Department of Otolaryngology, Head and Neck Surgery, University of Tokyo
Department of Otolaryngology, Head and Neck Surgery, University of Tokyo.
Jpn J Clin Oncol. 2014 Jun;44(6):564-9. doi: 10.1093/jjco/hyu042. Epub 2014 Apr 11.
To determine the clinical significance of human papillomavirus subclinical infection in patients with oropharyngeal squamous cell carcinoma in Japan.
Over a 9-year period, a retrospective case comparison study of the pathology database was conducted at the University of Tokyo to identify samples of oropharyngeal squamous cell carcinoma. We performed in situ hybridization for human papillomavirus-DNA to identify subclinical human papillomavirus infections among patients with oropharyngeal squamous cell carcinoma. Second primary malignancies were classified as synchronous, if identified within 6 months of the diagnosis of the first tumor, or metachronous, if identified after this 6-month period. Univariate and multivariate analyses using logistic stepwise regression models were performed to identify factors associated with synchronous and metachronous second primary malignancy.
Of the 150 patients with oropharyngeal squamous cell carcinoma, 14% (21/150) and 20.7% (31/150) developed synchronous and metachronous second primary malignancies, respectively. Esophageal carcinoma was the most frequent second primary malignancy (10/21 for synchronous and 10/31 for metachronous second primary malignancies). The prevalence of oropharyngeal squamous cell carcinoma positive for human papillomavirus was 31% (47/150). Multivariate analysis identified alcohol consumption as a significant unfavorable risk factor for the occurrence of synchronous second primary malignancy, and either a human papillomavirus-negative status or N0 classification was a significant unfavorable risk factor for the occurrence of metachronous second primary malignancy.
Evaluation of the human papillomavirus status may help identify patients at risk for metachronous second primary malignancy. Upper gastrointestinal endoscopy is very important in the diagnosis of oropharyngeal squamous cell carcinoma among heavy drinkers in Japan.
确定日本口咽鳞状细胞癌患者人乳头瘤病毒亚临床感染的临床意义。
在东京大学，通过对病理数据库进行 9 年的回顾性病例对照研究，确定口咽鳞状细胞癌的样本。我们使用人乳头瘤病毒-DNA 原位杂交技术来识别口咽鳞状细胞癌患者的亚临床人乳头瘤病毒感染。第二原发恶性肿瘤如果在诊断出第一个肿瘤后 6 个月内被发现，则归类为同步性，如果在该 6 个月后被发现，则归类为异时性。使用逻辑逐步回归模型进行单变量和多变量分析，以确定与同步和异时性第二原发恶性肿瘤相关的因素。
在 150 例口咽鳞状细胞癌患者中，分别有 14%（21/150）和 20.7%（31/150）发生了同步和异时性第二原发恶性肿瘤。食管癌是最常见的第二原发恶性肿瘤（同步性 10/21，异时性 10/31）。人乳头瘤病毒阳性的口咽鳞状细胞癌患病率为 31%（47/150）。多变量分析确定饮酒是同步性第二原发恶性肿瘤发生的显著不利危险因素，而人乳头瘤病毒阴性状态或 N0 分类是异时性第二原发恶性肿瘤发生的显著不利危险因素。
评估人乳头瘤病毒状态可能有助于识别发生异时性第二原发恶性肿瘤的高危患者。上消化道内镜检查在日本大量饮酒者的口咽鳞状细胞癌诊断中非常重要。
