Department of Otolaryngology, Head & Neck Surgery, The University of Western Ontario, Room B3-431A, 800 Commissioners Road East, London, N6A 5W9, , Ontario, Canada.
J Otolaryngol Head Neck Surg. 2013 Feb 1;42(1):9. doi: 10.1186/1916-0216-42-9.
An epidemic of human papillomavirus (HPV)-related oropharyngeal squamous cell cancer (OPSCC) has been reported worldwide largely due to oral infection with HPV type-16, which is responsible for approximately 90% of HPV-positive cases. The purpose of this study was to determine the rate of HPV-positive oropharyngeal cancer in Southwestern Ontario, Canada.
A retrospective search identified ninety-five patients diagnosed with OPSCC. Pre-treatment biopsy specimens were tested for p16 expression using immunohistochemistry and for HPV-16, HPV-18 and other high-risk subtypes, including 31,33,35,39,45,51,52,56,58,59,67,68, by real-time qPCR.
Fifty-nine tumours (62%) were positive for p16 expression and fifty (53%) were positive for known high-risk HPV types. Of the latter, 45 tumors (90%) were identified as HPV-16 positive, and five tumors (10%) were positive for other high-risk HPV types (HPV-18 (2), HPV-67 (2), HPV-33 (1)). HPV status by qPCR and p16 expression were extremely tightly correlated (p < 0.001, Fishers exact test). Patients with HPV-positive tumors had improved 3-year overall (OS) and disease-free survival (DFS) compared to patients with HPV-negative tumors (90% vs 65%, p = 0.001; and 85% vs 49%, p = 0.005; respectively). HPV-16 related OPSCC presented with cervical metastases more frequently than other high-risk HPV types (p = 0.005) and poorer disease-free survival was observed, although this was not statistically significant.
HPV-16 infection is responsible for a significant proportion of OPSCC in Southwestern Ontario. Other high-risk subtypes are responsible for a smaller subset of OPSCC that present less frequently with cervical metastases and may have a different prognosis.
人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）在全球范围内呈流行趋势，主要与 HPV 型 16 的口腔感染有关，该型病毒约占 HPV 阳性病例的 90%。本研究旨在确定加拿大安大略省西南部 HPV 阳性口咽癌的发病率。
通过回顾性搜索，确定了 95 例 OPSCC 患者。使用免疫组织化学法检测预处理活检标本中 p16 的表达，并通过实时 qPCR 检测 HPV-16、HPV-18 及其他高危亚型，包括 31、33、35、39、45、51、52、56、58、59、67、68。
59 例肿瘤（62%）p16 表达阳性，50 例（53%）HPV 高危型阳性。后者中，45 例（90%）肿瘤为 HPV-16 阳性，5 例（10%）为其他高危 HPV 型阳性（HPV-18（2），HPV-67（2），HPV-33（1））。qPCR 法和 p16 表达法检测 HPV 状态结果高度相关（p < 0.001，Fisher 确切检验）。HPV 阳性肿瘤患者的 3 年总生存率（OS）和无病生存率（DFS）明显优于 HPV 阴性肿瘤患者（90% vs 65%，p = 0.001；85% vs 49%，p = 0.005）。与其他高危 HPV 型相比，HPV-16 相关 OPSCC 更易发生颈部转移（p = 0.005），且无病生存率较差，但无统计学意义。
HPV-16 感染是安大略省西南部 OPSCC 的主要病因。其他高危亚型导致一小部分 OPSCC，这些患者较少发生颈部转移，且预后可能不同。
