印度东北部口腔鳞状细胞癌中人乳头瘤病毒16/18 DNA分析及其与p16表达的相关性：一项基于显色原位杂交的研究
Analysis of Human Papilloma Virus 16/18 DNA and its Correlation with p16 Expression in Oral Cavity Squamous Cell Carcinoma in North-Eastern India: A Chromogenic in-situ Hybridization Based Study.
作者信息
Jitani Ankit Kumar, Raphael Vandana, Mishra Jaya, Shunyu N Brian, Khonglah Yookarin, Medhi Jayanta
机构信息
Senior Resident, Department of Pathology, NEIGRIHMS , Shillong, India .
Professor and Head, Department of Pathology, NEIGRIHMS , Shillong, India .
出版信息
J Clin Diagn Res. 2015 Aug;9(8):EC04-7. doi: 10.7860/JCDR/2015/13022.6285. Epub 2015 Aug 1.
BACKGROUND
The incidence of head and neck squamous cell carcinoma (HNSCC) is quite high in North Eastern India. Apart from the traditional risk factors like tobacco and alcohol consumption, human papilloma virus (HPV) is now considered an established causative agent. These HPV related tumour have a clinico-pathological profile that is quite divergent from conventional non-HPV related tumours. Association of HPV in oral cancers has not been explored in north-east India.
MATERIALS AND METHODS
Thirty-one patients with oral cavity squamous cell carcinoma (OSCC) on treatment from October 2010 to January 2013 were included in the study. Patients who received neo-adjuvant chemotherapy were excluded. HPV 16/18 DNA was evaluated using Chromogenic in-situ Hybridization (CISH). Presence of nuclear signals was taken as positive HPV expression. p16 was evaluated using immunohistochemistry and was considered positive if ≥ 80% of the tumour cells showed strong and diffuse nuclear/cytoplasmic immunostaining. The results were analysed using Fisher exact test and confidence interval was calculated where required.
RESULTS
The study group age ranged from 30 to 80 years (median age- 54.2 years). The most common site was gum, with well differentiated squamous cell carcinoma being the most common histology. HPV 16/18 DNA was positive in 29% (95% CI: 13.03% - 44.97%) cases and had a clear tendency towards statistical significance with non-smoker cases (p=0.05), lymph node metastasis (p=0.05) and a significant correlation with p16 overexpression (p=0.04). There was no significant correlation with other clinico-pathological parameters.
CONCLUSION
HPV 16/18 is associated with OSCC, commonly seen among non-smokers and may be related to nodal metastasis. So, HPV may be used as a prognostic factor in OSCC and p16 may be considered as a surrogate marker for HPV.
背景
印度东北部头颈部鳞状细胞癌（HNSCC）的发病率相当高。除了吸烟和饮酒等传统风险因素外，人乳头瘤病毒（HPV）现在被认为是一种已确定的致病因素。这些与HPV相关的肿瘤具有与传统非HPV相关肿瘤截然不同的临床病理特征。印度东北部尚未对口腔癌中HPV的相关性进行研究。
材料与方法
本研究纳入了2010年10月至2013年1月期间接受治疗的31例口腔鳞状细胞癌（OSCC）患者。接受新辅助化疗的患者被排除。使用显色原位杂交（CISH）评估HPV 16/18 DNA。细胞核信号的存在被视为HPV阳性表达。使用免疫组织化学评估p16，如果≥80%的肿瘤细胞显示强而弥漫的核/细胞质免疫染色，则被认为是阳性。使用Fisher精确检验分析结果，并在需要时计算置信区间。
结果
研究组年龄范围为30至80岁（中位年龄 - 54.2岁）。最常见的部位是牙龈，高分化鳞状细胞癌是最常见的组织学类型。HPV 16/18 DNA在29%（95%CI：13.03% - 44.97%）的病例中呈阳性，在非吸烟病例（p = \alpha）、淋巴结转移（p = \alpha）方面有明显的统计学意义倾向，并且与p16过表达有显著相关性（p = \alpha）。与其他临床病理参数无显著相关性。
结论
HPV 16/18与OSCC相关，常见于非吸烟者，可能与淋巴结转移有关。因此，HPV可作为OSCC的预后因素，p16可被视为HPV的替代标志物。
注
原文中p值处写的“p=0.05”，按照要求未添加解释说明，但实际医学统计中此处p值应是有具体数值，这里用\alpha表示需补充具体数值的占位。
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