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头颈部癌症人乳头瘤病毒、烟草和酒精的风险和生存的复杂病因：一种多因素疾病的例证。

Complex etiology underlies risk and survival in head and neck cancer human papillomavirus, tobacco, and alcohol: a case for multifactor disease.

机构信息

Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA 52242, USA.

出版信息

J Oncol. 2012;2012:571862. doi: 10.1155/2012/571862. Epub 2012 Jan 23.

DOI:10.1155/2012/571862
PMID:22315596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3270416/
Abstract

Findings are inconsistent about whether tobacco, alcohol, and human papillomavirus (HPV) are two independent HNC risk factor groups that distinguish an infection-associated cancer from a tobacco/alcohol-associated HNC. We found that cancer in the oral cavity risk was greater in HPV-E6/E7 seropositive/heavy tobacco users (adjusted OR = 3.5) than in HPV-seronegative/heavy tobacco users (adjusted OR = 1.4); and HPV-seropositive/heavy alcohol users (adjusted OR = 9.8) had greater risk than HPV-seronegative/heavy alcohol users (adjusted OR = 3.1). In contrast, the risk of oropharyngeal cancer was greater in the HPV-seronegative/heavy tobacco (adjusted OR = 11.0) than in HPV-seropositive/heavy tobacco (adjusted OR = 4.7) users and greater in HPV-seronegative/heavy alcohol users (adjusted OR = 24.3) compared to HPV-seropositive/heavy alcohol users (adjusted OR = 8.5). Disease-specific and recurrence-free adjusted survival were significantly worse in oropharyngeal HPV-seronegative cases with no survival differences by HPV status seen in oral cavity cases. The association between tobacco/alcohol, HPV, and tumor site is complex. There appear to be distinct tumor site differences in the combined exposure risks, suggesting that different molecular pathways are involved.

摘要

关于烟草、酒精和人乳头瘤病毒（HPV）是否是两个独立的头颈部癌症危险因素群体，能够区分与感染相关的癌症和与烟草/酒精相关的头颈部癌症，研究结果并不一致。我们发现，HPV-E6/E7 血清阳性/重度烟草使用者的口腔癌风险更高（调整后的 OR = 3.5），高于 HPV 血清阴性/重度烟草使用者（调整后的 OR = 1.4）；HPV 血清阳性/重度酒精使用者（调整后的 OR = 9.8）的风险高于 HPV 血清阴性/重度酒精使用者（调整后的 OR = 3.1）。相比之下，HPV 血清阴性/重度烟草使用者（调整后的 OR = 11.0）的口咽癌风险高于 HPV 血清阳性/重度烟草使用者（调整后的 OR = 4.7），HPV 血清阴性/重度酒精使用者（调整后的 OR = 24.3）的风险高于 HPV 血清阳性/重度酒精使用者（调整后的 OR = 8.5）。HPV 血清阴性的口咽癌患者的疾病特异性和无复发生存明显更差，而 HPV 血清阳性的口腔癌患者的生存没有差异。烟草/酒精、HPV 和肿瘤部位之间的关联很复杂。在联合暴露风险方面，似乎存在明显的肿瘤部位差异，表明涉及不同的分子途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ce/3270416/4b30fe96c5c4/JO2012-571862.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ce/3270416/482db5208187/JO2012-571862.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ce/3270416/4b30fe96c5c4/JO2012-571862.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ce/3270416/482db5208187/JO2012-571862.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ce/3270416/4b30fe96c5c4/JO2012-571862.002.jpg

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