Institute of Pathology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany,
Eur Arch Otorhinolaryngol. 2014 Jun;271(6):1737-45. doi: 10.1007/s00405-013-2693-8. Epub 2013 Sep 25.
HPV infection is considered as an independent risk factor for head and neck squamous cell carcinomas (HNSCC). Due to highly variable prevalence results in numerous studies, it is, however, difficult to estimate the relevance of HPV infection as risk factor for a specific patient collective. This study aimed to elucidate the disparities of HPV prevalence by analyzing socioeconomically and regionally different patient collectives. Two age, gender, stage and tumor location matched cohorts of 18 private health insured (PHIP) and 16 statutory health insured patients (SIP) suffering from an oropharyngeal squamous cell carcinoma (OSCC) and treated at a university hospital were screened for p16 overexpression and HPV infection by immunohistochemistry and PCR. In addition 85 HNSCC patients of an otolaryngology private practice (PPP) in a rural area were screened for p16 overexpression and positive cases were tested for HPV infection. HPV prevalence was 72.2% in the PHIP collective in comparison to 25.0% (p = 0.015) in the SIP collective with a significantly improved 5-year overall survival (p = 0.003) of the PHIP collective. The total HPV prevalence of PPP group was 7.1% with the highest infection rate in tonsillar carcinomas (33.3%) and a larger percentage of female patients in the HPV positive group (p = 0.037). This study shows that variable HPV infection rates in HNSCC can be caused by the selection of particular patient collectives, which suggest taking socioeconomic and regional factors into account for a decision on HPV testing, if it is not performed on a routine basis.
HPV 感染被认为是头颈部鳞状细胞癌（HNSCC）的一个独立危险因素。然而，由于在许多研究中 HPV 感染的流行率存在很大差异，因此很难评估 HPV 感染对特定患者群体的相关性。本研究旨在通过分析社会经济和地域差异的患者群体，阐明 HPV 流行率的差异。我们分析了 18 名私人医疗保险（PHIP）和 16 名法定医疗保险（SIP）的年龄、性别、分期和肿瘤位置匹配的口咽鳞状细胞癌（OSCC）患者，他们在大学医院接受治疗，并通过免疫组化和 PCR 分析筛选 p16 过表达和 HPV 感染。此外，我们还对农村地区耳鼻喉科私人诊所（PPP）的 85 名 HNSCC 患者进行了 p16 过表达筛选，对阳性病例进行了 HPV 感染检测。PHIP 组 HPV 流行率为 72.2%，而 SIP 组为 25.0%（p = 0.015），PHIP 组的 5 年总生存率显著提高（p = 0.003）。PPP 组 HPV 总流行率为 7.1%，其中扁桃体癌感染率最高（33.3%），HPV 阳性组中女性患者比例较高（p = 0.037）。本研究表明，HNSCC 中 HPV 感染率的差异可能是由于选择了特定的患者群体所致，这表明如果不是常规进行 HPV 检测，则应考虑社会经济和地域因素，以决定是否进行 HPV 检测。
