HPV-associated head and neck cancer: a virus-related cancer epidemic.
HPV-associated head and neck cancer: a virus-related cancer epidemic.
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HPV 相关头颈癌：一种与病毒相关的癌症流行。
DOI：
10.1016/s1470-2045(10)70017-6
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
Forastiere AA
中科院分区：
文献类型：
--
作者：
Marur S;D'Souza G;Westra WH;Forastiere AA
在过去的十年中，观察到50岁以下、不吸烟和不酗酒的白色男性中口咽鳞状细胞癌（特别是舌扁桃体和腭扁桃体）的年发病率上升。该实体与人乳头瘤病毒-16感染有关，风险因素包括年轻时口腔和阴道性伴侣数量增加。HPV相关口咽癌的生物学特征与p53降解、Rb通路失活和p16上调不同。这与烟草相关的口咽癌相反，其特征在于p53突变和p16下调。检测肿瘤中病毒的最佳方法是有争议的，原位杂交和PCR是常用的，p16免疫组织化学可能作为一个潜在的替代标记。HPV相关的口咽癌似乎比HPV阴性的口咽癌对化疗和放疗更敏感。HPV-16是改善总生存期和无病生存期的预后标志物，但尚未被证明是预测标志物。研究人员继续探索关于口腔HPV感染的自然史，为什么男性占主导地位，HPV疫苗用于一级预防的潜力，开发商业上可用的准确方法来检测肿瘤中的病毒，以及降低毒性而不影响生存的治疗策略。这篇综述的目的是强调我们目前对HPV相关口咽HNSCC的流行病学、生物学、检测以及当前管理和未解决问题的理解。
A rise in the annual incidence of oropharynx squamous cell cancer, specifically the lingual and palatine tonsils, in white men under the age of 50, non-smokers and non-alcoholics, has been observed over the past decade. This entity is associated with human papilloma virus-16 infection and the risk factors include an increased number of oral and vaginal sex partners at a younger age. The biology of HPV-related oropharynx cancer is distinct with p53 degradation, Rb pathway inactivation, and p16 upregulation. This is in contrast to tobacco related oropharynx cancer which is characterized by p53 mutation and downregulation of p16. The optimal method to detect virus in tumor is controversial and both in situ hybridization and PCR are commonly used; p16 immunohistochemistry may serve as a potential surrogate marker. HPV-related oropharynx cancer appears to be more responsive to chemotherapy and radiation than HPV negative orpharynx cancer. HPV-16 is a prognostic marker for improved overall survival and disease-free survival but has not yet been shown to be a predictive marker. Investigators continue to explore unanswered questions regarding the natural history of oral HPV infection, why the increase dominates in men, the potential of HPV vaccines for primary prevention, developing a commercially available accurate method to detect the virus in tumor, and treatment strategies that reduce toxicity without compromising survival. The goal of this review is to highlight our current understanding of the epidemiology, biology, detection, as well as current management and unresolved issues of HPV-related oropharyngeal HNSCC.