人乳头瘤病毒与鼻窦鳞状细胞癌患者的生存。
Human papillomavirus and survival of patients with sinonasal squamous cell carcinoma.
机构信息
New York University School of Medicine, New York, New York.
Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York.
出版信息
Cancer. 2020 Apr 1;126(7):1413-1423. doi: 10.1002/cncr.32679. Epub 2019 Dec 30.
BACKGROUND
To the authors' knowledge, the question of whether human papillomavirus (HPV) infection is associated with outcomes in patients with sinonasal squamous cell carcinoma (SNSCC) is not well studied at this time. In the current study, the authors investigated patterns of HPV testing and its association with survival in patients with SNSCC using the National Cancer Data Base.
METHODS
The authors selected all SNSCC cases diagnosed between 2010 and 2016. HPV testing practices, clinicodemographic factors, treatments, and survival were analyzed. Multivariable Cox regression and propensity score-matched survival analyses were performed.
RESULTS
A total of 6458 SNSCC cases were identified. Of these, only 1523 cases (23.6%) were tested for HPV and included in the current study. The median patient age was 64 years and the majority had advanced stage tumors (overall AJCC stage III-IV, 721 patients; 62.1%). HPV-positive SNSCC comprised 31.5% (447 of 1418 cases) of the final study cohort. Among 15 hospitals that routinely tested nonoropharyngeal SCCs for HPV, the percentage of HPV-positive SNSCCs was smaller (24.6%; P = .04). Patients with HPV-positive SNSCC were younger (aged 60 years vs 65 years; P < .001), with tumors that were more likely to be high grade (55.3% vs 41.7%; P < .001), and attributed to the nasal cavity (62.2% vs 44.0%; P < .001). HPV-positive SNSCC was associated with significantly improved overall survival in multivariable regression analysis (hazard ratio, 0.45; 95% CI, 0.28-0.72 [P = .001]) and propensity score-matched (hazard ratio, 0.61; 95% CI, 0.38-0.96 [P = .03]) analyses controlling for clinicodemographic and treatment factors.
CONCLUSIONS
Currently, only a minority of patients with SNSCC are tested for HPV. However, a sizable percentage of SNSCC cases may be HPV related; furthermore, HPV-positive SNSCC is associated with improved overall survival. Routine HPV testing may be warranted in patients with SNSCC.
背景
据作者所知，目前关于人乳头瘤病毒（HPV）感染是否与鼻窦鳞状细胞癌（SNSCC）患者的结局相关，这一问题尚未得到充分研究。在本研究中，作者利用国家癌症数据库（National Cancer Data Base），研究了 HPV 检测模式及其与 SNSCC 患者生存的相关性。
方法
作者选择了 2010 年至 2016 年间诊断的所有 SNSCC 病例。分析 HPV 检测情况、临床病理特征、治疗方法和生存情况。采用多变量 Cox 回归和倾向评分匹配生存分析。
结果
共确定了 6458 例 SNSCC 病例，其中仅有 1523 例（23.6%）接受 HPV 检测并纳入本研究。患者中位年龄为 64 岁，多数为晚期肿瘤（总体 AJCC 分期 III-IV 期 721 例，占 62.1%）。HPV 阳性 SNSCC 占最终研究队列的 31.5%（447 例）。在 15 家常规检测非口咽 SCCs HPV 的医院中，HPV 阳性 SNSCC 的比例较小（24.6%；P =.04）。HPV 阳性 SNSCC 患者更年轻（年龄 60 岁 vs 65 岁；P <.001），肿瘤更有可能为高级别（55.3% vs 41.7%；P <.001），且原发于鼻腔（62.2% vs 44.0%；P <.001）。多变量回归分析显示，HPV 阳性 SNSCC 与总体生存显著改善相关（风险比，0.45；95%CI，0.28-0.72[P =.001]），倾向评分匹配后分析也显示（风险比，0.61；95%CI，0.38-0.96[P =.03]），在控制了临床病理和治疗因素后，这一相关性仍然存在。
结论
目前，仅有少数 SNSCC 患者接受 HPV 检测。然而，相当一部分 SNSCC 病例可能与 HPV 相关；此外，HPV 阳性 SNSCC 与总体生存改善相关。SNSCC 患者可能需要常规进行 HPV 检测。
Zotero 插件