Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, IL 60637, USA.
Oral Oncol. 2013 Jun;49(6):525-33. doi: 10.1016/j.oraloncology.2013.02.003. Epub 2013 Mar 13.
Oral cavity and in particular oral tongue cancers occur with a rising incidence in younger patients often lacking the typical risk factors of tobacco use, alcohol use, and human papilloma virus (HPV) infection. Their prognosis when treated with chemoradiation has not been well studied and responsible risk factors remain elusive. A viral etiology (other than HPV) has been hypothesized.
First we analyzed outcomes from 748 head and neck cancer patients with locoregionally advanced stage tumors treated with curative-intent chemoradiation by anatomic site. Second, we analyzed seven oral tongue (OT) tumors from young, non-smokers/non-drinkers for the presence of viral mRNA using short-read massively-parallel sequencing (RNA-Seq) in combination with a newly-developed digital subtraction method followed by viral screening and discovery algorithms. For positive controls we used an HPV16-positive HNC cell line, a cervical cancer, and an EBV-LMP2A transgene lymphoma.
Younger patients with oral cavity tumors had worse outcomes compared to non-oral cavity patients. Surprisingly none of the seven oral tongue cancers showed significant presence of viral transcripts. In positive controls the expected viral material was identified.
Oral cavity tumors in younger patients have a poor prognosis and do not appear to be caused by a transcriptionally active oncovirus.
口腔，尤其是舌部癌症在年轻患者中的发病率呈上升趋势，这些患者通常缺乏烟草使用、酒精使用和人乳头瘤病毒（HPV）感染等典型的风险因素。他们在接受放化疗治疗后的预后尚未得到充分研究，相关的风险因素仍难以确定。人们推测存在病毒病因（除 HPV 以外）。
首先，我们分析了 748 名接受根治性放化疗的局部晚期头颈部癌症患者的治疗结果，按解剖部位进行了分析。其次，我们对 7 例来自年轻非吸烟/非饮酒者的舌部肿瘤进行了病毒 mRNA 检测，采用短读长高通量平行测序（RNA-Seq）结合新开发的数字消减法，然后进行病毒筛选和发现算法。阳性对照包括 HPV16 阳性的 HNC 细胞系、宫颈癌和 EBV-LMP2A 转基因淋巴瘤。
口腔肿瘤的年轻患者预后较差，与非口腔肿瘤患者相比。令人惊讶的是，这 7 例舌部癌症中均未发现明显的病毒转录本。在阳性对照中，均鉴定到了预期的病毒物质。
年轻患者的口腔肿瘤预后较差，似乎不是由转录活性致癌病毒引起的。
