Meta analysis: HPV and p16 pattern determines survival in patients with HNSCC and identifies potential new biologic subtype.
Meta analysis: HPV and p16 pattern determines survival in patients with HNSCC and identifies potential new biologic subtype.
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DOI：
10.1038/s41598-017-16918-w
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发表时间：
2017-12-01
影响因子：
4.6
通讯作者：
Coordes A
中科院分区：
文献类型：
--
作者：
Albers AE;Qian X;Kaufmann AM;Coordes A
在头颈部鳞状细胞癌（HNSCC）中观察到p16/HPV阳性的一致差异。因此，如果所有HPV+和/或p16+检测的癌症都是HPV驱动的，则值得怀疑。根据HPV依赖性TNM分期下调的患者存在治疗不足的风险，临床试验中的数据可能因错误的患者纳入而发生偏差。我们进行了一项荟萃分析，对p16和HPV联合检测的不同亚组的临床结局进行分类。1677篇出版物中有25篇符合纳入标准。HPV+/p16+的亚组比例为35.6%，HPV−/p16−为50.4%，HPV−/p16+为6.7%，HPV+/P16−为7.3%。与HNSCC和口咽癌的其他亚组相比，HPV+/p16+亚组的5年总生存期（OS）和无病生存期显着改善。HPV−/p16+ HNSCC的5年OS为中等，而HPV+/p16−和HPV−/p16−的生存结局最短。HPV−/p16+癌症的明显不同的生存可能表征了一种新的相关HPV非依赖性亚型，但尚未进行生物学表征。在一些HPV+/p16+癌症中，HPV是无辜的旁观者，而p16是独立阳性的可能性也存在。因此，HPV检测应该区分旁观者HPV和真正的HPV驱动的癌症，以避免HPV+但非HPV驱动的HNSCC的潜在治疗不足。
Consistent discrepancies in the p16/HPV-positivity have been observed in head and neck squamous cell carcinoma (HNSCC). It is therefore questionable, if all HPV+ and/or p16+ tested cancers are HPV-driven. Patients down-staged according to the HPV-dependant TNM are at risk for undertreatment and data in clinical trials may be skewed due to false patient inclusion. We performed a meta-analysis to classify clinical outcomes of the distinct subgroups with combined p16 and HPV detection. 25 out of 1677 publications fulfilled the inclusion criteria. The proportion of the subgroups was 35.6% for HPV+/p16+, 50.4% for HPV−/p16−, 6.7% for HPV−/p16+ and 7.3% for HPV+/P16−. The HPV+/p16+ subgroup had a significantly improved 5-year overall-survival (OS) and disease-free-survival in comparison to others both for HNSCC and oropharyngeal cancers. The 5-year OS of the HPV−/p16+ HNSCC was intermediate while HPV+/p16− and HPV−/p16− had the shortest survival outcomes. The clearly distinct survival of HPV−/p16+ cancers may characterize a new relevant HPV-independent subtype yet to be biologically characterized. The possibility also exists that in some HPV+/p16+ cancers HPV is an innocent bystander and p16 is independently positive. Therefore, in perspective, HPV-testing should distinguish between bystander HPV and truly HPV-driven cancers to avoid potential undertreatment in HPV+ but non-HPV-driven HNSCC.
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经典的危险因素，但不是HPV状态，可以预测晚期和颈癌患者化学放疗后的生存。
影响因子：
3.6
作者：
Descamps G;Karaca Y;Lechien JR;Kindt N;Decaestecker C;Remmelink M;Larsimont D;Andry G;Hassid S;Rodriguez A;Khalife M;Journe F;Saussez S
通讯作者：
Saussez S
影响因子：
6.4
作者：
Hatano T;Sano D;Takahashi H;Hyakusoku H;Isono Y;Shimada S;Sawakuma K;Takada K;Oikawa R;Watanabe Y;Yamamoto H;Itoh F;Myers JN;Oridate N
通讯作者：
Oridate N
影响因子：
3.5
作者：
Alos, Llucia;Hakim, Sofia;Ordi, Jaume
通讯作者：
Ordi, Jaume
影响因子：
--
作者：
Benchekroun, M;DeGraw, J;Heiskala, M
通讯作者：
Heiskala, M
影响因子：
50.5
作者：
Bossi, P.;Orlandi, E.;Licitra, L.
通讯作者：
Licitra, L.