Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Dental Oncology Service, São Paulo State Cancer Institute (ICESP), School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Aug;134(2):190-205. doi: 10.1016/j.oooo.2022.03.016. Epub 2022 Apr 8.
High-risk (HR) human papillomavirus (HPV) infection is recognized as a primary etiologic factor of anogenital cancers and more recently of a subgroup of oropharyngeal squamous cell carcinomas (OPSCC). The incidence of HPV-related OPSCC has increased dramatically in several developed countries in the past 3 decades and is currently the most common cancer caused by HR-HPV in the United States and Germany, surpassing cervical cancer. Consequently, the patient's demographic and clinicopathologic profile has shifted to nonsmoking and nondrinking younger men with higher schooling level and with a history of multiple oral sex partners. Patients with HPV-related OPSCC often show better treatment outcomes and higher survival rates than their HPV-unrelated counterparts, which has led to a change in tumor staging for HPV-related cases. HPV vaccination is emerging as an effective primary prevention strategy, and systematic screening of HPV DNA in blood and salivary oral rinse samples of HR patients is being examined to determine if it may provide a surveillance method and support early diagnosis of HPV-related OPSCC. In this context, a narrative review was conducted to provide an overview of the state-of-the-art of HPV-related OPSCC, including epidemiology, risk factors, clinicopathologic and molecular features, screening, prevention, management, and prognosis.
高危型(HR)人乳头瘤病毒(HPV)感染被认为是肛门生殖器癌症的主要病因,最近也被认为是口咽鳞状细胞癌(OPSCC)亚组的病因之一。在过去 30 年中,一些发达国家 HPV 相关性 OPSCC 的发病率显著增加,目前在美国和德国,它是 HR-HPV 引起的最常见癌症,超过了宫颈癌。因此,患者的人口统计学和临床病理特征已转变为不吸烟、不饮酒、受教育程度较高、有多个口腔性伴侣的年轻男性。与 HPV 无关的 OPSCC 患者相比,HPV 相关性 OPSCC 患者的治疗效果和生存率更好,这导致 HPV 相关性病例的肿瘤分期发生了变化。HPV 疫苗接种作为一种有效的初级预防策略正在出现,人们正在对 HR 患者的血液和唾液口腔冲洗样本中的 HPV DNA 进行系统筛查,以确定它是否可以提供一种监测方法并支持 HPV 相关性 OPSCC 的早期诊断。在此背景下,本文进行了叙述性综述,以概述 HPV 相关性 OPSCC 的最新研究进展,包括流行病学、危险因素、临床病理和分子特征、筛查、预防、治疗和预后。