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喉癌中的人乳头瘤病毒感染。

Human papillomavirus infections in laryngeal cancer.

机构信息

Departamento de Otorrinolaringologia, Universidad de Chile, Santiago de Chile, Chile.

出版信息

Head Neck. 2011 Apr;33(4):581-6. doi: 10.1002/hed.21421.

Abstract

Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we review the currently known associations of HPV infections in diseases of the larynx and their potential for oncogenicity. Using several methods of detection, HPV DNA has been detected in benign (papillomatosis), indolent (verrucous carcinoma), and malignant (squamous cell carcinoma) lesions of the larynx. Consistent with the known oncogenic risk of HPV infections, common HPV types associated with laryngeal papillomatosis include low-risk HPV types 6 and 11, with high-risk HPV types 16 and 18 more commonly present in neoplastic lesions (verrucous carcinoma and squamous cell carcinoma). Although a broad range of prevalence has been noted in individual studies, approximately 25% of laryngeal squamous cell carcinomas harbor HPV infections on meta-analysis, with common involvement of high-risk HPV types 16 (highest frequency) and 18. Preliminary results suggest that these high-risk HPV infections seem to be biologically relevant in laryngeal carcinogenesis, manifested as having viral DNA integration in the cancer cell genome and increased expression of the p16 protein. Despite this knowledge, the clinical significance of these infections and the implications on disease prevention and treatment are unclear and require further investigation.

摘要

尽管人乳头瘤病毒 (HPV) 感染与一部分头颈部癌症,尤其是口咽癌之间的关联及其临床意义最近已得到充分证实,但 HPV 感染在喉癌中的作用尚未得到充分评估。在此,我们回顾了 HPV 感染在喉部疾病中的已知关联及其致癌潜能。通过多种检测方法,HPV DNA 已在喉部的良性(乳头状瘤病)、惰性(疣状癌)和恶性(鳞状细胞癌)病变中被检测到。与 HPV 感染的已知致癌风险一致,与喉乳头状瘤病相关的常见 HPV 类型包括低危型 HPV 6 和 11,而高危型 HPV 16 和 18 更常见于肿瘤病变(疣状癌和鳞状细胞癌)。尽管在个别研究中观察到了广泛的流行率,但荟萃分析显示约 25%的喉鳞状细胞癌存在 HPV 感染,常见的高危 HPV 类型 16(最高频率)和 18 涉及。初步结果表明,这些高危 HPV 感染似乎在喉癌发生中具有生物学相关性,表现为病毒 DNA 整合到癌细胞基因组中以及 p16 蛋白表达增加。尽管有这些认识,但这些感染的临床意义以及对疾病预防和治疗的影响尚不清楚,需要进一步研究。

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