泰国南部 HPV 相关口咽癌：比例趋势和生存结果。
HPV-Related Oropharyngeal Cancer in Southern Thailand: Proportion Trend and Survival Outcome.
机构信息
Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
出版信息
Asian Pac J Cancer Prev. 2024 Jan 1;25(1):57-64. doi: 10.31557/APJCP.2024.25.1.57.
BACKGROUND
Persistent high-risk human papillomavirus (HPV) infection is one of the major etiologies of oropharyngeal squamous cell carcinoma (OPSCC). This study aimed to determine the proportion, temporal trend, and prognostic significance of HPV-related OPSCC in Thai patients.
METHODS
The study included patients with OPSCC who were treated at Songklanagarind Hospital (Songkhla, Southern Thailand) from 2009 to 2020. HPV status was screened by p16 expression using immunohistochemistry and confirmed by real-time polymerase chain reaction. Cox regression was used to determine prognostic significance.
RESULTS
The overall proportion of HPV+ OPSCC was 15.3% (95% confidence interval [CI]: 12.1-18.5) with a slightly increased proportion from 10.6% in 2009-2010 to 16.5% (2019-2020) (P for trend = 0.166). Among the HPV+ cases, HPV16 was detected in 65.3%, HPV18 in 34.7%, and other high-risk HPV types in 24%. Patients with P16+ or HPV+ OPSCC had significantly better overall survival (hazard ratio [HR]: 0.63, 95% CI: 0.45-0.90 and HR: 0.63, 95% CI: 0.45-0.88, respectively).
CONCLUSION
Thai patients in the southern region have a low proportion of HPV-related OPSCC with an increasing trend. Both P16 expression and HPV DNA status are strong independent prognostic factors of OPSCC.
背景
持续性高危型人乳头瘤病毒（HPV）感染是口咽鳞状细胞癌（OPSCC）的主要病因之一。本研究旨在确定 HPV 相关 OPSCC 在泰国患者中的比例、时间趋势和预后意义。
方法
本研究纳入了 2009 年至 2020 年在宋卡王子大学医院（泰国南部宋卡）接受治疗的 OPSCC 患者。使用免疫组织化学法检测 p16 表达来筛查 HPV 状态，并通过实时聚合酶链反应进行确认。使用 Cox 回归来确定预后意义。
结果
HPV+ OPSCC 的总体比例为 15.3%（95%置信区间[CI]：12.1-18.5），从 2009-2010 年的 10.6%略有增加到 2019-2020 年的 16.5%（趋势 P=0.166）。在 HPV+病例中，HPV16 检测到 65.3%，HPV18 检测到 34.7%，其他高危型 HPV 类型检测到 24%。P16+或 HPV+ OPSCC 患者的总生存率显著提高（风险比[HR]：0.63，95%CI：0.45-0.90 和 HR：0.63，95%CI：0.45-0.88）。
结论
泰国南部地区 HPV 相关 OPSCC 的比例较低，呈上升趋势。P16 表达和 HPV DNA 状态均是 OPSCC 的独立强预后因素。
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