人乳头瘤病毒和p16（INK4a）对肛管癌患者治疗结果的影响。

Influence of human papillomavirus and p16(INK4a) on treatment outcome of patients with anal cancer.

作者信息

Koerber Stefan Alexander, Schoneweg Clara, Slynko Alla, Krug David, Haefner Matthias F, Herfarth Klaus, Debus Juergen, Sterzing Florian, von Knebel Doeberitz Magnus, Prigge Elena-Sophie, Reuschenbach Miriam

机构信息

Department of Radiation Oncology, University Hospital Heidelberg, Germany; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center Heidelberg, Germany.

Institute of Biostatistics, German Cancer Research Center, Heidelberg, Germany.

出版信息

Radiother Oncol. 2014 Dec;113(3):331-6. doi: 10.1016/j.radonc.2014.11.013. Epub 2014 Nov 22.

DOI:10.1016/j.radonc.2014.11.013

PMID:25465729

Abstract

BACKGROUND

The purpose of this study was to evaluate HPV-DNA and p16(INK4a) (p16) expression as prognostic markers for outcome in patients with anal cancer.

METHODS

From January 2000 to December 2011 a cohort of 105 anal cancer patients was treated with definitive chemoradiation at our institution. Tumor biopsies from 90 patients were analyzed for HPV-DNA by polymerase chain reaction and for p16 expression by immunohistochemistry.

RESULTS

Median follow-up was 48.6months (range 2.8-169.1months). HPV-DNA or p16-expression was found in 75 anal cancers each (83.3%), concordance was detectable in 70 tumors (77.8%). Significantly improved overall survival (OS) [77.1% vs. 51.4%, p=0.005], progression-free survival (PFS) [64.0% vs. 35.0%, p<0.001] and improved local control [81.0% vs. 55.9%, p=0.023] was found for concomitant HPV- and p16-positive anal carcinomas (cHPPAC) in univariate analysis. Multivariate analysis showed better OS [p=0.015] and PFS [p=0.002] for cHPPAC.

CONCLUSION

The combination of HPV-DNA and p16 can be used as an independent prognostic parameter in anal cancer patients.

摘要

背景

本研究的目的是评估HPV-DNA和p16（INK4a）（p16）表达作为肛管癌患者预后标志物的价值。

方法

2000年1月至2011年12月，我们机构对105例肛管癌患者进行了根治性放化疗。对90例患者的肿瘤活检组织进行聚合酶链反应检测HPV-DNA，免疫组织化学检测p16表达。

结果

中位随访时间为48.6个月（范围2.8 - 169.1个月）。75例肛管癌检测到HPV-DNA或p16表达（83.3%），70例肿瘤检测到一致性表达（77.8%）。单因素分析显示，HPV和p16均阳性的肛管癌（cHPPAC）患者的总生存期（OS）显著改善[77.1%对51.4%，p = 0.005]、无进展生存期（PFS）显著改善[64.0%对35.0%，p < 0.001]以及局部控制改善[81.0%对55.9%，p = 0.023]。多因素分析显示cHPPAC患者的OS [p = 0.015]和PFS [p = 0.002]更好。