Rhie Arang, Park Weon Seo, Choi Moon Kyung, Kim Ji-Hyun, Ryu Junsun, Ryu Chang Hwan, Kim Jong-Il, Jung Yuh-Seog
From the Department of Biomedical Science, Department of Biochemistry and Molecular Biology, Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul (AR, J-IIK); Department of Pathology, Center for Specific Organs Cancer, Hematologic Malignancy Branch, National Cancer Center, Goyang, Gyeonggi (WSP, MKC); and Department of Otolaryngology-Head and Neck Surgery, Graduate School of Cancer Science and Policy, Specific Organs Cancer Branch, National Cancer Center, Goyang, Gyeonggi, Korea (J-HK, JR, CHR, Y-SJ).
Medicine (Baltimore). 2015 Dec;94(50):e2187. doi: 10.1097/MD.0000000000002187.
Recently increasing high-risk HPV+ OSCC exhibits unique clinical and molecular characteristics compared to HPV-unrelated (HPV-) counterpart. Genomic copy number variations (CNVs), unique in HPV+ OSCCs, and their role for the prognosis prediction remains poorly studied. Here, we analyzed the distinct genomic copy number variations (CNVs) in human papillomavirus-related (HPV+) oropharyngeal squamous cell carcinoma (OSCC) and their role as a prognosticator after curative resection. For 58 consecutive, Korean OSCC patients that underwent surgery-based treatment with median 10 years of follow-up, HPV-related markers, and genome-wide CNV analysis were analyzed. Clinical associations between the CNV profile and survival analyses were followed. p16 expression predicted the overall survival (OS) (hazard ratio [HR] = 0.27, confidence interval [CI]: 0.39-0.80, P = 0.0006) better than HPV L1 PCR (HR = 0.83, CI: 0.66-1.29, P = 0.64), smoking, or other variables. Although the overall number of CNVs was not significantly different, 30 loci showed unique CNV patterns between the p16+ and p16- groups. A region containing PRDM2 was amplified only in the p16+ group, whereas EGFR and 11q13.3 showed increased amplification in p16- counterpart. Loss of a locus containing FGF18 led to a worse, but gain of region including CDK10 and RAD18 led to better overall survival (OS) in all OSCC patients. Meanwhile, subgroup analysis of p16+ OSCC revealed that amplification of regions harboring HRAS and loss of locus bearing KDR led to better OS. p16+ OSCC exhibit distinct CNV patterns compared with p16- counterpart. Specific patterns of CNVs predict better survival, especially in p16+ OSCC. This might allow better insights of the outcome after curative resection for HPV+ and HPV- OSCC.
与HPV阴性(HPV-)的口咽鳞状细胞癌(OSCC)相比,近年来高危HPV阳性的OSCC表现出独特的临床和分子特征。HPV阳性的OSCC中特有的基因组拷贝数变异(CNV)及其对预后预测的作用仍研究不足。在此,我们分析了人乳头瘤病毒相关(HPV+)口咽鳞状细胞癌(OSCC)中独特的基因组拷贝数变异(CNV)及其在根治性切除术后作为预后指标的作用。对58例连续接受手术治疗且中位随访10年的韩国OSCC患者进行了HPV相关标志物和全基因组CNV分析。随后分析了CNV图谱与生存分析之间的临床关联。p16表达比HPV L1 PCR(风险比[HR]=0.83,置信区间[CI]:0.66-1.29,P=0.64)、吸烟或其他变量更能预测总生存期(OS)(风险比[HR]=0.27,置信区间[CI]:0.39-0.80,P=0.0006)。尽管CNV的总数没有显著差异,但30个基因座在p16阳性和p16阴性组之间显示出独特的CNV模式。一个包含PRDM2的区域仅在p16阳性组中扩增,而EGFR和11q13.3在p16阴性组中显示出增加的扩增。在所有OSCC患者中,一个包含FGF18的基因座缺失导致较差的总生存期,但包含CDK10和RAD18的区域扩增导致较好的总生存期。同时,p16阳性OSCC的亚组分析显示,携带HRAS区域的扩增和携带KDR基因座的缺失导致较好的总生存期。与p16阴性的OSCC相比,p16阳性的OSCC表现出独特的CNV模式。特定的CNV模式可预测更好的生存期,尤其是在p16阳性的OSCC中。这可能有助于更好地了解HPV阳性和HPV阴性OSCC根治性切除术后的预后。