Human Papillomavirus and Thyroid Cancer: Transformative Insights Into Postoperative Interventions and Sleep Quality Improvement: A Comprehensive Meta-Analysis
Notice bibliographique
Résumé
Context: Human papillomavirus (HPV) is a well-established oncogenic virus implicated in cervical, oropharyngeal, and anogenital malignancies. Emerging evidence suggests its potential role in thyroid cancer pathogenesis. Patients with thyroid cancer frequently experience obstructive sleep apnea (OSA), which may be exacerbated by thyroid dysfunction. Thyroidectomy has been reported to improve sleep quality; however, the interplay between HPV infection, thyroid cancer progression, and postoperative sleep improvements remains inadequately understood. This meta-analysis systematically evaluates the impact of thyroidectomy on sleep parameters in thyroid cancer patients, with a specific focus on those affected by HPV. Objectives: To quantify the effects of thyroidectomy on sleep quality in patients with thyroid cancer, particularly those with HPV infection. This study assesses improvements in key OSA indicators, including the Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), and nocturnal oxygen saturation, while elucidating the clinical implications of the HPV-thyroid cancer association. Methods: A comprehensive literature search was conducted across PubMed, Embase, Scopus, and the Cochrane Library for studies published between January 2010 and December 2024. Eligible studies included randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating postoperative sleep outcomes in thyroid cancer patients with documented HPV status. Two independent reviewers conducted data extraction and quality assessment, resolving discrepancies through consensus. The methodological rigor of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS) and the Cochrane risk of bias tool. A meta-analysis was performed using the DerSimonian and Laird random-effects model, with heterogeneity assessed via Cochran’s Q and I2 statistics. Publication bias was examined using funnel plots and Egger’s test. Results: Out of 203 screened records, 11 studies (comprising 1,432 participants) met the inclusion criteria. Thyroidectomy led to statistically and clinically significant improvements in sleep quality. The mean preoperative AHI of 42.8 ± 8.6 declined to 36.6 ± 8.4 postoperatively (Hedges’ g = -0.38, 95% CI: -0.67 to -0.09, P = 0.01), reflecting a moderate yet meaningful improvement in OSA severity. Daytime sleepiness showed a substantial reduction, with ESS scores decreasing from 15.3 ± 4.7 to 7.5 ± 6.07, demonstrating a marked enhancement in daily functioning. The HPV infection was associated with a 2.2-fold increased risk of thyroid cancer (OR = 2.199, 95% CI: 1.31 - 3.23, P < 0.05), reinforcing its potential role in thyroid carcinogenesis. Moderate heterogeneity was observed in OSA-related outcomes (I2 = 59.27%, P = 0.01), while the HPV-thyroid cancer association displayed minimal heterogeneity (I2 = 0.00%, P = 0.64). Conclusions: Thyroidectomy significantly enhances sleep quality in thyroid cancer patients, with notable reductions in AHI and ESS scores, underscoring its clinical benefit. The strong association between HPV and thyroid cancer highlights the potential necessity of HPV screening in thyroid cancer risk assessment and postoperative surveillance. These findings advocate for the consideration of HPV as a modifiable risk factor, warranting further research into tailored screening protocols and refined postoperative strategies to optimize patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,025 | 0,054 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,001 |
| Méta-épidémiologie (sens large) | 0,014 | 0,057 |
| Bibliométrie | 0,006 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».