Vainshtein Jeffrey, McHugh Jonathan B, Spector Matthew E, Walline Heather M, Komarck Christine M, Stenmark Matthew H, Prince Mark E, Worden Francis P, Wolf Gregory T, Bradford Carol R, Chepeha Douglas B, Carey Thomas, Eisbruch Avraham
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.
Head Neck. 2015 Jan;37(1):8-11. doi: 10.1002/hed.23548. Epub 2014 Apr 15.
Although typically associated with a favorable prognosis, a minority of human papillomavirus (HPV)-related (+) oropharyngeal cancers recur after chemoradiation. We postulated that a minor HPV-negative tumor subfraction may be responsible for recurrences of HPV+ oropharyngeal cancer.
Paired untreated primary and recurrent tumor specimens were identified for 37 patients with oropharyngeal cancer who received definitive chemoradiotherapy at our institution. Concordance in HPV/p16 expression between primary and recurrent tumors was assessed.
Among 31 patients with HPV+/p16+ primary tumors, 30 (97%) retained evidence of both HPV and p16 expression at recurrence (27 HPV+/p16+; 3 HPV+/p16-partial). One (3%) initially HPV+/p16+ patient developed an HPV-negative/p16-negative lung squamous cell carcinoma (SCC), representing either a discordant oropharyngeal cancer metastasis or second primary tumor.
HPV-related oropharyngeal cancers retain HPV+/p16+ expression at recurrence. Our results fail to provide evidence that a minor HPV-negative tumor subfraction is responsible for biologically aggressive behavior of HPV+ oropharyngeal cancer that recurs after chemoradiation.
尽管人乳头瘤病毒（HPV）相关的（+）口咽癌通常预后良好，但少数此类癌症在放化疗后会复发。我们推测，一小部分HPV阴性肿瘤亚群可能是HPV阳性口咽癌复发的原因。
我们确定了37例在本院接受根治性放化疗的口咽癌患者的未经治疗的原发肿瘤和复发肿瘤配对标本。评估原发肿瘤和复发肿瘤之间HPV/p16表达的一致性。
在31例HPV+/p16+原发肿瘤患者中，30例（97%）在复发时仍有HPV和p16表达的证据（27例HPV+/p16+；3例HPV+/p16部分表达）。1例（3%）最初HPV+/p16+的患者发生了HPV阴性/p16阴性的肺鳞状细胞癌（SCC），这要么是不一致的口咽癌转移，要么是第二原发性肿瘤。
HPV相关的口咽癌在复发时仍保持HPV+/p16+表达。我们的结果未能提供证据表明一小部分HPV阴性肿瘤亚群是导致放化疗后复发的HPV阳性口咽癌具有生物学侵袭性的原因。
