Goodman Marc T, Saraiya Mona, Thompson Trevor D, Steinau Martin, Hernandez Brenda Y, Lynch Charles F, Lyu Christopher W, Wilkinson Edward J, Tucker Thomas, Copeland Glenn, Peters Edward S, Altekruse Sean, Unger Elizabeth R
Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Eur J Cancer. 2015 Dec;51(18):2759-67. doi: 10.1016/j.ejca.2015.09.005. Epub 2015 Nov 18.
The presence of human papillomavirus (HPV) DNA in oropharyngeal squamous cell cancer (OPSCC) tissue appears to be a strong predictor of improved prognosis, but this observation has not been explored in a population-based sample with generalisable findings.
Follow-up data from a large sample of OPSCC patients identified through six population-based cancer registries in the United States of America (USA) were used to characterise the association of tumour HPV status with survival.
HPV DNA was detected in tumour tissue from 71% (378 in 529) of the OPSCC patients. A total of 65% of patients with HPV16-associated tumours survived 5 years compared to 46% of patients with other HPV types and 28% of patients with HPV-negative tumours (p log-rank test <0.0001). The OPSCC patients with detectable HPV16 DNA had a 62% reduced hazard of death at 5 years, and patients with other HPV types had a 42% reduced hazard of death at 5 years compared to HPV-negative patients. Compared to non-Hispanic Whites, Blacks with OPSCC had a 2.6-fold greater risk of death at 5 years after adjustment for HPV status and other prognostic variables. Both surgery and radiation therapy were associated with a reduced 5-year risk of death, but no evidence was found for an interaction between HPV status and radiotherapy or surgery on survival time.
Data from this US study suggest that HPV16-positive OPSCC patients survive longer than HPV-negative patients regardless of treatment, highlighting the prognostic importance of HPV status for this malignancy. Optimal treatment regimens for OPSCC could be tailored to each patient's HPV status and prognostic profile.
口咽鳞状细胞癌（OPSCC）组织中人类乳头瘤病毒（HPV）DNA的存在似乎是预后改善的有力预测指标，但这一观察结果尚未在具有可推广结果的基于人群的样本中进行探讨。
利用从美国六个基于人群的癌症登记处识别出的大量OPSCC患者样本的随访数据，来描述肿瘤HPV状态与生存之间的关联。
在529例OPSCC患者中，71%（378例）的肿瘤组织检测到HPV DNA。与其他HPV类型患者的46%和HPV阴性肿瘤患者的28%相比，共有65%的HPV16相关肿瘤患者存活5年（对数秩检验p<0.0001）。与HPV阴性患者相比，检测到HPV16 DNA的OPSCC患者5年时死亡风险降低62%，其他HPV类型患者5年时死亡风险降低42%。在调整HPV状态和其他预后变量后，与非西班牙裔白人相比，患有OPSCC的黑人5年时死亡风险高2.6倍。手术和放射治疗均与5年死亡风险降低相关，但未发现HPV状态与放疗或手术对生存时间存在相互作用的证据。
这项美国研究的数据表明，无论接受何种治疗，HPV16阳性的OPSCC患者比HPV阴性患者存活时间更长，突出了HPV状态对这种恶性肿瘤的预后重要性。OPSCC的最佳治疗方案可根据每位患者的HPV状态和预后情况进行定制。
