The Role of the Human Papillomavirus in the Pathogenesis of Schneiderian Inverted Papillomas: An Analytic Overview of the Evidence

摘要: Background Evidence of an etiological role for human papillomavirus (HPV) in Schneiderian inverted papillomas IP arose the late 1980’s; yet almost three decades later, association between HPV and has to be universally accepted. This is probably due disparate detection rates reported literature. We analyzed weight published data order address following questions: why do vary so greatly? What relationship low-risk (LR) high-risk (HR) types IP? Is there a presence type recurrence malignant progression? Materials methods A search using Pubmed engine was performed identify studies English from 01/87 through 12/06 MeSH terms ‘‘HPV’’ ‘‘Inverted”, “Exophytic”, “Oncocytic Schneiderian” or “Fungiform papilloma’’. Data abstracted publications including histology, target, type, method detection, etc. results were stratified by histology other variables. Tests heterogeneity (between-study variability) conducted, weighted prevalence (WP) estimates 95% confidence intervals (CI) calculated random-effects inverse-variance model on study. The estimated odds ratio (OR). Results Weighted revealed similar across methods, 26.8% (95%CI 16.4–37.2%) ISH, 25.2% 14.7–35.6%) consensus PCR, 23.6% 12.2–35.0%) type-specific PCR. preponderance 6/11 found as compared 16/18; overall unadjusted LR HR 2.8:1 significantly increase (Wald t-test P < 0.02) IPs with high-grade dysplasia (WP 55.8%, 95%CI 30.5-81.0%) carcinoma 55.1%, 37.0–73.2%) no mild 22.3%, 15.9–28.6%). Furthermore, benign (ratio LR/HR = 4.8:1) shifts dysplastic IP. 1.1:1 dysplasias, this favor (1:2.4) Recurrences developed 44 236 patients; detected 27 57.9%, 31.6–84.2%) that recurrences 24 192 9.7%, 4.4–15.0%) did not develop recurrence. associated likelihood developing (weighted OR 10.2, 3.2–32.8). Conclusions hypothesize may induce formation, then are lost infected cells shed, “hit run” phenomenon. SCC-ex-IP increasing types, nondysplastic believe one explanation variation different actual histologic composition cohort. That is, if series contains higher frequency IP, it have rate than another which only related integration. implication sub-type testing patients at risk recurrence, progression malignancy, thus impact surveillance protocols.