Human Papillomavirus Infection as a Risk Factor for Oral Leukoplakia: A Systematic Review and Meta-Analysis

IF 3.7 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

International dental journal Pub Date : 2025-10-18 DOI:10.1016/j.identj.2025.103944

Joud Taha , Sajesh K. Veettil , Swagatika Panda , Divya Gopinath

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引用次数: 0

Abstract

Background

The correlation between human papillomavirus (HPV) infection and cervical neoplasia has been well documented. Nonetheless, its correlation with the progression of oral cancer and oral leukoplakia (OL) remains contentious. We aimed to conduct a comprehensive meta-analysis to examine the most recent evidence on the association between HPV infection and OL.

Methods

The protocol was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocol, INPLASY (INPLASY202540033) and complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA 2020 requirements. A systematic literature review was performed using the electronic databases PubMed, Scopus and Wiley Library without any date or time restrictions to identify observational studies that documented any association between HPV and OL. A pooled odds ratio (OR) estimate and its associated 95% confidence interval (CI) were calculated utilising the random effects model. The I² statistic and Cochran's Q test were used to evaluate heterogeneity among studies. Sensitivity analysis and credibility ceiling tests were conducted to assess the robustness of the findings.

Results

The database search retrieved 1716 articles, out of which 32 articles were selected for final analysis, meeting the inclusion criteria. The overall pooled OR and the corresponding 95% CI, estimated from a total of 1236 cases and 2916 controls in a random-effects model, demonstrated a positive association between HPV detection in OL (OR = 3.16; 95% CI, 2.06-4.95). OL was more strongly associated with high-risk HPV than low-risk HPV (OR = 5.42; 95% CI, 2.52-11.69 and OR = 1.90; 95% CI, 1.10-3.29, respectively). The sensitivity analysis and credibility ceiling test validated the robustness of the finding.

Conclusion

Oral HPV infection, especially with high-risk HPV, is significantly associated with OL. Further prospective trials are encouraged to validate these results and elucidate the exact role of HPV in OL.

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人乳头瘤病毒感染是口腔白斑的危险因素：一项系统综述和荟萃分析。

背景：人乳头瘤病毒（HPV）感染与宫颈肿瘤之间的关系已被充分证实。尽管如此，其与口腔癌和口腔白斑（OL）进展的相关性仍存在争议。我们的目的是进行一项全面的荟萃分析，以检查HPV感染与OL之间关系的最新证据。方法：该方案已在国际注册系统评价和荟萃分析方案平台INPLASY （INPLASY202540033）注册，并符合PRISMA 2020系统评价和荟萃分析首选报告项目的要求。在没有任何日期或时间限制的情况下，使用PubMed、Scopus和Wiley图书馆的电子数据库进行了系统的文献综述，以确定记录HPV和OL之间任何关联的观察性研究。利用随机效应模型计算合并优势比（OR）估计值及其相关的95%置信区间（CI）。采用I2统计量和Cochran’s Q检验评价各研究间的异质性。进行敏感性分析和可信度上限测试以评估研究结果的稳健性。结果：数据库检索到1716篇文章，最终选择32篇文章进行分析，符合纳入标准。在随机效应模型中，从总共1236例病例和2916例对照中估计的总体汇总OR和相应的95% CI显示OL中HPV检测呈正相关（OR = 3.16; 95% CI, 2.06-4.95）。OL与高危HPV的相关性高于低危HPV （OR = 5.42; 95% CI, 2.52-11.69; OR = 1.90; 95% CI, 1.10-3.29）。敏感性分析和可信度上限检验验证了研究结果的稳健性。结论：口腔HPV感染，特别是高危HPV感染与OL有显著相关性。鼓励进一步的前瞻性试验来验证这些结果并阐明HPV在OL中的确切作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International dental journal 医学-牙科与口腔外科

CiteScore

4.80

自引率

6.10%

发文量

159

审稿时长

63 days

期刊介绍： The International Dental Journal features peer-reviewed, scientific articles relevant to international oral health issues, as well as practical, informative articles aimed at clinicians.