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Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta-Analysis
Fayssal Alqudrah1, Sharwani Kota1, Jason Morgan1
1Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Objective:
Prior studies have been contradictory on the role of human papillomavirus (HPV) infection in sinonasal inverted papilloma (SNIP) recurrence. This systematic review and meta-analysis was performed to further evaluate this potential association.
Data Sources:
PubMed, Embase, and Scopus electronic databases.
Review Methods:
Case-control studies reporting SNIP recurrence data and HPV status identified by polymerase chain reaction (PCR) and in-situ hybridization (ISH). Meta-analysis was performed to determine pooled odds ratios (ORs) and 95% confidence intervals (CI).
Results:
25 studies were identified including a total of 1116 benign SNIP tumors. A total of 267 SNIP were HPV+, 103 of which were recurrent, and 849 SNIP were HPV-, with 231 being recurrent. The pooled standard OR for recurrence in HPV+ tumors was 2.05 (95% CI: 1.31-3.19). Stratification by low-risk and high-risk HPV subtypes were not statistically significant. The standard OR for SNIP recurrence in low-risk and high-risk HPV+ subtypes were 1.57 (95% CI: 0.98-2.54) and 1.67 (95% CI: 0.98-2.80), respectively.
Conclusion:
Infection with HPV may be associated with an increased risk of SNIP recurrence. This increased risk seems to be independent of HPV subtype based on low-risk or high-risk status. However, this correlation was variable among recently published studies requiring additional investigation.
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