Li Wei, Thompson Carol H, Xin Ding, Cossart Yvonne E, O'Brien Christopher J, McNeil Edward B, Gao Kan, Scolyer Richard A, Rose Barbara R
Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia.
Am J Pathol. 2003 Dec;163(6):2185-9. doi: 10.1016/S0002-9440(10)63576-6.
Epidemiological and experimental evidence from Western countries now consistently support an etiological role for human papillomavirus (HPV) in a subset of oropharyngeal squamous cell carcinomas (SCC), especially those originating in the tonsil. The role of HPV in the etiology of tonsil cancer in developing countries such as China has not been investigated. In this study, none of 16 tonsil cancer specimens from Chinese patients were positive for HPV DNA, whereas those from Australian patients using the same methodology gave a positivity rate of 46%. The tumors from Chinese patients, like the Australian HPV-negative subset, significantly overexpressed pRb and cyclin D1 and underexpressed p16(INK4A) (p16). In contrast, the Australian HPV-positive cancers overexpressed p16 and had reduced expression of pRb and cyclin D1. These findings may help explain why China has a relatively low rate of oropharyngeal cancer compared with Australia. They also support the hypothesis that molecular pathways to tonsil cancer mediated by HPV are distinct from those induced by mutagens present in cigarette smoke or alcohol.
西方国家的流行病学和实验证据现在一致支持人乳头瘤病毒（HPV）在一部分口咽鳞状细胞癌（SCC），尤其是起源于扁桃体的口咽鳞状细胞癌中具有病因学作用。HPV在中国等发展中国家扁桃体癌病因学中的作用尚未得到研究。在本研究中，16例中国患者的扁桃体癌标本中没有一例HPV DNA呈阳性，而采用相同方法检测的澳大利亚患者标本阳性率为46%。中国患者的肿瘤，与澳大利亚HPV阴性亚组一样，pRb和细胞周期蛋白D1显著过表达，而p16（INK4A）（p16）表达不足。相比之下，澳大利亚HPV阳性癌症患者的p16过表达，而pRb和细胞周期蛋白D1表达降低。这些发现可能有助于解释为什么与澳大利亚相比，中国口咽癌发病率相对较低。它们还支持这样一种假说，即HPV介导的扁桃体癌分子途径与香烟烟雾或酒精中存在的诱变剂所诱导的途径不同。
