Erkul Evren, Yilmaz Ismail, Narli Gizem, Babayigit Mustafa Alparslan, Gungor Atila, Demirel Dilaver
Department of Otorhinolaryngology, Gulhane School of Medicine, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.
Department of Pathology, University of Health Sciences, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2017 Jul;274(7):2921-2926. doi: 10.1007/s00405-017-4573-0. Epub 2017 Apr 21.
The aim of the present study was to evaluate the role of HPV in laryngeal squamous cell carcinoma and correlate it with patients' clinicopathological data. In total, 78 laryngeal squamous cell carcinoma patients enrolled in this study. The presence of genotype-specific HPV DNA was evaluated using Genotyping Assay in formalin-fixed paraffin-embedded tissue which was diagnosed between 2005 and 2015. All samples were also evaluated for p16 immunohistochemical staining. HPV DNA and p16 status were assessed in terms of location, smoking, alcohol consumption, lymph node status, tumor stage, overall survival, disease-free survival, perineural invasion, and vascular invasion retrospectively. Five test samples were excluded from the study due to inadequate deoxyribonucleic acid purity. HPV DNA was detected in 19 of 73 (26.02%) in patients with laryngeal squamous cell carcinoma. Human papilloma virus genotyping revealed double human papilloma virus in one case (types 16 and 59) and HPV 16 in the remaining cases. Although HPV-positive cases showed slightly better 3 years survival than HPV-negative ones, this finding was not statistically significant (overall survival p = 0.417, HPV positive: 92.3%, HPV negative: 81.4%, and disease-free survival p = 0.526, HPV positive: 93.8%, HPV negative: 80.9%). The presence of HPV DNA was not significantly associated with any clinicopathological features (p > 0.05). Among 73 patients, only 4 had an immunohistochemical staining of p16 and these patients were also HPV DNA 16 positive. Although our study results revealed a slightly better survival in patients with HPV DNA positivity for HPV 16 compared to the negative ones, the difference was not statistically significant. However, an increasing rate in especially high-risk-type HPV-16 prevalence in laryngeal squamous cell carcinoma by RT-PCR method was observed compared to our previous study. Although the presence of HPV in laryngeal SCCs seems to be associated with slightly better prognosis, additional studies may be needed, since our results were not statistically significant. We believed that HPV is not an adequate biomarker for diagnostic and prognostic purposes in laryngeal squamous cell carcinoma.
本研究的目的是评估人乳头瘤病毒（HPV）在喉鳞状细胞癌中的作用，并将其与患者的临床病理数据相关联。本研究共纳入78例喉鳞状细胞癌患者。使用基因分型检测法对2005年至2015年间诊断的福尔马林固定石蜡包埋组织中的基因型特异性HPV DNA进行评估。所有样本还进行了p16免疫组化染色评估。回顾性评估HPV DNA和p16状态与肿瘤位置、吸烟、饮酒、淋巴结状态、肿瘤分期、总生存期、无病生存期、神经侵犯和血管侵犯的关系。由于脱氧核糖核酸纯度不足，5个测试样本被排除在研究之外。在73例喉鳞状细胞癌患者中，19例（26.02%）检测到HPV DNA。人乳头瘤病毒基因分型显示1例为双重人乳头瘤病毒感染（16型和59型），其余病例为HPV 16型。虽然HPV阳性病例的3年生存率略高于HPV阴性病例，但这一发现无统计学意义（总生存期p = 0.417，HPV阳性：92.3%，HPV阴性：81.4%；无病生存期p = 0.526，HPV阳性：93.8%，HPV阴性：80.9%）。HPV DNA的存在与任何临床病理特征均无显著相关性（p>0.05）。73例患者中，仅4例p16免疫组化染色阳性，且这些患者HPV DNA 16型也呈阳性。虽然我们的研究结果显示HPV 16 DNA阳性患者的生存率略高于阴性患者，但差异无统计学意义。然而，与我们之前的研究相比，通过逆转录聚合酶链反应（RT-PCR）方法观察到喉鳞状细胞癌中尤其是高危型HPV-16的患病率有所上升。虽然喉鳞状细胞癌中HPV的存在似乎与预后略好相关，但由于我们的结果无统计学意义，可能需要进一步研究。我们认为，HPV在喉鳞状细胞癌的诊断和预后判断方面并非一个充分的生物标志物。
