作用；4项研究探讨了黄曲霉毒素B1（AFB1）与人类乳头瘤病毒（HPV）在宫颈癌发生中的关联；另有3项研究考察了AFB1与EB病毒（EBV）在淋巴瘤发生中的作用。 本综述显示，AFB1与乙型、丙型肝炎病毒在肝细胞癌发生过程中存在显著协同效应；同时观察到AFB1分别与HPV、EBV之间存在显著交互作用，但仍需开展更多相关研究予以验证。真菌毒素与致癌病毒的协同影响是一项至关重要的公共卫生议题，未来的研究——尤其是前瞻性队列研究与分子机制探索——对于破解这一复杂问题至关重要。