头颈部鳞状细胞癌中雌激素受体α阳性的生物学和行为关联。
Biologic and behavioral associations of estrogen receptor alpha positivity in head and neck squamous cell carcinoma.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.
Department of Pathology, Johns Hopkins University, Baltimore, MD, United States.
出版信息
Oral Oncol. 2021 Oct;121:105461. doi: 10.1016/j.oraloncology.2021.105461. Epub 2021 Jul 22.
OBJECTIVES
Tumor HPV status is an established independent prognostic marker for oropharynx cancer (OPC). Recent studies have reported that tumor estrogen receptor alpha (ERα) positivity is also associated with prognosis independent of HPV. Little is known about the biologic and behavioral predictors of ERα positivity in head and neck squamous cell cancer (HNSCC). We therefore explored this in a multicenter prospective cohort study.
MATERIALS AND METHODS
Participants with HNSCC completed a survey and provided a blood sample. Tumor samples were tested for ERα using immunohistochemistry. ERα positivity was defined as ≥1%, standardized by the American Society of Clinical Oncology/College of American Pathologists in breast cancer. Characteristics were compared with χ and Fisher's exact test. Odds ratios (OR) were calculated using logistic regression.
RESULTS
Of 318 patients with HNSCC, one third had ERα positive tumors (36.2%, n = 115). Odds of ERα expression were significantly increased in those with HPV-positive tumors (OR = 27.5, 95% confidence interval[CI] 12.1-62), smaller tumors (≤T2, OR = 3.6, 95% CI 1.9-7.1), male sex (OR = 2.0, 95% CI 1.1-3.6), overweight/obesity (BMI ≥ 25, OR = 1.9, 95% CI 1.1-3.3), and those married/living with a partner (OR = 1.7, 95% CI 1.0-3.0). In a multivariate model, HPV-positivity (aOR = 27.5, 95% CI 11.4-66) and small tumor size (≤T2, aOR = 2.2, 95% CI 1.0-4.8) remained independently associated with ERα status. When restricted to OPC (n = 180), tumor HPV status (aOR = 17.1, 95% CI 2.1-137) and small tumor size (≤T2, aOR = 4.0 95% CI 1.4-11.3) remained independently associated with ERα expression.
CONCLUSION
Tumor HPV status and small tumor size are independently associated with ERα expression in HNSCC.
目的
肿瘤 HPV 状态是口咽癌（OPC）的一个既定独立预后标志物。最近的研究报告称，肿瘤雌激素受体 alpha（ERα）阳性也与 HPV 无关的预后相关。关于头颈部鳞状细胞癌（HNSCC）中 ERα 阳性的生物学和行为预测因素知之甚少。因此，我们在一项多中心前瞻性队列研究中对此进行了探讨。
材料和方法
HNSCC 患者完成了一项调查并提供了一份血液样本。使用免疫组织化学法检测肿瘤样本中的 ERα。将 ERα 阳性定义为≥1%，由美国临床肿瘤学会/美国病理学家协会在乳腺癌中标准化。采用 χ 检验和 Fisher 确切概率法比较特征。使用 logistic 回归计算比值比（OR）。
结果
在 318 例 HNSCC 患者中，有三分之一的患者肿瘤 ERα 阳性（36.2%，n=115）。HPV 阳性肿瘤患者 ERα 表达的可能性显著增加（OR=27.5，95%置信区间[CI]12.1-62），肿瘤较小（≤T2，OR=3.6，95%CI 1.9-7.1），男性（OR=2.0，95%CI 1.1-3.6），超重/肥胖（BMI≥25，OR=1.9，95%CI 1.1-3.3）和已婚/与伴侣同居（OR=1.7，95%CI 1.0-3.0）。在多变量模型中，HPV 阳性（aOR=27.5，95%CI 11.4-66）和肿瘤较小（≤T2，aOR=2.2，95%CI 1.0-4.8）与 ERα 状态独立相关。当限制为 OPC（n=180）时，肿瘤 HPV 状态（aOR=17.1，95%CI 2.1-137）和肿瘤较小（≤T2，aOR=4.0，95%CI 1.4-11.3）与 ERα 表达仍独立相关。
结论
肿瘤 HPV 状态和肿瘤较小与 HNSCC 中 ERα 表达独立相关。
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