Faggons C E, Mabedi C, Shores C G, Gopal S
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
Malawi Med J. 2015 Sep;27(3):79-87. doi: 10.4314/mmj.v27i3.2.
Review the literature from 1990 to 2013 to determine known anatomic sites, risk factors, treatments, and outcomes of head and neck squamous cell carcinoma (HNSCC) in sub-Saharan Africa.
Using a systematic search strategy, literature pertaining to HNSCC in sub-Saharan Africa was reviewed and patient demographics, anatomic sites, histology, stage, treatment, and outcomes were abstracted. The contributions of human immunodeficiency virus (HIV), human papillomavirus (HPV) and behavioural risk factors to HNSCC in the region were assessed.
Of the 342 papers identified, 46 were utilized for review, including 8611 patients. In sub-Saharan Africa, the oropharyngeal/oral cavity was found to be the most common site, with 7750 cases (90% of all cases). Few papers distinguished oropharyngeal from oral cavity, making identification of possible HPV-associated oropharyngeal squamous cell carcinoma (SCC) difficult. SCC of the nasopharynx, nasal cavity, or paranasal sinuses was identified in 410 patients (4.8% of all cases). Laryngeal SCC was found in 385 patients (4.5% of all cases), and only 66 patients (0.8% of all cases) with hypopharyngeal SCC were identified. In 862 patients with data available, 43% used tobacco and 42% used alcohol, and reported use varied widely and was more common in laryngeal SCC than that of the oropharyngeal/oral cavity. Toombak and kola nut use was reported to be higher in patients with HNSCC. Several papers reported HIV-positive patients with HNSCC, but it was not possible to determine HNSCC prevalence in HIV-positive compared to negative patients. Reports of treatment and outcomes were rare.
The oropharyngeal/oral cavity was by far the most commonly reported site of HNSCC reported in sub-Saharan Africa. The roles of risk factors in HNSCC incidence in sub-Saharan Africa were difficult to delineate from the available studies, but a majority of patients did not use tobacco and alcohol.
回顾1990年至2013年的文献，以确定撒哈拉以南非洲地区头颈部鳞状细胞癌（HNSCC）已知的解剖部位、危险因素、治疗方法及治疗结果。
采用系统检索策略，对撒哈拉以南非洲地区有关HNSCC的文献进行回顾，并提取患者人口统计学资料、解剖部位、组织学类型、分期、治疗方法及治疗结果。评估人类免疫缺陷病毒（HIV）、人乳头瘤病毒（HPV）及行为危险因素对该地区HNSCC的影响。
在检索到的342篇论文中，46篇被用于综述，共纳入8611例患者。在撒哈拉以南非洲地区，口咽/口腔是最常见的发病部位，有7750例（占所有病例的90%）。很少有论文对口咽和口腔进行区分，这使得确定可能与HPV相关的口咽鳞状细胞癌（SCC）变得困难。410例患者（占所有病例的4.8%）被诊断为鼻咽癌、鼻腔癌或鼻窦癌。385例患者（占所有病例的4.5%）被诊断为喉癌，仅66例患者（占所有病例的0.8%）被诊断为下咽癌。在有数据的862例患者中，43%使用烟草，42%使用酒精，且报告的使用情况差异很大，在喉癌患者中比口咽/口腔癌患者更常见。据报告，HNSCC患者中使用toombak和可乐果的情况更为普遍。几篇论文报道了HIV阳性的HNSCC患者，但无法确定HIV阳性患者与阴性患者中HNSCC的患病率。关于治疗方法及治疗结果的报道很少。
口咽/口腔是迄今为止撒哈拉以南非洲地区报道的HNSCC最常见的发病部位。从现有研究中很难确定危险因素在撒哈拉以南非洲地区HNSCC发病中的作用，但大多数患者不使用烟草和酒精。
