Awawda Muhammad, Salman Saeed, Billan Salem
Joseph Fishman Oncology Center, Rambam Health Care Campus, Haifa 3109601, Israel.
J Clin Med. 2023 Jun 25;12(13):4264. doi: 10.3390/jcm12134264.
Nasopharyngeal carcinoma (NPC) is a head and neck cancer more frequent among East Asian populations compared with Western populations. While much is known about human papillomavirus's (HPV's) role in oropharyngeal cancer (OPC), little is known about its prevalence and prognostic value in NPC. The aim of this study is to investigate the role of HPV in NPC treated with definitive radiotherapy at a single institution.
A retrospective cohort analysis of patient's medical records and HPV status treated for NPC in Rambam Health Care Campus (Rambam HCC). Immunohistochemical staining for p16 was used as a surrogate marker of HPV infection in the tumor cells. All specimens were stained and evaluated by pathologists at the referring center independently.
In total, 87 patients diagnosed with NPC were treated at Rambam HCC between 2005 and 2018. Seventy-four patients had accessible data on the disease's clinical parameters and p16 status. In total, 10/74 (13.5%) had p16-positive staining in tumor cells; 75% were men and over 50% were smokers. The average age of diagnosis for the whole cohort was 48 years, being lower for p16-positive patients compared with p16-negative patients at 43 and 49 years old, respectively. A total of 84% of the patients had advanced disease of stage III and IV at presentation. Only 16% were diagnosed with stage I and II. Unlike the p16-negative group, the p16-positive group did not include any stage I or II disease. In univariate and multivariate analysis of overall survival rates, the age at diagnosis and the nodal spread status were the only statistically significant measures. P16 status was not found to be associated with survival.
The HPV prevalence in NPC is nontrivial. p16-positive patients had significantly less nodal spread and tended to be younger. Both age and nodal status were significantly correlated with the survival, but P16 status was not prognostic. Further large-scale trials are needed to elucidate the role of HPV in NPC.
与西方人群相比，鼻咽癌（NPC）在东亚人群中是一种更常见的头颈癌。虽然人们对人乳头瘤病毒（HPV）在口咽癌（OPC）中的作用了解很多，但对其在鼻咽癌中的流行情况和预后价值知之甚少。本研究的目的是调查HPV在一家机构接受根治性放疗的鼻咽癌中的作用。
对拉姆巴姆医疗保健校园（Rambam HCC）中接受鼻咽癌治疗的患者的病历和HPV状态进行回顾性队列分析。p16免疫组化染色用作肿瘤细胞中HPV感染的替代标志物。所有标本均由转诊中心的病理学家独立染色和评估。
2005年至2018年间，共有87例诊断为鼻咽癌的患者在Rambam HCC接受治疗。74例患者有关于疾病临床参数和p16状态的可获取数据。总共有10/74（13.5%）的患者肿瘤细胞中p16染色呈阳性；75%为男性，超过50%为吸烟者。整个队列的平均诊断年龄为48岁，p16阳性患者的诊断年龄低于p16阴性患者，分别为43岁和49岁。共有84%的患者在就诊时患有III期和IV期晚期疾病。只有16%被诊断为I期和II期。与p16阴性组不同，p16阳性组不包括任何I期或II期疾病。在总生存率的单因素和多因素分析中，诊断年龄和淋巴结转移状态是仅有的具有统计学意义的指标。未发现p16状态与生存率相关。
鼻咽癌中HPV的流行率不容小觑。p16阳性患者的淋巴结转移明显较少，且往往更年轻。年龄和淋巴结状态均与生存率显著相关，但P16状态不具有预后价值。需要进一步的大规模试验来阐明HPV在鼻咽癌中的作用。
