A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix

Philip E. Castle, Amanda Pierz, Mark H. Stoler

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta-analyses. Methods: PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. Results: For SCNC, 85% (95% confidence interval [95%CI]=71%-94%) were HPV positive, 78% (95%CI=64%-90%) were HPV16 and/or HPV18 positive, 51% (95%CI=39%-64%) were singly HPV18 positive, and 10% (95%CI=4%-19%) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93% were positive for p16INK4a by immunohistochemistry and 100% were HPV positive. For LCNC, 88% (95%CI=72%-99%) were HPV positive, 86% (95%CI=70%-98%) were positive for HPV16 or HPV18, 30% were singly HPV18 positive (95%CI=4%-60%), and 29% (95%CI=2%-64%) were singly HPV16 positive. Conclusions: In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines.

Original languageEnglish (US)
JournalGynecologic Oncology
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Neuroendocrine Carcinoma
Uterine Cervical Neoplasms
Meta-Analysis
Small Cell Carcinoma
Large Cell Carcinoma
Confidence Intervals
Papillomavirus Vaccines
Papillomavirus Infections
PubMed
Cervix Uteri
Uncertainty

Keywords

  • Cervical cancer
  • Cytology
  • Human papillomavirus (HPV)
  • Large cell neuroendocrine
  • Small cell neuroendocrine

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

@article{407788cad8aa41a29fb1b7593e4d0d57,
title = "A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix",
abstract = "Background: There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta-analyses. Methods: PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. Results: For SCNC, 85{\%} (95{\%} confidence interval [95{\%}CI]=71{\%}-94{\%}) were HPV positive, 78{\%} (95{\%}CI=64{\%}-90{\%}) were HPV16 and/or HPV18 positive, 51{\%} (95{\%}CI=39{\%}-64{\%}) were singly HPV18 positive, and 10{\%} (95{\%}CI=4{\%}-19{\%}) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93{\%} were positive for p16INK4a by immunohistochemistry and 100{\%} were HPV positive. For LCNC, 88{\%} (95{\%}CI=72{\%}-99{\%}) were HPV positive, 86{\%} (95{\%}CI=70{\%}-98{\%}) were positive for HPV16 or HPV18, 30{\%} were singly HPV18 positive (95{\%}CI=4{\%}-60{\%}), and 29{\%} (95{\%}CI=2{\%}-64{\%}) were singly HPV16 positive. Conclusions: In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines.",
keywords = "Cervical cancer, Cytology, Human papillomavirus (HPV), Large cell neuroendocrine, Small cell neuroendocrine",
author = "Castle, {Philip E.} and Amanda Pierz and Stoler, {Mark H.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.ygyno.2017.12.001",
language = "English (US)",
journal = "Gynecologic Oncology",
issn = "0090-8258",
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TY - JOUR

T1 - A systematic review and meta-analysis on the attribution of human papillomavirus (HPV) in neuroendocrine cancers of the cervix

AU - Castle, Philip E.

AU - Pierz, Amanda

AU - Stoler, Mark H.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta-analyses. Methods: PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. Results: For SCNC, 85% (95% confidence interval [95%CI]=71%-94%) were HPV positive, 78% (95%CI=64%-90%) were HPV16 and/or HPV18 positive, 51% (95%CI=39%-64%) were singly HPV18 positive, and 10% (95%CI=4%-19%) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93% were positive for p16INK4a by immunohistochemistry and 100% were HPV positive. For LCNC, 88% (95%CI=72%-99%) were HPV positive, 86% (95%CI=70%-98%) were positive for HPV16 or HPV18, 30% were singly HPV18 positive (95%CI=4%-60%), and 29% (95%CI=2%-64%) were singly HPV16 positive. Conclusions: In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines.

AB - Background: There remains uncertainty about the role of human papillomavirus (HPV) infection in causing small-cell neuroendocrine carcinoma (SCNC) and large-cell neuroendocrine carcinoma (LCNC) of the cervix. To clarify the role of HPV in the development of SCNC and LCNC, we conducted a systematic review and meta-analyses. Methods: PubMed and Embase were searched to initially identify 143 articles published on or before June 1, 2017. Studies were limited to methods that tested for HPV in the cancer tissue directly to minimize misattribution. Thirty-two studies with 403 SCNC and 9 studies of 45 LCNC were included in the analysis. Results: For SCNC, 85% (95% confidence interval [95%CI]=71%-94%) were HPV positive, 78% (95%CI=64%-90%) were HPV16 and/or HPV18 positive, 51% (95%CI=39%-64%) were singly HPV18 positive, and 10% (95%CI=4%-19%) were singly HPV16 positive. In a subset of 5 SCNC studies (75 cases), 93% were positive for p16INK4a by immunohistochemistry and 100% were HPV positive. For LCNC, 88% (95%CI=72%-99%) were HPV positive, 86% (95%CI=70%-98%) were positive for HPV16 or HPV18, 30% were singly HPV18 positive (95%CI=4%-60%), and 29% (95%CI=2%-64%) were singly HPV16 positive. Conclusions: In conclusion, most SCNC and LCNC are caused by HPV, primarily HPV18 and HPV16. Therefore, most if not all SCNC and LCNC will be prevented by currently available prophylactic HPV vaccines.

KW - Cervical cancer

KW - Cytology

KW - Human papillomavirus (HPV)

KW - Large cell neuroendocrine

KW - Small cell neuroendocrine

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U2 - 10.1016/j.ygyno.2017.12.001

DO - 10.1016/j.ygyno.2017.12.001

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JO - Gynecologic Oncology

JF - Gynecologic Oncology

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