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遗传变异预测 HPV 阳性口咽癌患者根治性放疗后的临床结局。

Genetic Variants Predict Clinical Outcomes of HPV-Positive Oropharyngeal Cancer Patients after Definitive Radiotherapy.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Beijing, China.

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.

出版信息

Clin Cancer Res. 2018 May 1;24(9):2225-2233. doi: 10.1158/1078-0432.CCR-17-1904. Epub 2018 Feb 20.

Abstract

TGFβ1 plays a critical role in inflammation and immune responses and treatment response and survival. variants may affect its expression level or functional efficiency, thus modifying tumor status and survival in human papillomavirus (HPV)-positive squamous cell carcinoma of the oropharynx (SCCOP). We determined tumor HPV16 status and genotyped three polymorphisms in 564 incident SCCOP patients treated with radiotherapy or chemoradiation. Univariate and multivariable Cox models were used to evaluate the associations between the three polymorphisms and survival. Overall, 85% of patients (482 of 564) had HPV16-positive SCCOP. We found that rs1982073 had statistically significant associations with survival, whereas rs1800469 and rs1800471 did not. Patients with rs1982073 CT/CC variant genotypes had significantly better overall, disease-specific, and disease-free survival compared with those with the corresponding common homozygous TT genotype (all log-rank: < 0.001). Furthermore, these genotypes were significantly associated with an approximately 5 times reduced risk of overall death, death owing to disease, and recurrence after multivariable adjustment. Moreover, the stratified analyses by tumor HPV status indicated that the significant effects of rs1982073 polymorphism on survival were found among HPV16-positive SCCOP patients only. Finally, the functional relevance of these variants was further characterized. Our findings support that the rs1982073 polymorphism plays a significant role in the prognosis of SCCOP, especially in HPV16-positive SCCOP patients treated with chemoradiation. Prospective studies with larger sample sizes are needed to confirm these findings. .

摘要

TGFβ1 在炎症和免疫反应以及治疗反应和生存中起着关键作用。 变体可能会影响其表达水平或功能效率,从而改变人乳头瘤病毒 (HPV) 阳性口咽鳞状细胞癌 (SCCOP) 中的肿瘤状态和生存。我们确定了肿瘤 HPV16 状态,并对 564 例接受放疗或放化疗的新发 SCCOP 患者中的三个 多态性进行了基因分型。单变量和多变量 Cox 模型用于评估三个多态性与生存之间的关联。总体而言,85%的患者(564 例中有 482 例)患有 HPV16 阳性 SCCOP。我们发现 rs1982073 与生存有统计学显著关联,而 rs1800469 和 rs1800471 则没有。与相应的常见纯合 TT 基因型相比, rs1982073 CT/CC 变异基因型的患者具有显著更好的总生存、疾病特异性生存和无病生存(所有对数秩: < 0.001)。此外,这些基因型与总死亡、因病死亡和多变量调整后复发的风险降低约 5 倍显著相关。此外,根据肿瘤 HPV 状态进行的分层分析表明,只有 HPV16 阳性 SCCOP 患者中, rs1982073 多态性对生存的显著影响。最后,进一步表征了这些变体的功能相关性。我们的研究结果支持 rs1982073 多态性在 SCCOP 预后中起着重要作用,特别是在接受放化疗的 HPV16 阳性 SCCOP 患者中。需要更大样本量的前瞻性研究来证实这些发现。

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