J Gynecol Oncol.  2020 Mar;31(2):e20. 10.3802/jgo.2020.31.e20.

Human papillomavirus (HPV) DNA detection in uterine cervix cancer after radiation indicating recurrence: a systematic review and meta-analysis

Affiliations
  • 1Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, India. sabeenauthradam@gmail.com
  • 2Gyneconcology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, India.
  • 3Department of Radiation Oncology, Government Medical College, Kozhikode, India.
  • 4Department of Statistics, Manipal Academy of Higher Education, Manipal, India.

Abstract


OBJECTIVE
The causal association of human papillomavirus (HPV) in uterine cervical cancer was well established and this oncogenic virus was reported to be a biomarker for overall recurrence and central pelvic recurrence. The objective of the present systematic review and meta-analysis was to assess the role of HPV DNA testing in early detection of recurrence among cervical cancer survivors after radiotherapy.
METHODS
We performed a systematic review and meta-analysis by means of searching electronic databases for published articles between January 1984 and June 2018, on the basis of standard systematic review guidelines prescribed by major agencies namely Cochrane Collaboration (https://www.cochrane.org) and Campbell Collaboration (https://www.campbellcollaboration.org). The meta-analysis component was further modified appropriately for the synthesis of sensitivity and specificity results.
RESULTS
A total of 1,055 cervical cancer cases who had received pelvic radiation with or without chemotherapy from ten cohort studies were evaluated. The overall pooled sensitivity and specificity of HPV DNA testing was 0.84 (95% confidence interval [CI]= 0.66-0.94) and 0.35 (95% CI=0.20-0.54) respectively. The positive likelihood ratio was 1.3 (95% CI=1.0-1.7) and the negative likelihood ratio was 0.45 (95% CI=0.18-1.10) with an estimated diagnostic odds ratio of 3 (95% CI=1-9).
CONCLUSION
The screening for HPV DNA testing during follow-up facilitates early detection of recurrence after radiotherapy.

Keyword

Human Papillomavirus; Recurrence; Radiotherapy, Uterine Cervical Cancer

MeSH Terms

Cervix Uteri*
Cohort Studies
Cooperative Behavior
DNA*
Drug Therapy
Female
Follow-Up Studies
Human Papillomavirus DNA Tests
Humans*
Mass Screening
Odds Ratio
Oncogenic Viruses
Radiotherapy
Recurrence*
Sensitivity and Specificity
Survivors
Uterine Cervical Neoplasms
DNA
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