a Department of Otorhinolaryngology, Head and Neck Surgery and Audiology , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark.
b Department of Pathology , Rigshospitalet University of Copenhagen , Copenhagen , Denmark.
Acta Oncol. 2019 Mar;58(3):267-272. doi: 10.1080/0284186X.2018.1546059. Epub 2019 Jan 9.
Persistent infection with high-risk genotypes of human papillomavirus (HPV) is the main risk factor in the development of uterine cervical precancerous lesions and cervical cancer (CC), and cases of HPV-induced oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the Western world. We investigated the association between HPV and p16 status and previous results of cervical examinations, including cytological and histological tests, in females with OPSCC.
We included females diagnosed with an OPSCC in Eastern Denmark from 2000 to 2014. OPSCCs were assessed for p16-overexpression and HPV DNA PCR. History of cervical tests was obtained from the Danish Pathology Registry. The cytology and histological results were categorized in accordance with the 2014 Bethesda System (TBS) and WHO. Hence, we divide the cervical results into two groups. Group I were negative for intraepithelial lesion or malignancy and group II had epithelial cell abnormalities and subdivided after increasingly neoplastic severity from A-D. Chi-tests and Fischer's exact tests were performed to compare the two groups.
A total of 417 women with OPSCC were identified; 203 with HPV-positive tumors (49%) of which cervical cytology or histology were available in 172 women (85%). Among these, 22 (13%) patients had a cervical history of ≥ IIC. A total of 171 out of 214 women in the HPV-negative group (80%) were examined with cytology and 17 had a history of ≥ IIC. No significant difference in diagnoses of (pre)cancerous lesions between the OPSCC HPV-positive and negative groups were observed (χ test p = .28, Fischer's exact test p = .29).
HPV status in oropharyngeal tumors was not correlated with a history of ≥ IIC in cervical examinations. The effect on cervical dysplasia may be masked by a higher incidence of smoking among the OPSCC HPV-negative group.
高危型人乳头瘤病毒（HPV）的持续感染是宫颈癌前病变和宫颈癌（CC）发展的主要危险因素，HPV 引起的口咽鳞状细胞癌（OPSCC）在西方世界的发病率正在上升。我们研究了 HPV 和 p16 状态与 OPSCC 女性以前的宫颈检查结果（包括细胞学和组织学检查）之间的关联。
我们纳入了 2000 年至 2014 年在丹麦东部诊断为 OPSCC 的女性。评估 OPSCC 中 p16 的过表达和 HPV DNA PCR。从丹麦病理登记处获得宫颈检查史。细胞学和组织学结果按照 2014 年 Bethesda 系统（TBS）和世界卫生组织进行分类。因此，我们将宫颈结果分为两组。第 I 组为上皮内病变或恶性肿瘤阴性，第 II 组为上皮细胞异常，并根据越来越严重的肿瘤程度从 A-D 进行细分。进行卡方检验和 Fischer 确切检验比较两组。
共确定 417 例 OPSCC 女性；203 例 HPV 阳性肿瘤（49%），其中 172 例（85%）有宫颈细胞学或组织学检查结果。在这些患者中，22 例（13%）患者有宫颈病史≥IIIC。HPV 阴性组 214 例女性中有 171 例行细胞学检查，17 例有病史≥IIIC。OPSCC HPV 阳性和阴性组之间（前）癌前病变的诊断无显著差异（卡方检验 p=0.28，Fischer 确切检验 p=0.29）。
口咽肿瘤 HPV 状态与宫颈检查中≥IIIC 的病史无关。HPV 阴性 OPSCC 组吸烟发生率较高，可能掩盖了对宫颈发育不良的影响。
