Riders A, Oberste M, Abbaspour B, Beule A, Rudack C
Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Münster, Kardinal-von-Galen-Ring 10, 48149, Münster, Deutschland.
HNO. 2022 Feb;70(2):102-109. doi: 10.1007/s00106-021-01076-3. Epub 2021 Jun 25.
Due to their differing carcinogenesis, prognosis and clinical manifestation, human papillomavirus (HPV)-associated and HPV-negative oropharyngeal squamous cell carcinoma (OSCC) have been classified separately as two entities since the 8th edition of the AJCC/UICC TNM staging system (UICC 8).
A total of 524 patients with OSCC treated between 2000 and 2016 at the Department of Otorhinolaryngology, Head and Neck Surgery of the University Hospital Muenster, Germany, were examined for the detection of HPV type 16-specific DNA (HPV16-DNA), nicotine and alcohol consumption and the influence of therapy on overall survival (OS).
There was a significant increase in the annual prevalence of HPV16-DNA-positive OSCC from 40% (n = 12/30) in 2000 to 46% (n = 18/39) in 2016 (p = 0.025, β = 0.539). Of the HPV16-DNA-positive OSCC, 89% (n = 212) were downgraded on the basis of UICC 8 compared to UICC 7. In the overall collective, frequent alcohol and nicotine (≥ 10 pack years) consumption showed a significant negative influence on OS (p = 0.004 and p = 0.009, respectively). Frequent alcohol consumption was also prognostically relevant in the HPV16-DNA-negative group (p = 0.049). In the HPV16-DNA-positive group, the prognosis for OS according to UICC 8 showed no statistically significant difference between stages I and II (p = 0,481), or between III and IV (p = 0.439).
The current UICC 8 improves the prognostic stratification of OSCC due to the separation of HPV-positive and HPV-negative tumors in comparison to UICC 7. However, the prognostic significance of UICC 8 for HPV-associated OSCC is still insufficient. In the future, alcohol and nicotine consumption could influence the UICC classification in order to further improve prognostic significance.
由于人乳头瘤病毒（HPV）相关和HPV阴性口咽鳞状细胞癌（OSCC）在致癌作用、预后和临床表现方面存在差异，自美国癌症联合委员会/国际抗癌联盟（AJCC/UICC）TNM分期系统第8版（UICC 8）以来，它们被分别归类为两种不同的实体。
对2000年至2016年期间在德国明斯特大学医院耳鼻咽喉头颈外科接受治疗的524例OSCC患者进行检测，以确定16型人乳头瘤病毒特异性DNA（HPV16-DNA）、尼古丁和酒精的摄入量，以及治疗对总生存期（OS）的影响。
HPV16-DNA阳性OSCC的年患病率从2000年的40%（n = 12/30）显著增加到2016年的46%（n = 18/39）（p = 0.025，β = 0.539）。与UICC 7相比，在HPV16-DNA阳性的OSCC中，89%（n = 212）根据UICC 8进行了降级。在整个队列中，频繁饮酒和吸烟（≥10包年）对总生存期有显著负面影响（分别为p = 0.004和p = 0.009）。频繁饮酒在HPV16-DNA阴性组中对预后也有影响（p = 0.049）。在HPV16-DNA阳性组中，根据UICC 8，I期和II期之间（p = 0.481）或III期和IV期之间（p = 0.439）的总生存期预后无统计学显著差异。
与UICC 7相比，当前的UICC 8通过区分HPV阳性和HPV阴性肿瘤，改善了OSCC的预后分层。然而，UICC 8对HPV相关OSCC的预后意义仍然不足。未来，酒精和尼古丁的摄入量可能会影响UICC分类，以进一步提高预后意义。
