评估 p16 在中国人群口咽鳞状细胞癌中转录活性人乳头瘤病毒状态中的替代标志物作用。
Evaluation of p16 as a surrogate marker for transcriptionally active human papillomavirus status of oropharyngeal squamous cell carcinoma in an eastern Chinese population.
机构信息
Department of Oral and Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China; National Clinical Research Center for Oral Diseases, Shanghai, P.R. China; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, P.R. China.
Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, P.R. China.
出版信息
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Mar;129(3):236-245.e2. doi: 10.1016/j.oooo.2019.11.008. Epub 2019 Nov 21.
OBJECTIVES
The aim of this study was to characterize the clinicopathologic features of patients with oropharyngeal squamous cell carcinoma (OPSCC) in an eastern Chinese population and to evaluate the diagnostic validity of p16 immunochemistry (IHC) for HPV status detection in OPSCC.
STUDY DESIGN
A total of 257 paraffin-embedded primary OPSCC specimens were collected from 2014 to 2019. HPV RNA in situ hybridization (ISH) was conducted as the gold standard for the detection of transcriptionally active HPV status and HPV DNA polymerase chain reaction (PCR), p16 IHC, next-generation-sequencing for TP53 exons were also performed and the results analyzed for comparison.
RESULTS
The overall HPV infection rate was 18.29% (47 of 257) and the TP53 mutation frequency was 13.16% (5 of 38) and 94.74% (18 of 19) in patients with HPV-positive and HPV-negative OPSCC, respectively (P < .001). p16 IHC had the worst diagnostic ability and prognosis predictive value (disease-specific survival [DSS]; P = .405) compared with HPV DNA PCR as well as combination of p16 IHC and HPV DNA PCR. However, the diagnostic ability of p16 IHC was better in OPSCC without tobacco or alcohol exposure.
CONCLUSIONS
Solitary p16 IHC is insufficient for HPV status detection in patients with OPSCC with tobacco and/or alcohol exposure but performs better in those without exposure, and additional HPV DNA specific testing may be necessary for accurate HPV status determination.
目的
本研究旨在描述中国东部人群口咽鳞状细胞癌（OPSCC）患者的临床病理特征，并评估 p16 免疫组织化学（IHC）用于检测 OPSCC 中 HPV 状态的诊断有效性。
设计
本研究共收集了 2014 年至 2019 年间的 257 例石蜡包埋的原发性 OPSCC 标本。采用 HPV RNA 原位杂交（ISH）作为检测转录活性 HPV 状态的金标准，并进行 HPV DNA 聚合酶链反应（PCR）、p16 IHC、TP53 外显子的下一代测序（NGS），对检测结果进行分析比较。
结果
HPV 感染总率为 18.29%（257 例中有 47 例），HPV 阳性和 HPV 阴性 OPSCC 患者的 TP53 突变频率分别为 94.74%（18 例中有 18 例）和 13.16%（5 例中有 5 例）（P <.001）。与 HPV DNA PCR 相比，p16 IHC 的诊断能力和预后预测价值（疾病特异性生存 [DSS]；P =.405）最差，与 p16 IHC 和 HPV DNA PCR 联合检测相比也是如此。然而，p16 IHC 在无烟草或酒精暴露的 OPSCC 患者中具有更好的诊断能力。
结论
在有烟草和/或酒精暴露的 OPSCC 患者中，单独使用 p16 IHC 不足以检测 HPV 状态，但在无暴露的患者中效果更好，可能需要进行额外的 HPV DNA 特异性检测以准确确定 HPV 状态。
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