Departments of Otolaryngology, Head and Neck Surgery.
Departments of Otolaryngology, Head and Neck Surgery.
Ann Oncol. 2010 Oct;21(10):1961-1966. doi: 10.1093/annonc/mdq210. Epub 2010 Apr 27.
Currently, staging of head neck squamous cell carcinoma (HNSCC) is on the basis of primary tumor extension (cT), lymph node involvement (cN) and distant metastasis (cM). The aim of cancer staging was to improve diagnosis, prognosis and to compare outcome results. A new subgroup of oropharyngeal squamous cell carcinoma (OPSCC) induced by human papillomavirus (HPV) infection is reported to show an increasing incidence. These HPV-positive OPSCC show distinct molecular differences, specific p16 overexpression and a significantly better prognosis. Therefore, the aim of this study was to evaluate the prognostic influence of p16 expression in OPSCC and compare its relevance with the established prognostic markers cT and cN classification and the clinical stages I-IV.
Immunohistochemistry for p16 was carried out on the basis of a tissue microarray including 102 OPSCC patients with corresponding retrospective clinicopathological and follow-up data.
p16 is the strongest independent prognostic marker in OPSCC, surpassing the significance of cT and cN classification as well as the clinical stages I-IV. Prognosis of p16-positive OPSCC of an advanced stage reached or even exceeded prognosis of the next clinically smaller conventionally staged group of tumors.
p16 is the most relevant prognostic marker in OPSCC and should be considered for inclusion into the official staging system of HNSCC.
目前，头颈部鳞状细胞癌（HNSCC）的分期基于原发肿瘤的扩展（cT）、淋巴结受累（cN）和远处转移（cM）。癌症分期的目的是改善诊断、预后，并比较结果。由人乳头瘤病毒（HPV）感染引起的口咽鳞状细胞癌（OPSCC）的一个新亚组报告发病率不断增加。这些 HPV 阳性的 OPSCC 显示出明显的分子差异，特异性的 p16 过表达，以及显著更好的预后。因此，本研究旨在评估 OPSCC 中 p16 表达的预后影响，并比较其与既定的预后标志物 cT 和 cN 分类以及临床分期 I-IV 的相关性。
对包含 102 例 OPSCC 患者的组织微阵列进行 p16 的免疫组织化学染色，这些患者均具有相应的回顾性临床病理和随访数据。
p16 是 OPSCC 中最强的独立预后标志物，其意义超过了 cT 和 cN 分类以及临床分期 I-IV。p16 阳性的晚期 OPSCC 的预后甚至达到或超过了下一个临床分期较小的传统肿瘤组的预后。
p16 是 OPSCC 中最相关的预后标志物，应考虑将其纳入 HNSCC 的官方分期系统。
