Role of High‐Risk HPV Detected by PCR in Malignant Sinonasal Inverted Papilloma: A Meta‐Analysis
Justin P. McCormick, Jeffrey D. Suh, Jivianne T. Lee, Christine R. Wells, Marilene B. Wang
Abstract
Introduction Prior studies suggest that there may be a link between human papillomavirus (HPV) infection and malignant sinonasal inverted papilloma (SNIP). This systematic review and meta‐analysis was performed to further evaluate this potential association. Study design Systematic review with meta‐analysis. Methods The Medline and Embase databases were used to identify case–control studies reporting the risk of malignant SNIP in patients with high‐risk HPV subtypes identified by polymerase chain reaction (PCR). Meta‐analysis was performed to determine pooled odds ratios (ORs) and 95% confidence intervals (CI). Results Twenty‐one studies were identified, including a total of 841 subjects with SNIP. Seventeen studies were included in the final analysis, as four studies did not have any HPV‐positive tumors in either group. A total of 56 malignant SNIP and 551 benign SNIP were ultimately identified. The pooled log‐OR was 1.80 (95% CI: 1.03–2.57) for all high‐risk HPV subtypes. Stratification by high‐risk HPV subtype showed a log‐OR of 1.67 (95% CI: 0.88–2.46) for HPV‐16 and log‐OR of 2.68 (95% CI: 1.30–4.05) for HPV‐18. Conclusion Infection with high‐risk HPV subtypes may be associated with an increased risk of malignant SNIP. HPV‐18 showed the greatest overall average effect size of the common high‐risk subtypes. Level of Evidence NA Laryngoscope , 132:926–932, 2022