Näsman Anders, Attner Per, Hammarstedt Lalle, Du Juan, Eriksson Mathilda, Giraud Geraldine, Ahrlund-Richter Sofie, Marklund Linda, Romanitan Mircea, Lindquist David, Ramqvist Torbjörn, Lindholm Johan, Sparén Pär, Ye Weimin, Dahlstrand Hanna, Munck-Wikland Eva, Dalianis Tina
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Int J Cancer. 2009 Jul 15;125(2):362-6. doi: 10.1002/ijc.24339.
In the county of Stockholm, between 1970 and 2002, we have previously reported a 3-fold parallel increase in the incidence of tonsillar squamous cell carcinoma (SCC) and the proportion of human papillomavirus (HPV) positive tonsillar SCC. Here, we have followed the above parameters in all patients (n = 120) diagnosed with tonsillar SCC during 2003-2007 in the same area, and also in correlation to our previous data. Ninety-eight pretreatment biopsies were available and presence of HPV DNA and HPV-16 E6 and E7 RNA were tested by polymerase chain reaction (PCR) and RT-PCR. Incidence data were obtained from the Swedish Cancer Registry. Data reported from 1970 to 2002 were also obtained for comparison. HPV DNA was present in 83 of 98 (85%) of the tonsillar SCC biopsies from 2003 to 2007 and 77 of these were HPV-16 positive. HPV-16 E6 and E7 RNA were found in 98% of 52 analyzed HPV-16 positive cases. The proportion of HPV-positive cancers had significantly increased both from 1970 to 2007 (p < 0.0001) as well from 2000 to 2007 (p < 0.01), with 68% (95% confidence interval (CI), 53-81) 2000-2002; 77% (95% CI, 63-87) 2003-2005; and 93% (95% CI, 82-99) 2006-2007. The incidence rate of HPV-positive tumors almost doubled each decade between 1970 and 2007, in parallel with a decline of HPV-negative tumors. In conclusion, the incidence of HPV-positive cancers is still increasing in the County of Stockholm, suggesting an epidemic of a virus-induced carcinoma, with soon practically all tonsillar SCC being HPV positive, as in cervical cancer.
在斯德哥尔摩县，1970年至2002年期间，我们之前曾报道扁桃体鳞状细胞癌（SCC）的发病率与人乳头瘤病毒（HPV）阳性扁桃体SCC的比例呈3倍的平行增长。在此，我们追踪了2003年至2007年期间在同一地区诊断为扁桃体SCC的所有患者（n = 120）的上述参数，并与我们之前的数据进行了关联分析。可获得98份治疗前活检样本，通过聚合酶链反应（PCR）和逆转录PCR检测HPV DNA以及HPV-16 E6和E7 RNA的存在情况。发病率数据来自瑞典癌症登记处。还获取了1970年至2002年报告的数据用于比较。2003年至2007年的98份扁桃体SCC活检样本中，83份（85%）存在HPV DNA，其中77份为HPV-16阳性。在52例分析的HPV-16阳性病例中，98%检测到HPV-16 E6和E7 RNA。HPV阳性癌症的比例从1970年至2007年（p < 0.0001）以及从2000年至2007年（p < 0.01）均显著增加，2000 - 2002年为68%（95%置信区间（CI），53 - 81）；2003 - 2005年为77%（95% CI，63 - 87）；2006 - 2007年为93%（95% CI，82 - 99）。1970年至2007年期间，HPV阳性肿瘤的发病率几乎每十年翻一番，与此同时HPV阴性肿瘤的发病率下降。总之，斯德哥尔摩县HPV阳性癌症的发病率仍在上升，这表明一种病毒诱导的癌症正在流行，很快几乎所有扁桃体SCC都将像宫颈癌一样为HPV阳性。
