16型人乳头瘤病毒状态在非口咽头颈癌中的预后意义:一项倾向评分匹配分析

Prognostic implications of human papillomavirus type 16 status in non-oropharyngeal head and neck cancer: a propensity score matching analysis.

作者信息

Zhu Yingying, Xia Xin, Gao Liming, Zhu Xiaoli, Diao Wenwen, Liang Zhiyong, Gao Zhiqiang, Chen Xingming

机构信息

Department of Otolaryngology-Head and Neck Surgery, China.

Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Ann Transl Med. 2019 Dec;7(23):759. doi: 10.21037/atm.2019.11.72.

Abstract

BACKGROUND

The purpose of this study was to investigate the association between HPV 16 status and survival outcomes in patients with non-oropharyngeal squamous carcinoma (non-OPSCC).

METHODS

Patients with non-OPSCC diagnosed between 2006 and 2016 were included in this study. The presence of HPV 16 DNA was confirmed by quantitative real-time polymerase chain reaction. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching (PSM).

RESULTS

Overall, 1,539 patients with adequate specimens were identified, of whom 131 (8.51%) were positive for HPV 16. Compared to HPV 16-negative patients, the adjusted hazard ratios (aHR) for HPV 16-positive non-OPSCC patients were 0.77 and 0.81 for disease-specific survival (DSS) and overall survival (OS), respectively. Additionally, the larynx was the only subsite in which DSS was significantly improved. After PSM, cohorts consisted of 129 patients in the HPV 16-positive group and 129 in the HPV 16-negative group. HPV 16-positive non-OPSCC patients had favorable survival outcomes, however, these outcomes were not significantly different compared to HPV 16-negative patients. Stratified analysis performed according to primary site showed that only in the larynx was HPV 16-positive status a significant factor for predicting favorable DSS.

CONCLUSIONS

Our findings indicate that HPV 16-positive non-OPSCC patients did not have significantly better survival outcomes compared to HPV 16-negative patients.

摘要

背景

本研究旨在调查非口咽鳞状细胞癌(non-OPSCC)患者中HPV 16状态与生存结果之间的关联。

方法

本研究纳入了2006年至2016年间诊断为non-OPSCC的患者。通过定量实时聚合酶链反应确认HPV 16 DNA的存在。使用Kaplan-Meier估计、Cox比例风险模型和倾向评分匹配(PSM)进行生存分析。

结果

总体而言,共识别出1539例有足够标本的患者,其中131例(8.51%)HPV 16呈阳性。与HPV 16阴性患者相比,HPV 16阳性的non-OPSCC患者的疾病特异性生存(DSS)和总生存(OS)的调整风险比(aHR)分别为0.77和0.81。此外,喉是唯一DSS显著改善的亚部位。PSM后,HPV 16阳性组有129例患者,HPV 16阴性组有129例患者。HPV 16阳性的non-OPSCC患者有良好的生存结果,然而,与HPV 16阴性患者相比,这些结果没有显著差异。根据原发部位进行的分层分析表明,只有在喉中,HPV 16阳性状态是预测良好DSS的重要因素。

结论

我们的研究结果表明,与HPV 16阴性患者相比,HPV 16阳性的non-OPSCC患者的生存结果没有显著更好。

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