Department of Radiation Oncology, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Eur J Cancer. 2010 Jul;46(11):2088-96. doi: 10.1016/j.ejca.2010.04.016. Epub 2010 May 25.
This study examines the prognostic significance of epidermal growth factor receptor (EGFR) expression in relation to human papillomavirus (HPV) status in oropharyngeal squamous cell carcinoma (SCC).
Pathological diagnosis of 270 oropharyngeal SCCs was verified by the study pathologist; clinical details were extracted from institutional databases. Recurrence in any form or death from any cause was recorded for a median of 2.5 (range: 0-19.3) years after diagnosis. HPV status was determined by HPV E6-targeted multiplex real-time PCR/p16 immunohistochemistry; EGFR expression was evaluated by semiquantitative immunohistochemistry. Determinants of recurrence and mortality hazards were modelled using Cox regression with censoring at dates of last follow-up.
Thirty-seven percent of cancers were HPV-positive (91% type 16). HPV was a predictor of loco-regional recurrence, event-free and overall survival after adjustment for clinicopathological variables and EGFR. Patients with EGFR-positive cancers were 5-fold more likely to have loco-regional failure relative to those with EGFR-negative cancers. Patients with HPV-negative/EGFR-positive cancers had an adjusted 13-fold increased risk of having a loco-regional failure, an almost 4-fold increased risk of having an event and more than a 4-fold increased risk of dying of any cause relative to those with HPV-positive/EGFR-negative cancers. There was weak evidence that the effects of EGFR on outcome were limited to patients with HPV-negative cancers.
HPV and EGFR are independent prognostic markers in oropharyngeal SCC. Combining testing for HPV and EGFR appears to provide additional prognostic information.
本研究旨在探讨表皮生长因子受体（EGFR）表达与口咽鳞状细胞癌（SCC）中人类乳头瘤病毒（HPV）状态的相关性及其预后意义。
由研究病理学家对 270 例口咽 SCC 的病理诊断进行了验证；临床详细信息从机构数据库中提取。在诊断后中位数为 2.5 年（范围：0-19.3 年）的时间内记录任何形式的复发或任何原因导致的死亡。HPV 状态通过 HPV E6 靶向多重实时 PCR/p16 免疫组化确定；EGFR 表达通过半定量免疫组化评估。使用 Cox 比例风险回归模型，对包括 HPV 状态和 EGFR 表达在内的多个因素进行分析，同时考虑了删失数据。
37%的癌症为 HPV 阳性（91%为 16 型）。HPV 是局部区域复发、无事件和总体生存的预测因子，在调整了临床病理变量和 EGFR 后仍然成立。与 EGFR 阴性癌症相比，EGFR 阳性癌症患者局部区域失败的风险增加了 5 倍。HPV 阴性/EGFR 阳性癌症患者的局部区域失败、事件发生和任何原因死亡的风险分别是 HPV 阳性/EGFR 阴性癌症患者的 13 倍、近 4 倍和 4 倍以上。有证据表明，EGFR 对结局的影响仅限于 HPV 阴性癌症患者。
HPV 和 EGFR 是口咽 SCC 的独立预后标志物。联合检测 HPV 和 EGFR 似乎可以提供额外的预后信息。
