人乳头瘤病毒和 Epstein-Barr 病毒在鼻咽癌中的预后意义。
Prognostic significance of human papillomavirus and Epstein-Bar virus in nasopharyngeal carcinoma.
机构信息
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Radiation Oncology, NYC Health and Hospitals Elmhurst and Queens, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
Head Neck. 2020 Sep;42(9):2364-2374. doi: 10.1002/hed.26245. Epub 2020 May 16.
BACKGROUND
The clinical significance of Epstein-Barr virus (EBV) and human papillomavirus (HPV) infection in nasopharyngeal carcinoma (NPC) is unclear.
METHODS
Three hundred and forty three patients with NPC diagnosed between 1998 and 2017 and treated at our institution were included. Chi-square was used to identify characteristics associated with viral status. Kaplan-Meier methods were used to estimate overall survival (OS) and Cox proportional regression was used to identify prognostic factors.
RESULTS
Patients with HPV-associated NPC were more likely to have a positive smoking history and to present at a higher T classification. At a median follow-up time of 59.9 months (range: 0.1-222.4 months), there were no differences in OS (P = .198), time to local failure (LF, P = .403), or time to distant metastasis (DM, P = .849) between the viral subgroups. Older age (hazard ratio [HR]: 2.242, 95% confidence interval [CI] 1.374-3.659, P = .001) and higher overall stage (HR: 2.047, 95% CI 1.235-3.391, P = .005) were prognostic for worse OS.
CONCLUSION
In our population, viral status was not prognostic for OS, LF, or DM.
背景
EBV（爱泼斯坦-巴尔病毒）和 HPV（人乳头瘤病毒）感染在鼻咽癌（NPC）中的临床意义尚不清楚。
方法
纳入了 1998 年至 2017 年间在本机构诊断并治疗的 343 例 NPC 患者。采用卡方检验来确定与病毒状态相关的特征。采用 Kaplan-Meier 方法估计总生存期（OS），并采用 Cox 比例风险回归分析来确定预后因素。
结果
HPV 相关 NPC 患者更有可能有吸烟史和更高的 T 分类。在中位随访时间为 59.9 个月（范围：0.1-222.4 个月）的情况下，病毒亚组之间的 OS（P=0.198）、局部失败时间（LF，P=0.403）和远处转移时间（DM，P=0.849）均无差异。年龄较大（风险比[HR]：2.242，95%置信区间[CI] 1.374-3.659，P=0.001）和更广泛的总体分期（HR：2.047，95%CI 1.235-3.391，P=0.005）是 OS 预后不良的因素。
结论
在我们的人群中，病毒状态与 OS、LF 或 DM 无关。
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