Nomura Fuminori, Sugimoto Taro, Kitagaki Keisuke, Ito Takashi, Kawachi Hiroshi, Eishi Yoshinobu, Watanabe Ken, Igaue Miki, Shimizu Norio, Tomita Makoto, Kitamura Ken, Kishimoto Seiji
Department of Head and Neck Surgery, Tokyo Medical and Dental University , Tokyo , Japan.
Acta Otolaryngol. 2014 Dec;134(12):1265-74. doi: 10.3109/00016489.2014.944272.
Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is considered to be a distinct entity in Japan. The combination of both HPV-DNA sequencing analysis and immunohistochemistry (IHC) for p16(INK4A) is useful to discriminate the OPSCC patients with a better prognosis from other cases, especially in the advanced stage. Surgical treatment is recommended for HPV-negative advanced cancer.
The number of HPV-related OPSCCs has been increasing worldwide. However, the incidence and prognostic significance of this cancer in Japan have not yet been fully elucidated.
Seventy-seven Japanese patients with OPSCC were enrolled in this study. The prevalence of HPV-DNA was assessed by PCR and sequencing. The expression of p16(INK4A) and p53 was examined by IHC. The clinicopathological parameters and disease-specific survival were analyzed for HPV-positive and -negative patients.
HPV-DNA was detected in 32 patients. Thirty-four patients were p16(INK4A)-positive by IHC. The patients who were positive for HPV infection were significantly younger. Furthermore, in the stage III or IV cases, the 3-year disease-specific survival of the HPV infection-positive group was significantly better than that of the HPV-negative group. Surgical treatment was demonstrated to lead to a good prognosis for the patients with HPV-negative advanced cancer.
在日本，人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）被视为一种独特的实体。HPV-DNA测序分析与p16（INK4A）免疫组化（IHC）相结合，有助于区分预后较好的OPSCC患者与其他病例，尤其是在晚期病例中。对于HPV阴性的晚期癌症，建议进行手术治疗。
全球范围内，HPV相关的OPSCC病例数量一直在增加。然而，这种癌症在日本的发病率和预后意义尚未完全阐明。
本研究纳入了77例日本OPSCC患者。通过PCR和测序评估HPV-DNA的流行情况。通过IHC检测p16（INK4A）和p53的表达。分析HPV阳性和阴性患者的临床病理参数及疾病特异性生存率。
32例患者检测到HPV-DNA。34例患者经IHC检测p16（INK4A）呈阳性。HPV感染阳性的患者明显更年轻。此外，在III期或IV期病例中，HPV感染阳性组的3年疾病特异性生存率明显高于HPV阴性组。对于HPV阴性的晚期癌症患者，手术治疗显示出良好的预后。
