Boscolo-Rizzo Paolo, Zorzi Manuel, Del Mistro Annarosa, Da Mosto Maria Cristina, Tirelli Giancarlo, Buzzoni Carlotta, Rugge Massimo, Polesel Jerry, Guzzinati Stefano
Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy.
Veneto Tumor Registry, Veneto Region, Padova, Italy.
PLoS One. 2018 Feb 7;13(2):e0192621. doi: 10.1371/journal.pone.0192621. eCollection 2018.
The current study aimed to investigate the incidence and survival patterns of HNSCCs arising from different anatomic sites, potentially related (the oropharynx) or unrelated (the oral cavity, the larynx/hypopharynx) to HPV, to provide clues on possible growing impact of HPV in the epidemiology of HNSCC in Italy. Epidemiological data were retrieved from ten long-term Cancer Registries covering a population of 7.8 million inhabitants. Trends were described by means of the estimated annual percent change (APC) stratified by age and gender, and compared between HPV-related and HPV-unrelated anatomical sites. The data regarding 28,295 HNSCCs diagnosed in Italy between 1988 and 2012 were analyzed. In males, the incidence rate (IR) of cancers arising from sites unrelated to HPV infection significantly decreased in all age groups (APC:-3.31 for larynx/hypopharynx; APC:-1.77 for oral cavity), whereas stable IR were observed for cancers arising from sites related to HPV infection. In females, IR for cancers from HPV-related sites increased significantly over the observed period; the largest increment was noted in those over 60 (APC:2.92%) who also showed a significantly lower number of HNSCCs from the larynx/hypopharynx (APC:- 0.84) and a significantly higher number of oral cavity tumors (APC = 2.15). The five-year relative survival remained largely unchanged in the patients with laryngeal/hypopharyngeal SCC and, conversely, significantly improved in the patients with SCC at HPV-related sites. The trends observed suggest a potential increasing impact of HPV infection on the epidemiology of HNSCC in Italy, but to a lesser extent and with a different pattern from that observed in other Western countries.
本研究旨在调查源于不同解剖部位的头颈部鳞状细胞癌（HNSCC）的发病率和生存模式，这些部位可能与HPV相关（口咽）或不相关（口腔、喉/下咽），以提供有关HPV在意大利HNSCC流行病学中可能日益增加的影响的线索。从十个长期癌症登记处检索了流行病学数据，覆盖人口780万。通过按年龄和性别分层的估计年度百分比变化（APC）描述趋势，并在HPV相关和HPV不相关的解剖部位之间进行比较。分析了1988年至2012年期间在意大利诊断出的28295例HNSCC的数据。在男性中，与HPV感染无关部位发生的癌症发病率在所有年龄组中均显著下降（喉/下咽APC：-3.31；口腔APC：-1.77），而与HPV感染相关部位发生的癌症发病率则保持稳定。在女性中，HPV相关部位癌症的发病率在观察期内显著增加；60岁以上人群的增幅最大（APC：2.92%），这些人群中喉/下咽HNSCC的数量也显著减少（APC：-0.84），口腔肿瘤的数量显著增加（APC = 2.15）。喉/下咽鳞状细胞癌患者的五年相对生存率基本保持不变，相反，HPV相关部位鳞状细胞癌患者的五年相对生存率显著提高。观察到的趋势表明，HPV感染对意大利HNSCC流行病学的潜在影响可能在增加，但程度较小，且模式与其他西方国家不同。
