Smith Elaine M, Ritchie Justine M, Summersgill Kurt F, Hoffman Henry T, Wang Dong Hong, Haugen Thomas H, Turek Lubomir P
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City 52242, USA.
J Natl Cancer Inst. 2004 Mar 17;96(6):449-55. doi: 10.1093/jnci/djh074.
Human papillomavirus (HPV) has been associated with the development of head and neck cancers. In this study, we investigated whether the risk factors for head and neck cancer in relation to HPV infection are different from those in the absence of HPV infection and whether HPV detected in oral exfoliated cells is an independent predictor of head and neck cancer risk.
We conducted a case-control study in 201 head and neck cancer case patients and 333 control subjects, frequency matched for age and sex. Oral exfoliated cells and tumor tissue were evaluated for HPV using polymerase chain reaction and DNA sequencing to type HPV. Logistic regression was used to calculate odds ratios (ORs) for head and neck cancer with HPV infection and 95% confidence intervals (CIs), adjusted for age, tobacco use, and alcohol consumption.
Oncogenic, or high-risk (HR), HPV types were detected in oral cells from 22.9% of case patients and 10.8% of control subjects. HPV16 was the most frequently detected type (19% versus 10% of case patients and control subjects, respectively). After adjusting for age, tobacco use, and alcohol consumption, the risk of head and neck cancer was statistically significantly greater in individuals with HPV-HR types (adjusted OR = 2.6, 95% CI = 1.5 to 4.2) but not in individuals with nononcogenic HPV types (adjusted OR = 0.8, 95% CI = 0.4 to 1.7) compared with HPV-negative individuals. Compared with individuals who were HPV-negative and did not use alcohol or tobacco, there was a statistically significant synergistic effect between detection of HPV-HR and heavy alcohol consumption (OR = 18.8, 95% CI = 5.1 to 69.5) but an additive effect between detection of HPV-HR and tobacco use (OR = 5.5, 95% CI = 2.1 to 14.1). HPV-HR types detected in oral exfoliated cells were predictive of HPV-HR types in tumor tissue.
Infection of oral exfoliated cells with HPV-HR types is a risk factor for head and neck cancer, independent of alcohol and tobacco use, and acts synergistically with alcohol consumption. HPV testing of an oral rinse may be predictive of an HPV-related head and neck cancer.
人乳头瘤病毒（HPV）与头颈癌的发生有关。在本研究中，我们调查了与HPV感染相关的头颈癌危险因素是否不同于未感染HPV的情况，以及口腔脱落细胞中检测到的HPV是否是头颈癌风险的独立预测因素。
我们对201名头颈癌病例患者和333名对照受试者进行了一项病例对照研究，根据年龄和性别进行频率匹配。使用聚合酶链反应和DNA测序对口腔脱落细胞和肿瘤组织进行HPV评估，以确定HPV类型。采用逻辑回归计算HPV感染情况下头颈癌的比值比（OR）和95%置信区间（CI），并对年龄、烟草使用和酒精消费进行调整。
在22.9%的病例患者和10.8%的对照受试者的口腔细胞中检测到致癌性或高危（HR）HPV类型。HPV16是最常检测到的类型（病例患者和对照受试者中分别为19%和10%）。在调整年龄、烟草使用和酒精消费后，感染HR-HPV类型的个体患头颈癌的风险在统计学上显著更高（调整后的OR = 2.6，95%CI = 1.5至4.2），但与HPV阴性个体相比，感染非致癌性HPV类型的个体风险无显著差异（调整后的OR = 0.8，95%CI = 0.4至1.7）。与HPV阴性且不使用酒精或烟草的个体相比，检测到HR-HPV与大量饮酒之间存在统计学上显著的协同效应（OR = 18.8，95%CI = 5.1至69.5），但检测到HR-HPV与烟草使用之间存在相加效应（OR = 5.5，95%CI = 2.1至14.1）。在口腔脱落细胞中检测到的HR-HPV类型可预测肿瘤组织中的HR-HPV类型。
口腔脱落细胞感染HR-HPV类型是头颈癌的一个危险因素，独立于酒精和烟草使用，且与酒精消费具有协同作用。口腔冲洗液的HPV检测可能预测与HPV相关的头颈癌。
