舌根部与扁桃体或口咽癌的流行病学差异。

Epidemiologic distinctions between base of tongue and tonsil oropharyngeal carcinomas.

机构信息

Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

出版信息

Head Neck. 2021 Oct;43(10):3076-3085. doi: 10.1002/hed.26804. Epub 2021 Jul 20.

DOI:10.1002/hed.26804

PMID:34288202

Abstract

BACKGROUND

Human papillomavirus (HPV)-positive tonsil and base of tongue (BOT) cancers have been considered together. However, important differences may exist.

METHODS

Demographic and tumor characteristics, and survival, were compared by oropharyngeal cancer subsite from 2004 to 2016 in the National Cancer Database (NCDB). Trends in tonsillectomy from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were examined.

RESULTS

HPV-positive BOT (N = 13 081) were older than HPV-positive tonsil patients (N = 16 874; mean 61.5 vs. 58.4 years, p < 0.001), and individuals 70+ years were significantly more likely to have BOT tumors compared with individuals <50 (adjusted odd ratio [aOR] = 2.9, 95% confidence interval = 2.6-3.2). BOT patients were also more likely to be white, male, and have advanced tumor classification. Among 7418 NHANES participants, tonsillectomy was associated with older age and white race.

CONCLUSIONS

There are epidemiologic and tumor-related differences among HPV-positive tonsil and BOT carcinomas. Demographic differences may be attributable to tonsillectomy trends.

摘要

背景

人乳头瘤病毒（HPV）阳性的扁桃体和舌根（BOT）癌通常被视为一类疾病。然而，两者之间可能存在重要差异。

方法

本研究利用国家癌症数据库（NCDB），比较了 2004 年至 2016 年间不同口咽癌亚部位的人口统计学和肿瘤特征及生存情况。还利用 2011-2014 年全国健康和营养调查（NHANES）数据，分析了扁桃体切除术的趋势。

结果

HPV 阳性 BOT（N=13081）患者比 HPV 阳性扁桃体患者年龄更大（N=16874；平均年龄 61.5 岁 vs. 58.4 岁，p<0.001），70 岁以上患者中 BOT 肿瘤的比例明显高于<50 岁患者（调整后的优势比[aOR]为 2.9，95%置信区间为 2.6-3.2）。BOT 患者也更可能为白人、男性和肿瘤分期较晚。在 7418 名 NHANES 参与者中，扁桃体切除术与年龄较大和白种人有关。