J Infect Dis：研究发现人乳头瘤病毒或诱发喉癌

根据中国的一项研究，一种通常被认为与宫颈癌存在关联的性传播病毒还会让患喉癌的风险增加四倍。

中国的研究人员综合了近20年来进行的5 5项研究的结果，发现28%的喉癌患者的癌变组织中人乳头瘤病毒(HPV)检测呈阳性。这一研究结果刊登在美国《传染病期刊》(The Journal of Infectious Diseases)上。

这项研究的负责人、来自中国医学科学院和北京大学医学部的李向伟(音)写道：“研究发现，感染HPV，特别是具有高致病风险的HPV-16会大大增加患上喉鳞状细胞癌的风险。”

研究人员除了对总体情况进行评估外，还分析了12项研究的结果，这些研究对比了630名患者的癌变组织与非癌变组织。结果发现，癌变的喉部组织HPV检测呈阳性的概率是非癌变的喉部组织的5.4倍。

并未参加此项研究的美国佛罗里达大学肿瘤学家威廉·门登霍尔说：“我们发现，HPV似乎与头、颈和喉部的一些鳞状细胞癌存在着联系。我认为HPV导致喉癌的风险可能相对较低。我们目前看到的喉癌患者大多有很长的吸烟史，而且饮酒量也大。”

除了烟草和酒精外，饮食不均衡及接触一些化学品也会增加患上喉癌和其他头颈部癌症的风险。

门登霍尔说，在所有头颈部癌症中，HPV作用最为明显的似乎并非喉癌，而是扁桃体癌和舌根癌。“病人可能是在几十年前感染病毒的。有些人在50岁患上舌根癌，他们可能早在十几或二十几岁时就感染了这种病毒。”

据美国疾病控制和预防中心说，至少半数性活跃人群会在人生的某个阶段感染HPV，不过这种病毒通常会被免疫系统清除。只有大约40多种HPV毒株与癌症有关联。

研究人员说，根据当前的研究，很难弄清最初所研究的喉癌患者中有多少人真的是因HPV而致病的。

doi: 10.1093/infdis/jis698
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Human Papillomavirus Infection and Laryngeal Cancer Risk: A systematic review and meta-analysis

Xiangwei Li1,#, Huijun Li2,#, Jing Gao2, Yu Yang1, Feng Zhou1, Cong Gao1,Mufei Li1, Qi Jin1,* and Lei Gao1,*

Background. Numbers of molecular epidemiological studies have been conducted to explore the association of human papillomavirus (HPV) infection with laryngeal cancer. However, the findings were heterogeneous.Methods. We systematically reviewed published studies on HPV infection and laryngeal cancer until 15 May 2012, and quantitatively summarized the prevalence of HPV infection and its association with the risk of laryngeal cancer by means of meta-analysis.Results. In total, 55 eligible studies were included. The overall HPV prevalence in laryngeal cancer tissues was 28.0% (95% confidence interval [CI], 23.5%-32.9%). There were 26.6% laryngeal cancer patients were infected with high-risk types only, and HPV-16 was most frequently observed with a prevalence of 19.8% (95% CI, 15.7%-24.6%). The meta-analysis based on 12 eligible case-control studies suggests a strong association between HPV infection and laryngeal squamous cell carcinoma with a summarized odds ratio (OR) of 5.39 (95% CI, 3.25-8.94). Different magnitude of the association was observed for HPV-16 (OR=6.07, 95% CI: 3.44-10.70) and HPV-18 (OR=4.16, 95% CI: 0.87-20.04) (p<0.01). Stratified analyses were performed with respect to HPV genotypes and characteristics of the study population.Conclusions. HPV infection, especially high-risk type HPV-16, was found to be significantly associated with the risk of laryngeal squamous cell carcinoma.