Weiss Bernhard G, Anczykowski Mahalia Zoe, Küffer Stefan, Spiegel Jennifer L, Bertlich Mattis, Canis Martin, Ihler Friedrich, Kitz Julia, Jakob Mark
Department of Otorhinolaryngology, LMU University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Eur Arch Otorhinolaryngol. 2021 Jun;278(6):1983-2000. doi: 10.1007/s00405-020-06262-7. Epub 2020 Aug 20.
p16 overexpression was considered as surrogate marker to identify human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCCs).
102 patients with advanced stage OPSCCs treated primarily by transoral lasermicrosurgery were included. Prognostic associations of p16- and HPV-status were analyzed separately and combined.
In contrast to p16, the HPV-status resulted in no significant survival discrepancies (5-year overall survival (OS) HPV-positive 64.9%, HPV-negative 78.7%). Combining both markers, p16-positive (p16-positive/HPV-positive, p16-positive/HPV-negative) and p16-negative/HPV-negative groups demonstrated comparable high survival (OS 78.1% vs. 85.6% vs. 73.6%). Lowest survival was observed for patients with p16-negative/HPV-positive OPSCCs (OS 40.8%). Never smoking patients with p16-positive OPSCCs demonstrated the highest survival, whereas within former/current smokers with p16-positive and p16-negative disease it was comparable low (OS 90.0% vs. 63.0% vs. 57.4%).
p16- and HPV-status should not be considered as equivalent markers for a better prognosis. Furthermore, they should not generally predominate patient associated factors like smoking.
p16过表达被视为识别与人乳头瘤病毒（HPV）相关的口咽鳞状细胞癌（OPSCC）的替代标志物。
纳入102例主要接受经口激光显微手术治疗的晚期OPSCC患者。分别并联合分析p16状态和HPV状态与预后的相关性。
与p16不同，HPV状态未导致显著的生存差异（5年总生存率（OS）：HPV阳性为64.9%，HPV阴性为78.7%）。联合两种标志物，p16阳性组（p16阳性/HPV阳性、p16阳性/HPV阴性）和p16阴性/HPV阴性组显示出相当高的生存率（OS分别为78.1%、85.6%和73.6%）。p16阴性/HPV阳性的OPSCC患者生存率最低（OS为40.8%）。从不吸烟的p16阳性OPSCC患者生存率最高，而在曾经/当前吸烟的p16阳性和p16阴性疾病患者中，生存率相当低（OS分别为90.0%、63.0%和57.4%）。
p16状态和HPV状态不应被视为等同于预后较好的标志物。此外，它们一般不应优先于吸烟等患者相关因素。
