Kanzow Philipp, Mielke Katharina, Hrasky Valentina, Wiegand Susanne, Schliephake Henning, Beutner Dirk, Wiegand Annette
Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany.
Department of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.
Front Oncol. 2023 Jan 26;13:1083067. doi: 10.3389/fonc.2023.1083067. eCollection 2023.
This study compared oral health in oropharyngeal squamous cell carcinoma (OPSCC) patients with positive or negative human papillomavirus (HPV) status and analysed whether oral health was associated with survival. Patients referred for dental assessment prior to radio(chemo)therapy between 2009 and 2019 were included. Patient-related risk factors for OPSCC (alcohol, tobacco, HPV status), age, sex, treatment (primary treatment, intent), performance status, tumor/node/metastasis (TNM) staging, and oral health parameters (DMFT, periodontal status, teeth with/without root canal treatment and with/without periodontitis apicalis) were compared between HPV-negative and HPV-positive patients. Survival was assessed using Kaplan-Meier statistics. The effect of patient-related risk factors and oral health parameters was analysed by cox regression analyses (α=5%). A total of 119 patients (n=50 HPV-negative, n=69 HPV-positive) was included. HPV-positive patients showed more present teeth, a higher number of filled teeth, were less often edentulous and presented a lower DMFT compared to HPV-negative patients (p≤0.003). Among dentulous patients, HPV-positive patients showed more present teeth and fewer teeth with periodontitis apicalis lacking a root canal treatment (p≤0.036). Survival probability differed between groups (p=0.006) and trended towards being associated with HPV status, tobacco exposure, performance status, T stage, N stage, and the number of missing or filled teeth as well as the number of root canal treated teeth with periodontitis apicalis and the number of teeth with periodontitis apicalis lacking a root canal treatment (p≤0.077). However, only tobacco exposure, performance status, and the number of teeth with periodontitis apicalis lacking a root canal treatment in dentulous patients remained significant in the multivariate analyses (p≤0.047). HPV-negative patients with OPSCC showed a poorer oral health compared to HPV-positive patients, but survival was not associated with oral health.
本研究比较了人乳头瘤病毒（HPV）状态为阳性或阴性的口咽鳞状细胞癌（OPSCC）患者的口腔健康状况，并分析了口腔健康与生存率之间是否存在关联。纳入了2009年至2019年间在进行放（化）疗前接受牙科评估的患者。比较了HPV阴性和HPV阳性患者之间与OPSCC相关的患者风险因素（酒精、烟草、HPV状态）、年龄、性别、治疗（初始治疗、治疗意图）、体能状态、肿瘤/淋巴结/转移（TNM）分期以及口腔健康参数（龋失补指数、牙周状况、有/无根管治疗以及有/无根尖周炎的牙齿）。使用Kaplan-Meier统计方法评估生存率。通过Cox回归分析（α = 5%）分析与患者相关的风险因素和口腔健康参数的影响。共纳入119例患者（n = 50例HPV阴性，n = 69例HPV阳性）。与HPV阴性患者相比，HPV阳性患者的现存牙齿更多、补牙数量更多、无牙情况更少且龋失补指数更低（p≤0.003）。在有牙患者中，HPV阳性患者的现存牙齿更多，且根尖周炎但未进行根管治疗的牙齿更少（p≤0.036）。两组之间的生存概率存在差异（p = 0.006），并且有与HPV状态、烟草暴露、体能状态、T分期、N分期以及缺失或补牙数量以及根尖周炎且进行根管治疗的牙齿数量和根尖周炎但未进行根管治疗的牙齿数量相关的趋势（p≤0.077）。然而，在多因素分析中，仅烟草暴露、体能状态以及有牙患者中根尖周炎但未进行根管治疗的牙齿数量仍然具有显著性（p≤0.047）。与HPV阳性患者相比，HPV阴性的OPSCC患者口腔健康状况较差，但生存率与口腔健康无关。
