Korean J Urol.  2012 Apr;53(4):240-247.

Meta-Analysis of Studies Analyzing the Role of Human Papillomavirus in the Development of Bladder Carcinoma

• Jimenez-Pacheco A
• Exposito-Ruiz M
• Arrabal-Polo MA
• Lopez-Luque AJ

Abstract

PURPOSE
We aimed to ascertain the degree of association between bladder cancer and human papillomavirus (HPV) infection.
MATERIALS AND METHODS
We performed a meta-analysis of observational studies with cases and controls with publication dates up to January 2011. The PubMed electronic database was searched by using the key words "bladder cancer and virus." Twenty-one articles were selected that met the required methodological criteria. We implemented an internal quality control system to verify the selected search method. We analyzed the pooled effect of all the studies and also analyzed the techniques used as follows: 1) studies with DNA-based techniques, among which we found studies with polymerase chain reaction (PCR)-based techniques and 2) studies with non-PCR-based techniques, and studies with non-DNA-based techniques.
RESULTS
Taking into account the 21 studies that were included in the meta-analysis, we obtained a heterogeneity chi-squared value of Qexp=26.45 (p=0.383). The pooled odds ratio (OR) was 2.13 (95% confidence interval [CI], 1.54 to 2.95), which points to a significant effect between HPV and bladder cancer. Twenty studies assessed the presence of DNA. The overall effect showed a significant relationship between virus presence and bladder cancer, with a pooled OR of 2.19 (95% CI, 1.40 to 3.43). Of the other six studies, four examined the virus's capsid antigen and two detected antibodies in serum by Western blot. The estimated pooled OR in this group was 2.11 (95% CI, 1.27 to 3.51), which confirmed the relationship between the presence of virus and cancer.
CONCLUSIONS
The pooled OR value showed a moderate relationship between viral infection and bladder tumors.

Keyword

Human papillomavirus; Infection; Meta-analysis; Urinary bladder neoplasms; Viruses

MeSH Terms

Antibodies
Blotting, Western
Capsid
Chronology as Topic
DNA
Electronics
Electrons
Humans
Odds Ratio
Polymerase Chain Reaction
Population Characteristics
Publications
Quality Control
Urinary Bladder
Urinary Bladder Neoplasms
Viruses
Antibodies
DNA

Figure

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  FIG. 1 Meta-analysis of all included studies.

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  FIG. 2 Funnel Plot of all included studies.

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  FIG. 3 Meta-analysis of the studies that used DNA-based techniques.

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  FIG. 4 Meta-analysis of studies that used PCR-based techniques.

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  FIG. 5 Meta-analysis of studies that used non-PCR-based techniques.

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  FIG. 6 Meta-analysis of studies that used non-DNA-based techniques.

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