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HPV 检测在鼻窦鳞状细胞癌患者中的应用趋势:一项全国性分析。

Trends in HPV Testing for Patients With Sinonasal Squamous Cell Carcinoma: A National Analysis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Otolaryngol Head Neck Surg. 2022 Sep;167(3):501-508. doi: 10.1177/01945998211067505. Epub 2021 Dec 28.

Abstract

OBJECTIVE

The objective of this study was to analyze national trends in human papillomavirus (HPV) testing for patients diagnosed with sinonasal squamous cell carcinoma (SNSCC).

STUDY DESIGN

Retrospective database study.

SETTING

National Cancer Database (2010-2016).

METHODS

Cases from 2010 to 2016 with a primary SNSCC diagnosis and known HPV testing status were extracted from the National Cancer Database. Univariate and multivariate analyses were then performed to assess differences in socioeconomic, hospital, and tumor characteristics between tested and nontested patients.

RESULTS

A total of 2308 SNSCC cases were collected, with 1210 (52.4%) HPV tested and 1098 (47.6%) not tested. On univariate analyses, patient age, insurance, income quartile, population density, treatment facility location, and tumor grade were significantly associated with HPV testing status. After multivariate logistic regression modeling, living in a suburban area had lower odds of HPV testing as compared with living in urban areas (odds ratio, 0.74 [95% CI, 0.55-0.99]; = .041), while tumor grade III/IV had higher odds than grade I (odds ratio, 1.73 [95% CI, 1.29-2.33]; < .001). HPV-tested patients had a similar 5-year overall survival to nontested patients (48.3% vs 45.3%, log-rank = .405). A sharp increase in HPV testing rates was observed after 2010 ( < .001).

CONCLUSION

Among patients with SNSCC, those with high-grade tumors were more likely to be tested for HPV, while patients with a suburban area of residence were less likely. Additionally, there was no significant survival benefit to HPV testing, with tested and nontested groups having similar overall survival.

LEVEL OF EVIDENCE

摘要

目的

本研究旨在分析诊断为鼻旁窦鳞状细胞癌(SNSCC)患者的人乳头瘤病毒(HPV)检测的国家趋势。

研究设计

回顾性数据库研究。

设置

国家癌症数据库(2010-2016 年)。

方法

从国家癌症数据库中提取了 2010 年至 2016 年期间具有原发性 SNSCC 诊断和已知 HPV 检测状态的病例。然后进行单变量和多变量分析,以评估测试和未测试患者在社会经济、医院和肿瘤特征方面的差异。

结果

共收集了 2308 例 SNSCC 病例,其中 1210 例(52.4%)进行了 HPV 检测,1098 例(47.6%)未进行检测。在单变量分析中,患者年龄、保险、收入四分位、人口密度、治疗设施位置和肿瘤分级与 HPV 检测状态显著相关。经过多变量逻辑回归模型分析,与居住在城市地区相比,居住在郊区的患者进行 HPV 检测的可能性较低(优势比,0.74[95%CI,0.55-0.99];P=.041),而肿瘤分级 III/IV 比分级 I 更高(优势比,1.73[95%CI,1.29-2.33];P<.001)。HPV 检测患者的 5 年总生存率与未检测患者相似(48.3%比 45.3%,对数秩检验 P=.405)。2010 年后,HPV 检测率急剧上升(P<.001)。

结论

在 SNSCC 患者中,肿瘤分级较高的患者更有可能接受 HPV 检测,而居住在郊区的患者则不太可能接受检测。此外,HPV 检测并没有显著的生存获益,测试组和未测试组的总生存率相似。

证据水平

4 级。

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