口咽鳞状细胞癌中PET-CT淋巴结SUVmax与p16阳性的相关性
Correlation of PET-CT nodal SUVmax with p16 positivity in oropharyngeal squamous cell carcinoma.
作者信息
Clark Jessica, Jeffery Caroline C, Zhang Han, Cooper Tim, O'Connell Daniel A, Harris Jeffrey, Seikaly Hadi, Biron Vincent L
机构信息
Faculty of Medicine and Dentistry, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Medicine and Dentistry, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada. dan.o'
出版信息
J Otolaryngol Head Neck Surg. 2015 Sep 15;44(1):37. doi: 10.1186/s40463-015-0091-5.
BACKGROUND
The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has been rising in recent years. Given the clinical impact of HPV/p16 positivity in OPSCC, identifying surrogate markers of this disease early in the diagnostic work-up of these patients could improve patient care.
METHODS
Demographic, pathologic, staging and PET-CT data from patients diagnosed with OPSCC from 2009-2014 were obtained from a prospectively collected provincial cancer registry. Tumor HPV/p16 status was correlated to the maximum standard uptake value (SUVmax) of the primary tumor and cervical nodes. Comparisons of means and multinomial regression models were used to determine associations between p16 status and SUVmax. A diagnostic odds ratio was calculated using a cut off value for predicting HPV/p16 positivity based on nodal SUVmax.
RESULTS
PET-CT and HPV/p16 data was obtained for 65 patients treated surgically for OPSCC. Significantly higher nodal SUVmax was associated with HPV/p16 positive nodes (SUVmax 10.8 vs 7.9). No significant differences were seen between HPV/p16 positive vs negative primary tumor SUVmax (10.3 vs 13.7). In combination with other clinical parameters, higher nodal SUVmax was highly correlated with HPV/p16 positivity.
CONCLUSION
Elevated nodal SUVmax is a significant predictor of HPV/p16 positive disease.
背景
近年来，人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）发病率一直在上升。鉴于HPV/p16阳性在OPSCC中的临床影响，在这些患者的诊断检查早期识别该疾病的替代标志物可改善患者护理。
方法
从一个前瞻性收集的省级癌症登记处获得2009年至2014年诊断为OPSCC的患者的人口统计学、病理学、分期和PET-CT数据。肿瘤HPV/p16状态与原发肿瘤和颈部淋巴结的最大标准摄取值（SUVmax）相关。采用均值比较和多项回归模型来确定p16状态与SUVmax之间的关联。基于淋巴结SUVmax，使用预测HPV/p16阳性的临界值计算诊断比值比。
结果
获得了65例接受手术治疗的OPSCC患者的PET-CT和HPV/p16数据。淋巴结SUVmax显著升高与HPV/p16阳性淋巴结相关（SUVmax分别为10.8和7.9）。HPV/p16阳性与阴性原发肿瘤SUVmax之间未见显著差异（分别为10.3和13.7）。结合其他临床参数，较高的淋巴结SUVmax与HPV/p16阳性高度相关。
结论
淋巴结SUVmax升高是HPV/p16阳性疾病的重要预测指标。
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