Programa de Pós-Graduação em Saúde do Adulto, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil.
Departamento de Medicina I, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil.
PeerJ. 2022 Jul 12;10:e13684. doi: 10.7717/peerj.13684. eCollection 2022.
A high prevalence and incidence of head and neck tumors make Brazil the country with the third-highest number of cases of these malignant neoplasms. The main risk factors are smoking and alcohol consumption; however, cases related to the human papillomavirus (HPV) have tripled in number, demonstrating a changing disease profile. Studies have reported the prevalence of HPV in laryngeal squamous cell carcinoma (LSCC) to vary between 8% and 83%. The role of HPV as an important causative factor in LSCC remains unclear.
This retrospective study included 82 patients with LSCC diagnosed between 2014 and 2019 at two oncology hospitals in São Luís, Brazil. Sociodemographic and clinical data, and the histopathologic characteristics of the tumors, were collected directly from medical records. Genetic material was extracted from paraffin-embedded samples using nested polymerase chain reaction (PCR) and automated sequencing for HPV detection and genotyping. The results by social and clinicopathologic variables were then compared using the chi-squared test and multivariate analysis.
Sociodemographic analysesdemonstrated that most patients were men (87.8%), brown-skinned (75.6%), and resident in the state capital (53.7%). They generally had a poor education status (53.7%), having only an elementary school education (completed/incomplete), and 51.2% were self-employed in occupations such as farming or fishing. Smoking and alcohol consumption habits were observed in approximately half the patients. With respect to clinical characteristics, 39% of patients exhibited T1/T2 staging, 51.2% had no distant metastasis, and 30.5% had lymph node invasion. HPV DNA was detected in half the samples (50%), with the high oncogenic type 16 being the most prevalent. There was no significant relationship observed between the economic, educational, occupational with the HPV LSCC in the presented data, although multivariate analysis demonstrated that HPV DNA was more likely to be present in T3-T4 tumors ( = 0.002).
由于头颈部肿瘤的高发病率和发生率，巴西成为了恶性肿瘤病例数第三多的国家。主要的风险因素是吸烟和饮酒；然而，与人类乳头瘤病毒（HPV）相关的病例数量增加了两倍，表明疾病谱正在发生变化。研究报告称，HPV 在喉鳞状细胞癌（LSCC）中的患病率在 8%至 83%之间变化。HPV 作为 LSCC 的一个重要致病因素的作用仍不清楚。
本回顾性研究纳入了 2014 年至 2019 年在巴西圣路易斯的两家肿瘤医院诊断的 82 例 LSCC 患者。直接从病历中收集社会人口统计学和临床数据以及肿瘤的组织病理学特征。使用巢式聚合酶链反应（PCR）和自动化测序从石蜡包埋样本中提取遗传物质，以检测和 HPV 基因分型。然后使用卡方检验和多变量分析比较社会和临床病理变量的结果。
社会人口统计学分析表明，大多数患者为男性（87.8%）、棕色皮肤（75.6%）和首府居民（53.7%）。他们的教育程度普遍较低（53.7%），仅完成或未完成小学教育，51.2%为从事农业或渔业等职业的自雇人士。大约一半的患者存在吸烟和饮酒习惯。就临床特征而言，39%的患者表现为 T1/T2 分期，51.2%无远处转移，30.5%有淋巴结侵犯。一半的样本中检测到 HPV DNA（50%），其中高致癌型 16 最为常见。虽然多变量分析表明 HPV DNA 更可能存在于 T3-T4 肿瘤中（=0.002），但在提供的数据中未观察到经济、教育和职业与 HPV LSCC 之间存在显著关系。
