Clinical and Diagnostic Sciences, King's College London Dental Institute, London, UK.
Infect Agent Cancer. 2013 Aug 12;8(1):30. doi: 10.1186/1750-9378-8-30.
Nasopharyngeal carcinoma (NPC) accounts for 0.6% of all cancers worldwide with the highest prevalence in South East Asia, Southern China and Northern Africa but the disease is uncommon in Europe with an annual incidence in this region of less than 1 per 100 000. Although the Epstein-Barr virus (EBV) is a well known causative agent in NPC, recent reports have implicated oncogenic Human Papillomavirus (HPV) in a subgroup of these tumours. The recent striking rise of oropharyngeal carcinoma has been attributed to HPV, but little is known about the prevalence and clinical significance of the virus in NPC. The aim of this study was to determine the prevalence of oncogenic HPV in NPC from tissue archives of two head and neck cancer centres in the UK.
Samples were available for 67 patients with clinically validated NPC. The detection of high-risk HPV was carried out by screening all cases for p16 using immunohistochemistry and HPV DNA by polymerase chain reaction (PCR) using GP5+/6+ primers. All cases with p16 over-expression or positive for HPV by PCR were then examined by high-risk HPV DNA in-situ hybridisation and genotype analysis by PCR.
Eleven cases (11/67, 16.4%) showed concurrent over-expression of p16 and evidence of high-risk HPV DNA by in-situ hybridisation; the majority were HPV16 positive. Of these 11 cases, nine occurred in Whites and two in Blacks. Histologically, there were two keratinising squamous cell carcinoma and nine non-keratinising carcinomas (eight differentiated and one undifferentiated). None of the HPV-positive cases showed any co-infection with EBV. There was no statistically significant difference in overall survival outcome between patients with HPV-positive and HPV-negative NPC.
The results of this study show that oncogenic HPV is associated with a subgroup of NPCs and is more likely to occur in Whites. However, unlike oropharyngeal carcinoma there was no significant difference in overall survival between patients with HPV-positive and HPV-negative NPC.
鼻咽癌（NPC）占全球所有癌症的 0.6%，在东南亚、中国南方和北非最为常见，但在欧洲这种疾病并不常见，该地区的年发病率低于每 10 万人 1 例。虽然 Epstein-Barr 病毒（EBV）是 NPC 的已知致病因子，但最近的报告表明，致癌性人类乳头瘤病毒（HPV）也与这些肿瘤的亚群有关。最近口咽癌的显著增加归因于 HPV，但人们对该病毒在 NPC 中的流行程度和临床意义知之甚少。本研究旨在确定英国两个头颈癌中心的 NPC 组织档案中致癌 HPV 的流行率。
对 67 例经临床证实的 NPC 患者的样本进行了检测。通过免疫组织化学法对所有病例进行 p16 筛查，用 GP5+/6+引物进行聚合酶链反应（PCR）检测高危型 HPV。对 p16 过表达或 PCR 阳性的所有病例，再用高危型 HPV DNA 原位杂交和 PCR 进行基因型分析进行检测。
11 例（11/67，16.4%）同时出现 p16 过表达和高危 HPV DNA 阳性的证据；大多数为 HPV16 阳性。这 11 例中，白人 9 例，黑人 2 例。组织学上，有 2 例角化鳞状细胞癌和 9 例非角化癌（8 例分化型和 1 例未分化型）。HPV 阳性病例均未检出 EBV 合并感染。HPV 阳性和 HPV 阴性 NPC 患者的总生存结果无统计学差异。
本研究结果表明，致癌性 HPV 与 NPC 的亚群有关，且更可能发生在白人中。然而，与口咽癌不同，HPV 阳性和 HPV 阴性 NPC 患者的总生存无显著差异。
