Chan Michael W, Higgins Kevin, Enepekides Danny, Poon Ian, Symons Sean P, Moineddin Rahim, Weinreb Ilan, Shearkhani Omid, Chen Amy, Beelen Jocelyne, Chan Aimee, Maralani Pejman Jabehdar
Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
ORL J Otorhinolaryngol Relat Spec. 2016;78(6):344-352. doi: 10.1159/000458446. Epub 2017 Mar 1.
Human papilloma virus-related oropharyngeal carcinoma (HPV+ OPC) is a unique entity compared to HPV-unrelated (HPV-) OPC. Previous studies were inconclusive regarding the differences between HPV+ and HPV- OPCs on diffusion-weighted imaging (DWI). This study sought to determine if there is an association between HPV status and apparent diffusion coefficient (ADC) values as an imaging biomarker in OPCs.
OPC patients with pretreatment MRI including DWI were retrospectively reviewed and analyzed as a blinded, controlled cohort. HPV status was biopsy-ascertained with p16 staining. ADC values were determined by placing the largest possible circular region of interest in solid portions of primary tumors and/or metastatic lymph nodes. Necrotic and cystic portions were excluded.
Twenty-eight HPV+ and 12 HPV- patients were included. Adjusted for age and sex, ADC values were significantly lower in HPV+ OPC primary tumors (p = 0.013) and lymph node metastases (p = 0.013). The area under the curve (AUC) was 0.85 and 0.90, respectively. A model with a linear combination of the 2 variables yielded an AUC of 0.92.
ADC values were significantly lower in both the primary tumors and lymph node metastases in HPV+ OPCs compared to HPV- OPCs. These results confirm the results of prior studies.
与人类乳头瘤病毒无关的口咽癌（HPV-OPC）相比，人乳头瘤病毒相关的口咽癌（HPV+OPC）是一种独特的实体。先前关于HPV+和HPV-OPC在扩散加权成像（DWI）上差异的研究尚无定论。本研究旨在确定HPV状态与表观扩散系数（ADC）值之间是否存在关联，将其作为OPC的一种成像生物标志物。
对接受过包括DWI在内的预处理MRI的OPC患者进行回顾性分析，作为一个盲法对照队列。HPV状态通过p16染色活检确定。通过在原发性肿瘤和/或转移性淋巴结的实性部分放置尽可能大的圆形感兴趣区域来确定ADC值。坏死和囊性部分被排除。
纳入28例HPV+患者和12例HPV-患者。经年龄和性别校正后，HPV+OPC原发性肿瘤（p = 0.013）和淋巴结转移灶（p = 0.013）的ADC值显著更低。曲线下面积（AUC）分别为0.85和0.90。一个包含这两个变量线性组合的模型产生的AUC为0.92。
与HPV-OPC相比，HPV+OPC的原发性肿瘤和淋巴结转移灶中的ADC值均显著更低。这些结果证实了先前研究的结果。
