口咽鳞癌HPV感染型别及其预后意义

项目名称： 口咽鳞癌HPV感染型别及其预后意义

项目编号： No.81072206

项目类型： 面上项目

立项/批准年度： 2011

项目学科： 金属学与金属工艺

项目作者： 张彬

作者单位： 中国医学科学院

项目金额： 10万元

中文摘要： 人乳头状瘤病毒（Human Papillomavirus，HPV），尤其是高危型感染与口咽鳞癌发病明显相关，且有重要预后相关性。中国大陆还没有专门的相关研究。本研究采用SPF10-DNA LiPA分型法对符合入组条件口咽癌标本进行检测，分析其临床病理特点及预后相关性。HPV总感染率为16.7%，其中，HPV-16感染者8例（7例HPV16和1例HPV11/16）。HPV阳性组女性、非吸烟及非饮酒者所占比例明显高于HPV阴性组,分别为36.4%对比1.8%，36.4%对比0和45.5%对比1.8%，均具有统计学差异（P值分别为0.002、0.001和0.001）。HPV阳性患者总体生存率和疾病特异性生存率均明显好于HPV阴性口咽癌患者（P=0.016和P=0.030）。3年总体生存率和疾病特异性生存率分别为90%对比52.4%和90%对比56.4%。本组HPV感染率为16.7%，与文献报道相比处于较低水平，HPV相关口咽鳞癌具有独特的流行病学和临床病理特点。HPV阳性的口咽鳞癌患者预后明显优于HPV阴性患者，HPV感染是独立的预后因素。中国大陆人群HPV感染状况尚需多中心的深入研究。

中文关键词： 人乳头状瘤状病毒；口咽鳞癌；PCR；感染率；预后

英文摘要： Recent studies have shown an etiologic role of infection with high-risk human papillomavirus (HR-HPV) in a subset of oropharyngeal squamous cell carcinomas and with significant prognostic predicting. None study about the relationship between HPV and OSCC have been derived from mainland China.We respectively evaluated 66 patients with oropharyngeal carcinoma who met the enrollment criteria during the period from January 1999 to December 2009 .The presence or absence of HPV oncogenic types in specimen was determined using the SPF10 LiPA25 assay.Clinico-pathological features of HPV positive and HPV negative OSCC were analyzed.HPV-DNA was detected in 11(16.7%) of all specimens,eight of which were HPV-16 subtype (seven HPV-16 and one HPV-16/11). There were more females in HPV-positive tumors than HPV-negative tumors(36.4% and 1.8%,respectively, P=0.002).Patients with HPV-positive tumors were more likely to be non-smokers (36.4% vs 0,respectively) and non-drinkers(45.5% vs 1.8%,respectively) than HPV negative tumors,with statistically significant difference(P=0.001,0.001, respectively).Patients with HPV-positive tumors had significantly better overall survival(P =0.016) and disease specific survival(P =0.030),the 3-year OS and DSS was 90% vs 52.4% and 90% vs 56.4%,respectively.Conclusions：HPV infection rate of OSCCs in this study was 16.7%，a little lower than that reported previously. HPV-positive OSCC is a unique clinical entity with different epidemiological and clinicopathological characteristics.Patients with HPV-positive OSCC have significantly better prognosis than patients with HPV-negative tumors.HPV infection is an independent prognostic factor.HPV infection in oropharyngeal carcinoma in the Chinese population warrants further investigation with larger clinical trials.

英文关键词： Human papillomavirus (HPV)；Oropharyngeal Squamous cell carcinoma；PCR；Infection rate ；Prognosis.