Ziai Hedyeh, Warner Andrew, Mundi Neil, Patel Krupal, Chung Eun Jae, Howlett Christopher J, Plantinga Paul, Yoo John, MacNeil S Danielle, Fung Kevin, Mymryk Joe S, Barrett John W, Palma David A, Nichols Anthony C
Department of Otolaryngology-Head and Neck Surgery, Western University, ON, Canada.
Department of Oncology, Western University, ON, Canada.
Int J Otolaryngol. 2021 Feb 9;2021:6672373. doi: 10.1155/2021/6672373. eCollection 2021.
Recently, reanalysis of The Cancer Genome Atlas study demonstrated that human papillomavirus (HPV) genotypes in head and neck cancers other than HPV-16 have inferior survival to HPV-16-positive tumors. We aimed to examine the association of HPV subtypes and survival in a large cohort of patient samples from our institution.
Fresh frozen primary site biopsy samples were collected either in clinic or at the time of surgery. Patient demographic, staging, and survival data were also collected. Tumors were tested for HPV subtypes by quantitative polymerase chain reaction (qPCR). Univariable and multivariable analyses were performed using Cox proportional hazards regression.
280 patient biopsy samples were collected between 2011 and 2017. Mean ± standard deviation (SD) age was 61.9 ± 11.1 years and most patients (78%) were male. The majority of cancers were of the oral cavity (60%) or oropharynx (25%) and 30% had HPV-positive disease. Median follow-up was 3.76 years and 96/280 patients (34%) developed recurrences. Patients with p16-positive versus negative disease had significantly improved 5-year overall survival (OS, 77.6% vs. 53.3%; =0.009) and progression-free survival (PFS, 67.3% vs. 41.0%, =0.006). Similarly improved 5-year OS and PFS were observed for patients with HPV-positive versus negative disease (65.0% vs. 55.0%, =0.084; 53.3% vs. 43.2%, =0.072, resp.). Patients with HPV-16 compared to other HPV diseases had worse 5-year OS and PFS (62.1% vs. 88.9%, =0.273; 49.0% vs. 88.9%, =0.081, resp.).
In contrast to the data derived from The Cancer Genome Atlas, patients with HPV-16 tumors trended towards decreased PFS and OS compared with tumors driven by other HPV genotypes. Further larger multi-institutional studies are necessary to understand the relationship between other HPV genotypes and survival in head and neck squamous cell carcinomas.
最近，对癌症基因组图谱研究的重新分析表明，头颈部癌中除人乳头瘤病毒16型（HPV-16）以外的HPV基因型患者的生存率低于HPV-16阳性肿瘤患者。我们旨在研究来自我们机构的大量患者样本中HPV亚型与生存率之间的关联。
新鲜冷冻的原发部位活检样本在临床或手术时采集。还收集了患者的人口统计学、分期和生存数据。通过定量聚合酶链反应（qPCR）检测肿瘤的HPV亚型。使用Cox比例风险回归进行单变量和多变量分析。
2011年至2017年间收集了280份患者活检样本。平均年龄±标准差为61.9±11.1岁，大多数患者（78%）为男性。大多数癌症发生在口腔（60%）或口咽（25%），30%的患者患有HPV阳性疾病。中位随访时间为3.76年，280例患者中有96例（34%）出现复发。p16阳性与阴性疾病患者的5年总生存率（OS，77.6%对53.3%；P<0.009）和无进展生存率（PFS，67.3%对41.0%，P<0.006）显著提高。HPV阳性与阴性疾病患者的5年OS和PFS也有类似改善（分别为65.0%对55.0%，P = 0.084；53.3%对43.2%，P = 0.072）。与其他HPV疾病相比，HPV-16患者的5年OS和PFS更差（分别为62.1%对88.9%，P = 0.273；49.0%对88.9%，P = 0.081）。
与癌症基因组图谱得出的数据相反，与其他HPV基因型驱动的肿瘤相比，HPV-16肿瘤患者的PFS和OS有下降趋势。需要进一步开展更大规模的多机构研究，以了解其他HPV基因型与头颈部鳞状细胞癌生存率之间的关系。
