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Meta-Analysis
. 2025 Apr;172(4):1155-1163.
doi: 10.1002/ohn.1108. Epub 2024 Dec 31.

Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta-Analysis

Fayssal Alqudrah  1 , Sharwani Kota  1 , Jason Morgan  1 , Phillip R Purnell  1 , Justin P McCormick  1
Affiliations
Meta-Analysis

Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta-Analysis

Fayssal Alqudrah et al. Otolaryngol Head Neck Surg. 2025 Apr.

Abstract

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.

Keywords: human papillomavirus; inverted papilloma; meta‐analysis; recurrence; sinonasal tumor.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Meta‐analysis study selection flowchart diagram.
Figure 2
Figure 2
Forest plot including all HPV subtypes tumor recurrences as being positive for HPV. Effect size is listed as log‐OR. No rec, nonrecurrent tumor; Rec, recurrent tumor.
Figure 3
Figure 3
Funnel plot with Egger test performed to assess for small‐study effect on publication bias.
Figure 4
Figure 4
Forest plot including only recurrences in tumors positive for low‐risk HPV subtypes as being positive for HPV. Effect size listed as log‐OR. No rec, nonrecurrent tumor; Rec, recurrent tumor.
Figure 5
Figure 5
Forest plot including only recurrences in tumors positive for high‐risk HPV subtypes as being positive for HPV. Effect size listed as log‐OR. No rec, nonrecurrent tumor; Rec, recurrent tumor.
See this image and copyright information in PMC

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