Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University, Munich, Germany,
J Cancer Res Clin Oncol. 2014 Jun;140(6):1011-9. doi: 10.1007/s00432-014-1631-5. Epub 2014 Mar 11.
To assess risk factors of patients with oropharyngeal squamous cell carcinoma in the Munich area of Southern Germany in relation to human papillomavirus (HPV) association of the tumors. To demonstrate differences in tumor characteristics and their impact on adjuvant treatment.
Between November 2010 and July 2013, patients were prospectively interviewed for risk factors before they underwent surgical resection of their tumors. HPV association was evaluated by p16 immunohistochemistry; tumor characteristics and type of adjuvant treatment were recorded. Follow-up data were collected after a median follow-up of 12.1 month.
In contrast to many recent studies, we could not detect any difference in overall age and age at sexual debut between p16-positive and p16-negative patients. P16-negative patients are characterized by a more intensive tobacco and alcohol use, a more abusive way of consumption, less nonoral and less oral sex partners. P16-positive patients had a significantly higher risk of lymph node metastases, but nevertheless a significant lower risk to recur or to die. No difference in the incidence of synchronous second primary tumors was seen. P16-positive patients generally received a more aggressive adjuvant treatment because of more frequently involved lymph nodes.
Lifestyle risk factors such as smoking, drinking, and sexual habits were independent from age, but showed marked differences between the p16-positive and p16-negative group. Since p16-positive patients were treated more aggressively, it is not possible to distinguish whether the better outcome of HPV-positive patients is a result of less aggressive cancers or more aggressive treatment. With regard to the ongoing debate about treatment deintensification, we should keep in mind that the survival of HPV-positive cancer patients is not 100 %.
评估德国南部慕尼黑地区口咽鳞状细胞癌患者的风险因素与肿瘤人乳头瘤病毒（HPV）相关性。以展示肿瘤特征及其对辅助治疗的影响的差异。
在 2010 年 11 月至 2013 年 7 月期间，对患者进行了前瞻性访谈，以了解他们在接受肿瘤手术切除前的风险因素。通过 p16 免疫组化评估 HPV 相关性；记录肿瘤特征和辅助治疗类型。中位随访 12.1 个月后收集随访数据。
与许多最近的研究不同，我们没有发现 p16 阳性和 p16 阴性患者的总体年龄和性初年龄之间有任何差异。p16 阴性患者的吸烟、饮酒和性行为更为频繁，消费方式更为恶劣，非口腔和口腔性伴侣也较少。p16 阳性患者发生淋巴结转移的风险显著更高，但复发或死亡的风险显著更低。没有观察到同步第二原发肿瘤的发生率差异。p16 阳性患者通常因淋巴结受累更频繁而接受更积极的辅助治疗。
生活方式危险因素如吸烟、饮酒和性行为独立于年龄，但在 p16 阳性和 p16 阴性组之间存在明显差异。由于 p16 阳性患者的治疗更为积极，因此无法确定 HPV 阳性患者的较好预后是由于癌症侵袭性较低还是治疗更为积极所致。鉴于目前关于治疗强度降低的争论，我们应该记住，HPV 阳性癌症患者的生存率并非 100%。
