Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Department of Radiation Oncology, Rutgers New Jersey Medical School, Newark, NJ.
Int Forum Allergy Rhinol. 2017 Oct;7(10):980-989. doi: 10.1002/alr.21996. Epub 2017 Aug 31.
The role of human papillomavirus (HPV) in sinonasal squamous cell carcinoma (SNSCC) is not well understood.
The National Cancer Database was queried for cases of SNSCC with known HPV status. Demographics, socioeconomic variables, TNM stage, histology, grade, treatment modalities, and overall survival (OS) through 5 years were compared between HPV-positive and HPV-negative tumors. Cox proportional hazard regression analyses were performed.
Seven hundred seventy (770) cases were identified; 526 were HPV-negative (68.3%) and 244 (31.7%) were HPV-positive. Patients with HPV-positive tumors were younger (58.0 vs 63.7 years, p < 0.0001). Nasal cavity (49.4%) tumors were more likely to be HPV-positive (p < 0.05) than maxillary (18.8%), ethmoid (18.8%), and frontal (18.2%) sinus tumors. Large cell nonkeratinizing (42.4%), papillary (42.1%), and basaloid (56.5%) tumors were more likely than keratinizing (25.2%) tumors to be HPV-positive (p < 0.05). Well-differentiated (grade I) tumors (9.0%) were less likely than higher grade tumors to be HPV-positive (p < 0.05). Gender, race, facility type, insurance type, median income, education level, Charlson-Deyo comorbidity score, overall stage, T stage, N stage, M stage, tumor size, treatment modality, surgical approach, and surgical margins did not vary by HPV status (p ≥ 0.05). HPV-positive tumors had higher OS than HPV-negative tumors (p < 0.0001). At 5 years, OS was 68.1% and 51.5% for HPV-positive and HPV-negative tumors, respectively. On multivariate analyses, HPV positivity remained a favorable prognostic factor (hazard ratio, 0.49; 95% confidence interval, 0.34-0.70).
HPV positivity is more common in nasal cavity SCC and nonkeratinizing SNSCC. It is also a favorable prognostic factor in SNSCC. Future studies on SNSCC should take HPV positivity into consideration.
人乳头瘤病毒（HPV）在鼻窦鳞状细胞癌（SNSCC）中的作用尚不清楚。
从国家癌症数据库中查询已知 HPV 状态的 SNSCC 病例。比较 HPV 阳性和 HPV 阴性肿瘤的人口统计学、社会经济变量、TNM 分期、组织学、分级、治疗方式和 5 年总生存率（OS）。采用 Cox 比例风险回归分析。
共确定了 770 例病例；526 例为 HPV 阴性（68.3%），244 例为 HPV 阳性（31.7%）。HPV 阳性肿瘤患者年龄较小（58.0 岁 vs 63.7 岁，p<0.0001）。鼻腔（49.4%）肿瘤更可能为 HPV 阳性（p<0.05），而上颌窦（18.8%）、筛窦（18.8%）和额窦（18.2%）肿瘤则不然。大细胞非角化（42.4%）、乳头状（42.1%）和基底细胞样（56.5%）肿瘤比角化（25.2%）肿瘤更有可能为 HPV 阳性（p<0.05）。分化良好（分级 I）肿瘤（9.0%）比高级别肿瘤更不可能为 HPV 阳性（p<0.05）。性别、种族、医疗机构类型、保险类型、中位收入、教育水平、Charlson-Deyo 合并症评分、总体分期、T 分期、N 分期、M 分期、肿瘤大小、治疗方式、手术方式和手术切缘不因 HPV 状态而不同（p≥0.05）。HPV 阳性肿瘤的 OS 高于 HPV 阴性肿瘤（p<0.0001）。5 年时，HPV 阳性肿瘤的 OS 为 68.1%，HPV 阴性肿瘤的 OS 为 51.5%。多因素分析显示，HPV 阳性仍是有利的预后因素（风险比，0.49；95%置信区间，0.34-0.70）。
HPV 阳性在鼻腔 SCC 和非角化性 SNSCC 中更为常见。它也是 SNSCC 的一个有利的预后因素。未来对 SNSCC 的研究应考虑 HPV 阳性。
