Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1679-1687. doi: 10.31557/APJCP.2020.21.6.1679.
Head and neck squamous cell carcinoma (HNSCC) is a common malignancy in Asia. Infection by human papilloma virus (HPV) has been recognized as an etiological risk for HNSCC, especially oropharyngeal region. While the association between HPV and HNSCC has been well evaluated in Western countries, only a few investigated the HPV-associated HNSCC in Southeast Asia. This study evaluated the prevalence, the characteristics, and the impact of HPV on the treatment outcomes in Thai HNSCC patients.
Non-nasopharyngeal HNSCC patients treated at Ramathibodi Hospital during 2007-2013 were identified through the cancer registry database. Baseline patient, treatment data and survivals were retrospectively reviewed. The formalin-fixed paraffin-embedded (FFPE) tissue sections were retrieved for p16 analysis. The HPV status was determined by p16 immunohistochemistry. The survival outcomes were analyzed in cases which p16 status was confirmed.
Total of 200 FFPE tissues of HNSCC patients was evaluated for p16 expression. Positive p16 status was observed in 24 cases (12%); majority of p16-positive were men (20:4 cases). The oropharynx (37.9%) was the most common site found in p16-positive while oral cavity (3.2%) was the least common site. Interestingly, 66.7% of p16-positive were former/current smokers, and 70.8% of this subgroup was categorized as clinical AJCC stage III-IV. The p16-positive HNSCC was significantly superior in 5-year overall survival [5-yrs OS 63% vs. 40%, p=0.03], 5-year disease-free survival [5-yrs DFS 61% vs. 36%, p=0.03] and in 5-year locoregional relapse-free survival [5-yrs LRFS 93% vs. 68%, p=0.018] when compared with p16-negative.
In comparison to the results from the Western countries, the prevalence of HPV-related HNSCC in Thai patients was less, and differences in some characteristics were observed. Nevertheless, improvement in OS, DFS and LRFS were observed in p16-positive patients. Our analyses suggested that p16 status is also a strong prognostic marker for HNSCC patients in Thailand.
头颈部鳞状细胞癌（HNSCC）是亚洲常见的恶性肿瘤。人乳头瘤病毒（HPV）感染已被认为是 HNSCC 的病因风险因素，尤其是口咽部位。HPV 与 HNSCC 之间的相关性在西方国家已得到充分评估，但在东南亚只有少数研究调查了 HPV 相关的 HNSCC。本研究评估了泰国 HNSCC 患者 HPV 的流行率、特征及其对治疗结果的影响。
通过癌症登记数据库，确定了 2007 年至 2013 年在 Ramathibodi 医院治疗的非鼻咽癌 HNSCC 患者。回顾性分析了基线患者、治疗和生存数据。检索福尔马林固定石蜡包埋（FFPE）组织切片进行 p16 分析。通过 p16 免疫组化确定 HPV 状态。对 p16 状态得到证实的病例进行生存结果分析。
共评估了 200 例 HNSCC 患者的 FFPE 组织的 p16 表达。24 例（12%）患者的 p16 状态为阳性；大多数 p16 阳性患者为男性（20:4 例）。p16 阳性最常见的部位是口咽（37.9%），而口腔（3.2%）是最不常见的部位。有趣的是，66.7%的 p16 阳性患者为现/ former/current 吸烟者，且该亚组中有 70.8%被归类为临床 AJCC 分期 III-IV。与 p16 阴性相比，p16 阳性的 HNSCC 在 5 年总生存率[5-yrs OS 63% vs. 40%，p=0.03]、5 年无病生存率[5-yrs DFS 61% vs. 36%，p=0.03]和 5 年局部区域无复发生存率[5-yrs LRFS 93% vs. 68%，p=0.018]方面均显著提高。
与西方国家的结果相比，泰国患者 HPV 相关 HNSCC 的流行率较低，观察到一些特征存在差异。然而，p16 阳性患者的 OS、DFS 和 LRFS 得到改善。我们的分析表明，p16 状态也是泰国 HNSCC 患者的一个强有力的预后标志物。
