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印度南部一家三级转诊中心头颈鳞状细胞癌患者中人乳头瘤病毒的检测及危险因素分析

Detection of Human Papilloma Virus and Risk Factors among Patients with Head and Neck Squamous Cell Carcinoma Attending a Tertiary Referral Centre in South India.

作者信息

Bandhary Satheesh K, Shetty Veena, Saldanha Marina, Gatti Priya, Devegowda Devananda, R Pushkal S, Shetty Avinash K

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, K.S.Hegde Medical Academy, NITTE University-575018 Mangalore, Karnataka, India. Email:

出版信息

Asian Pac J Cancer Prev. 2018 May 26;19(5):1325-1330. doi: 10.22034/APJCP.2018.19.5.1325.

Abstract

Background: Head and Neck Squamous Cell Carcinomas (HNSCC) is the sixth most common cancer globally. In India, on an average 25-30% of all cancer cases affect the head and neck. The etiological factors associated with HNSCC are tobacco, alcohol and environmental carcinogens. However there are few cases, where there are no obvious risk factors involved. In western counties, there are many reports of human papilloma virus (HPV) association with HNSCC. Hence, we conducted a study to determine the role of HPV infection and risk factors among patients with HNSCC. Materials and Methods: A prospective, cross-sectional study was conducted in a tertiary referral centre from January 2014 to March 2016. 88 patients were enrolled in the study. Socio- demographic, behavioural data, site and subsite involvement, histopathology, staging and treatment were documented. Polymerase chain reaction (PCR) was performed to detect the presence of HPV DNA using consensus primers MY 09/11 and GP5+/GP6+ and further the samples were subjected to PCR for detecting HPV type 16 and 18. Results: The study included 88 participants with HNSCC. 57 had oral and oropharyngeal squamous cell carcinoma, 11 with laryngeal malignancy and 20 involving hypopharynx. Among the participants buccal mucosa (n=22) was the most common subsite involved, majority (50%) had moderately differentiated squamous cell carcinoma and 53.4% presented in stage IV. 2 (2.6%) cases were positive for HPV consensus and both were positive for HPV 16, one case each in larynx and hypopharynx. There was statistical significance in the association between betel nut chewing, cigarette smoking and alcohol intake as risk factors in the carcinogenesis of HNSCC. Conclusion: In our setting in South India, HPV does not play a major role in the carcinogenesis of HNSCC but betel nut chewing, tobacco exposure and alcohol consumption remain major risk factors for HNSCC.

摘要

背景

头颈部鳞状细胞癌(HNSCC)是全球第六大常见癌症。在印度,所有癌症病例中平均有25 - 30%累及头颈部。与HNSCC相关的病因因素包括烟草、酒精和环境致癌物。然而,也有少数病例不存在明显的危险因素。在西方国家,有许多关于人乳头瘤病毒(HPV)与HNSCC关联的报道。因此,我们开展了一项研究以确定HPV感染及危险因素在HNSCC患者中的作用。

材料与方法

2014年1月至2016年3月在一家三级转诊中心进行了一项前瞻性横断面研究。88例患者纳入该研究。记录了社会人口统计学、行为数据、病变部位及亚部位累及情况、组织病理学、分期和治疗情况。使用通用引物MY 09/11和GP5+/GP6+进行聚合酶链反应(PCR)以检测HPV DNA的存在,进一步对样本进行PCR以检测HPV 16型和18型。

结果

该研究纳入了88例HNSCC患者。57例患有口腔和口咽鳞状细胞癌,11例患有喉恶性肿瘤,20例累及下咽。在参与者中,颊黏膜(n = 22)是最常累及的亚部位,大多数(50%)患有中度分化鳞状细胞癌,53.4%为IV期。2例(2.6%)HPV通用检测呈阳性,且均为HPV 16阳性,分别为1例喉癌和1例下咽癌。槟榔咀嚼、吸烟和饮酒作为HNSCC致癌的危险因素之间存在统计学关联。

结论

在我们印度南部的研究环境中,HPV在HNSCC致癌过程中不起主要作用,但槟榔咀嚼、烟草暴露和饮酒仍然是HNSCC的主要危险因素。

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