Carpén Timo, Sjöblom Anni, Lundberg Marie, Haglund Caj, Markkola Antti, Syrjänen Stina, Tarkkanen Jussi, Mäkitie Antti, Hagström Jaana, Mattila Petri
a Department of Otorhinolaryngology - Head and Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
b Department of Pathology , Haartman Institute and HUSLAB, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
Acta Otolaryngol. 2018 May;138(5):513-518. doi: 10.1080/00016489.2017.1405279. Epub 2017 Nov 21.
Oropharyngeal squamous cell carcinoma (OPSCC) is divided in two different disease entities depending on HPV involvement. We investigated differences in presenting symptoms and clinical findings in patients with HPV-positive and -negative OPSCC tumors.
Altogether 118 consecutive patients diagnosed with primary OPSCC between 2012 and 2014 at the Helsinki University Hospital were included. HPV-status of the tumors was assessed by PCR detection of HPV DNA and immunostaining with p16-INK4a antibody.
Fifty-one (47.7%) of the patients had HPV-positive and 56 (52.3%) HPV-negative tumors. Forty-nine (49/51, 96.1%) of the HPV+ tumors were also p16+ showing high concordance. The most common presenting symptom among HPV+/p16+ patients was a neck mass (53.1%), whereas any sort of pain in the head and neck area was more frequently related to the HPV-/p16- (60.0%) group. HPV+/p16+ tumors had a tendency to locate in the tonsillar complex and more likely had already spread into regional lymph nodes compared with HPV-/p16- tumors. Smoking and heavy alcohol consumption were significantly more common among HPV−/p16− patients but also rather common among HPV+/p16+ patients [corrected].
This analysis of symptoms and signs confirm that OPSCC can be dichotomized in two distinct disease entities as defined by HPV status.
根据人乳头瘤病毒（HPV）的感染情况，口咽鳞状细胞癌（OPSCC）可分为两种不同的疾病实体。我们研究了HPV阳性和阴性OPSCC肿瘤患者在症状表现和临床检查结果上的差异。
纳入2012年至2014年期间在赫尔辛基大学医院连续诊断为原发性OPSCC的118例患者。通过PCR检测HPV DNA和使用p16-INK4a抗体进行免疫染色来评估肿瘤的HPV状态。
51例（47.7%）患者的肿瘤为HPV阳性，56例（52.3%）为HPV阴性。49例（49/51，96.1%）HPV阳性肿瘤也为p16阳性，显示出高度一致性。HPV阳性/p16阳性患者中最常见的症状是颈部肿块（53.1%），而头颈部区域的任何疼痛在HPV阴性/p16阴性组中更为常见（60.0%）。与HPV阴性/p16阴性肿瘤相比，HPV阳性/p16阳性肿瘤倾向于位于扁桃体复合体，并且更有可能已经扩散到区域淋巴结。HPV阴性/p16阴性患者中吸烟和大量饮酒明显更为常见，但在HPV阳性/p16阳性患者中也相当常见[校正后]。
对症状和体征的分析证实，根据HPV状态，OPSCC可分为两种不同的疾病实体。
