Marshall Deborah C, Kao Derek D, Bakst Richard, Sharma Sonam, Ferrandino Rocco, Rosenzweig Kenneth, Wisnivesky Juan, Sigel Keith
Icahn School of Medicine at Mount Sinai New York New York USA.
Laryngoscope Investig Otolaryngol. 2020 Aug 11;5(5):860-867. doi: 10.1002/lio2.443. eCollection 2020 Oct.
Although the prognostic role of human papilloma virus (HPV) status in oropharyngeal head and neck squamous cell carcinoma (SCC) is well established, growing evidence shows that there may be a prognostic role for HPV status in hypopharyngeal SCC. The objective of this study was to determine the prognostic role of HPV status in hypopharyngeal SCC.
We performed a retrospective, population-based analysis of 1934 adult patients with HNSCC diagnosed between 2010-2016 and treated with a combination of surgery and/or radiotherapy, with or without chemotherapy, and a subset of 641 patients with hypopharyngeal SCC and known HPV status included in the Surveillance, Epidemiology, and End Results (SEER) Head and Neck with HPV Status Database. Patient data were used to determine the adjusted 2-year cancer-specific survival (CSS) and overall survival (OS) for the entire cohort and the specific subgroup of hypopharyngeal cancer patients with known HPV status.
Of the 1934 hypopharynx SCC cases, HPV status was unknown in 1294 (66.9%), and 167 (8.6%) were HPV positive; among hypopharynx cases with known HPV status, 21.6% were HPV positive. In models adjusting for sex, age, race/ethnicity, marital status and stage, patients with HPV-positive hypopharyngeal tumors had improved CSS compared with patients with HPV-negative tumors (CSS: HR: .57, 95% CI = .38 to .86, = .008; OS: HR: .49, 95% CI = .34 to .71, = <.001).
Our findings in a large cohort of hypopharyngeal SCC with known HPV status and cancer-specific survival support the hypothesis that HPV has a prognostic role in hypopharyngeal cancer. Consideration should be given to increased testing for HPV in hypopharyngeal SCC.
尽管人乳头瘤病毒（HPV）状态在口咽头颈鳞状细胞癌（SCC）中的预后作用已得到充分证实，但越来越多的证据表明，HPV状态在下咽SCC中可能也具有预后作用。本研究的目的是确定HPV状态在下咽SCC中的预后作用。
我们对1934例在2010年至2016年间确诊并接受手术和/或放疗联合或不联合化疗的成人HNSCC患者进行了一项基于人群的回顾性分析，其中641例下咽SCC患者且已知HPV状态的数据纳入了监测、流行病学和最终结果（SEER）头颈HPV状态数据库。患者数据用于确定整个队列以及已知HPV状态的下咽癌患者特定亚组的校正2年癌症特异性生存率（CSS）和总生存率（OS）。
在1934例下咽SCC病例中，1294例（66.9%）HPV状态未知，167例（8.6%）为HPV阳性；在已知HPV状态的下咽病例中，21.6%为HPV阳性。在对性别、年龄、种族/民族、婚姻状况和分期进行校正的模型中，HPV阳性的下咽肿瘤患者与HPV阴性肿瘤患者相比，CSS有所改善（CSS：HR：0.57，95%CI = 0.38至0.86，P = 0.008；OS：HR：0.49，95%CI = 0.34至0.71，P ＜0.001）。
我们在一大群已知HPV状态和癌症特异性生存情况的下咽SCC患者中的研究结果支持了HPV在下咽癌中具有预后作用这一假设。应考虑增加在下咽SCC中对HPV的检测。
4级。
