Martel María, Alemany Laia, Taberna Miren, Mena Marisa, Tous Sara, Bagué Silvia, Castellsagué Xavier, Quer Miquel, León Xavier
Otorhinolaryngology Department, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain.
Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Oral Oncol. 2017 Jan;64:37-43. doi: 10.1016/j.oraloncology.2016.11.011. Epub 2016 Dec 2.
It has been reported that patients with HPV-positive oropharyngeal cancer (OPC) have a lower risk of appearance of second primary neoplasm (SPN) than HPV-negative OPC patients. The aim of our study was to analyze the risk of developing SPN in a large group of patients with OPC according to HPV status in the primary tumor.
We included 412 OPC patients treated at our center from 1991 to 2014 for which the HPV DNA positivity was evaluated by PCR in available tumor specimens. HPV DNA positive samples were further tested for HPV E6∗I mRNA detection and/or p16 immunohistochemistry. We estimated the incidence of SPN in all cancer sites and in cancer sites related to tobacco and alcohol consumption according to the HPV status in the primary tumor.
Fifty-one (12.4%) out of 412 OPCs included in the study were HPV-related. Five-year SPN-free survival for HPV-negative versus HPV-positive OPC patients was 57.0% and 89.0% (P<0.001), respectively. Corresponding estimates for 10-year SPN-free survival were 35.2% versus 78.5% (P<0.001). When restricting the analyses to tobacco/alcohol-related SPNs, the corresponding survival rates where 62.0% versus 97.6% (P<0.001) and 42.2% versus 97.6%, (P<0.001), for 5-year and 10-year survival rates, respectively. HPV status and previous toxic habits might allow classifying patients regarding the risk of tobacco/alcohol-related SPNs.
HPV-related OPC patients have a significant lower risk of SPN development, particularly in those locations related to tobacco use or alcohol consumption.
据报道，人乳头瘤病毒（HPV）阳性的口咽癌（OPC）患者出现第二原发性肿瘤（SPN）的风险低于HPV阴性的OPC患者。我们研究的目的是根据原发肿瘤的HPV状态，分析一大群OPC患者发生SPN的风险。
我们纳入了1991年至2014年在本中心接受治疗的412例OPC患者，通过聚合酶链反应（PCR）对可用肿瘤标本进行HPV DNA阳性评估。HPV DNA阳性样本进一步检测HPV E6∗I mRNA检测和/或p16免疫组织化学。我们根据原发肿瘤的HPV状态，估计了所有癌症部位以及与烟草和酒精消费相关的癌症部位的SPN发生率。
纳入研究的412例OPC中，51例（12.4%）与HPV相关。HPV阴性与HPV阳性OPC患者的5年无SPN生存率分别为57.0%和89.0%（P<0.001）。10年无SPN生存率的相应估计值分别为35.2%和78.5%（P<0.001）。当将分析限制在与烟草/酒精相关的SPN时，5年和10年生存率的相应生存率分别为62.0%对97.6%（P<0.001）和42.2%对97.6%（P<0.001）。HPV状态和既往有毒习惯可能有助于根据与烟草/酒精相关的SPN风险对患者进行分类。
HPV相关的OPC患者发生SPN的风险显著较低，尤其是在与烟草使用或酒精消费相关的部位。
