美国少数民族和种族的头颈部鳞状细胞癌病例匹配分析——HPV 可能在生存差异中起作用。
Case-matching analysis of head and neck squamous cell carcinoma in racial and ethnic minorities in the United States--possible role for human papillomavirus in survival disparities.
机构信息
Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, USA.
出版信息
Head Neck. 2011 Jan;33(1):45-53. doi: 10.1002/hed.21398.
BACKGROUND
Several studies have documented disparities in head and neck cancer outcomes for black patients in the United States. Recent studies have found that differences in oropharyngeal tumor human papillomavirus (HPV) status may be a cause of this disparity.
METHODS
In all, 76,817 cases of head and neck squamous cell carcinoma (HNSCC) recorded in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were analyzed. Racial/ethnic groups were studied, for disease-specific survival in both case-matched and nonmatched cohorts. Calculation of expected disparity magnitudes based on HPV status was performed using data reported in the literature.
RESULTS
A disease-specific survival disparity was demonstrated for Hispanic patients. However, case matching eliminated this disparity. Conversely, the disparity for black patients persisted in matched cohorts. The oropharyngeal subsite was found to be the dominant contributor to this disparity.
CONCLUSIONS
The survival disparity for Hispanic patients in SEER with HNSCC is explained by differences in presentation and treatment. Also, HPV tumor status is likely a key determinant of the disparity for black patients.
背景
多项研究记录了美国黑人群体在头颈部癌症治疗结果方面存在差异。最近的研究发现，口咽肿瘤人乳头瘤病毒（HPV）状态的差异可能是造成这种差异的原因之一。
方法
共分析了美国国家癌症研究所监测、流行病学和最终结果（SEER）计划中记录的 76817 例头颈部鳞状细胞癌（HNSCC）病例。研究了不同种族/族裔群体在病例匹配和非匹配队列中的疾病特异性生存率。根据文献报道的数据，使用 HPV 状态计算了预期差异幅度。
结果
在 SEER 中，与 HNSCC 相关的 Hispanic 患者存在疾病特异性生存率的差异。然而，病例匹配消除了这种差异。相反，黑人群体在匹配队列中的差异仍然存在。口咽部位被发现是造成这种差异的主要原因。
结论
在 SEER 中，与 HNSCC 相关的 Hispanic 患者的生存率差异是由不同的表现和治疗方式造成的。此外，HPV 肿瘤状态可能是黑人群体差异的关键决定因素。
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