Evaluation of Human Papillomavirus Antibodies and Risk of Subsequent Head and Neck Cancer
Evaluation of Human Papillomavirus Antibodies and Risk of Subsequent Head and Neck Cancer
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DOI：
10.1200/jco.2012.47.2738
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发表时间：
2013-07-20
影响因子：
45.3
通讯作者：
Brennan, Paul
中科院分区：
文献类型：
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作者：
Kreimer, Aimee R.;Johansson, Mattias;Brennan, Paul
研究目的人乳头瘤病毒16型（HPV 16）感染在美国和欧洲引起越来越多的口咽癌。我们研究的目的是调查HPV抗体是否与头颈部癌的风险有关，当在诊断前血清中测量时，我们确定了638名参与者与头颈部癌的发病率（病人; 180例口腔癌、135例口咽癌和247例下咽/喉癌）和300例食管癌患者以及1，来自欧洲癌症和营养队列前瞻性研究的599例可比对照。分析了来自患者（平均在诊断前6年收集）和对照参与者的诊断前血浆样本中针对HPV 16以及HPV 6、HPV 11、HPV 18、HPV 31、HPV 33、HPV 45和HPV 52的多种蛋白质的抗体。计算癌症的比值比（OR）和95%CI，并调整潜在的混杂因素。采用考克斯比例风险回归法对患者的全因死亡率进行了评估。结果口咽癌患者和对照组中HPV 16 E6血清阳性率分别为34.8%和0.6%（OR为274; 95%CI为110 ~ 681），但与其他癌症部位无关。HPV 16 E6血清阳性参与者中口咽癌风险的增加与采血和诊断之间的时间无关，并且在诊断前10年以上观察到。HPV 16 E6血清学阳性患者与阴性患者的全因死亡率之比为0.30（95%CI为0.13 ~ 0.67）。(C)2013年美国临床肿瘤学会
PurposeHuman papillomavirus type 16 (HPV16) infection is causing an increasing number of oropharyngeal cancers in the United States and Europe. The aim of our study was to investigate whether HPV antibodies are associated with head and neck cancer risk when measured in prediagnostic sera.MethodsWe identified 638 participants with incident head and neck cancers (patients; 180 oral cancers, 135 oropharynx cancers, and 247 hypopharynx/larynx cancers) and 300 patients with esophageal cancers as well as 1,599 comparable controls from within the European Prospective Investigation Into Cancer and Nutrition cohort. Prediagnostic plasma samples from patients (collected, on average, 6 years before diagnosis) and control participants were analyzed for antibodies against multiple proteins of HPV16 as well as HPV6, HPV11, HPV18, HPV31, HPV33, HPV45, and HPV52. Odds ratios (ORs) of cancer and 95% CIs were calculated, adjusting for potential confounders. All-cause mortality was evaluated among patients using Cox proportional hazards regression.ResultsHPV16 E6 seropositivity was present in prediagnostic samples for 34.8% of patients with oropharyngeal cancer and 0.6% of controls (OR, 274; 95% CI, 110 to 681) but was not associated with other cancer sites. The increased risk of oropharyngeal cancer among HPV16 E6 seropositive participants was independent of time between blood collection and diagnosis and was observed more than 10 years before diagnosis. The all-cause mortality ratio among patients with oropharyngeal cancer was 0.30 (95% CI, 0.13 to 0.67), for patients who were HPV16 E6 seropositive compared with seronegative.ConclusionHPV16 E6 seropositivity was present more than 10 years before diagnosis of oropharyngeal cancers. (C) 2013 by American Society of Clinical Oncology