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人乳头瘤病毒相关性口咽鳞状细胞癌的病因、诊断、治疗和预防。

Etiology, diagnosis, treatment, and prevention of human papilloma virus-associated oropharyngeal squamous cell carcinoma.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650-0017, Japan.

出版信息

Int J Clin Oncol. 2023 Aug;28(8):975-981. doi: 10.1007/s10147-023-02336-8. Epub 2023 Apr 24.

Abstract

Classical oropharyngeal squamous cell carcinoma (OPSCC) caused by alcohol consumption and smoking and HPV-associated OPSCC caused by human papillomavirus (HPV) infection have different etiologies, incidences, and prognoses. Therefore, the 8th American Joint committee on Cancer (AJCC) and Union for International Cancer Control (UICC) TNM classifications propose distinguishing HPV-associated OPSCC from classical OPSCC and classifying it as an independent disease. Therefore, this review provides an overview of HPV-associated OPSCC from the perspectives of epidemiology, carcinogenesis, development, diagnosis, treatment, and prevention. The incidence of HPV-associated OPSCC is increasing. Although HPV vaccination has been shown to be effective at reducing the incidence of cervical cancer, it is still unclear how it affects the incidence of HPV-associated OPSCC. Additionally, the prognosis of patients with HPV-associated OPSCC is extremely favorable compared to that of patients with classical OPSCC. Therefore, patients with HPV-associated OPSCC may undergo reduced-dose therapy, although attempts to reduce treatment intensity should be carefully planned to ensure they do not compromise oncological outcomes, and large-scale trials aimed at reducing treatment intensity are ongoing.

摘要

经典口咽鳞状细胞癌(OPSCC)由饮酒和吸烟引起,而人乳头瘤病毒(HPV)感染引起的 HPV 相关 OPSCC 具有不同的病因、发病率和预后。因此,第 8 版美国癌症联合委员会(AJCC)和国际癌症控制联盟(UICC)TNM 分类建议将 HPV 相关 OPSCC 与经典 OPSCC 区分开来,并将其归类为一种独立的疾病。因此,本综述从流行病学、发病机制、发展、诊断、治疗和预防等方面概述了 HPV 相关 OPSCC。HPV 相关 OPSCC 的发病率正在增加。虽然 HPV 疫苗接种已被证明可有效降低宫颈癌的发病率,但尚不清楚其对 HPV 相关 OPSCC 发病率的影响。此外,与经典 OPSCC 患者相比,HPV 相关 OPSCC 患者的预后极好。因此,HPV 相关 OPSCC 患者可能接受低剂量治疗,尽管减少治疗强度的尝试应仔细计划,以确保不影响肿瘤学结果,并且正在进行旨在降低治疗强度的大规模试验。

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