Effect of HPV on head and neck cancer patient survival, by region and tumor site: A comparison of 1362 cases across three continents.
Effect of HPV on head and neck cancer patient survival, by region and tumor site: A comparison of 1362 cases across three continents.
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DOI：
10.1016/j.oraloncology.2016.09.005
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发表时间：
2016-11
期刊：
影响因子：
4.8
通讯作者：
Brennan P
中科院分区：
文献类型：
--
作者：
D'Souza G;Anantharaman D;Gheit T;Abedi-Ardekani B;Beachler DC;Conway DI;Olshan AF;Wunsch-Filho V;Toporcov TN;Ahrens W;Wisniewski K;Merletti F;Boccia S;Tajara EH;Zevallos JP;Levi JE;Weissler MC;Wright S;Scelo G;Mazul AL;Tommasino M;Cadoni G;Brennan P
探讨HPV相关生物标志物是否在全球不同地区相似地预测口咽鳞状细胞癌（OPSCC）生存率，并探讨其在非口咽（非OP）头颈部癌症中的预后效用。使用了2002-2011年诊断的1362例头颈部SCC（HNSCC）的数据，这些数据来自以下国家的流行病学研究：巴西（GENCAPO研究，n=388）、美国（CHANCE研究，n=472）和欧洲（ARCAGE研究，n=502）。集中检测肿瘤的p16 INK 4a和HPV 16 DNA（通过PCR）。使用考克斯比例风险模型检查死亡风险。有517例OPSCC和845例非OP HNSCC。病例主要为男性（81%），曾吸烟者（91%），中位年龄为58岁，中位随访时间为3.1年（IQR=1.4- 5.9）。在OPSCC中，184例HPV相关（即，p16+/HPV 16+）与333例HPV无关（p16−和/或HPV 16 −）病例相比（HR=0.25，95%CI=0.18- 0.34）。美国HPV相关OPSCC病例的死亡率降低，欧洲和巴西（各p≤0.01），调整后仍显著降低（aHR=0.34，95%CI=0.24- 0.49）。在非OP HNSCC中，p16（aHR=0.83，95%CI=0.60-1.14）、HPV 16 DNA（aHR=1.20，95%CI=0.89-1.63）或p16+/HPV 16+（aHR=0.59，95%CI=0.32-1.08）均不是死亡率的显著预测因子。当测试相互作用时，HPV 16/p16在OPSCC中的作用与非OP HNSCC显著不同（p-相互作用=0.02）。HPV相关的OPSCC在这三个地区具有相似的生存益处。HPV在非OP HNSCC中的预后效用有限，因此肿瘤HPV/p16检测不应在非OP HNSCC中常规进行。
To explore whether HPV-related biomarkers predict oropharyngeal squamous cell cancer (OPSCC) survival similarly across different global regions, and to explore their prognostic utility among non-oropharyngeal (non-OP) head and neck cancers. Data from 1362 head and neck SCC (HNSCC) diagnosed 2002-2011 was used from epidemiologic studies in: Brazil (GENCAPO study, n=388), U.S. (CHANCE study, n=472), and Europe (ARCAGE study, n=502). Tumors were centrally tested for p16INK4a and HPV16 DNA (by PCR). Risk of mortality was examined using Cox proportional hazard models. There were 517 OPSCC and 845 non-OP HNSCC. Cases were primarily male (81%), ever smokers (91%), with median age of 58 years and median follow-up of 3.1 years (IQR=1.4- 5.9). Among OPSCC, the risk of mortality was significantly lower among 184 HPV-related (i.e., p16+/HPV16+) compared to 333 HPV-unrelated (p16− and/or HPV16−) cases (HR=0.25, 95%CI=0.18- 0.34). Mortality was reduced among HPV-related OPSCC cases from the U.S., Europe, and Brazil (each p≤0.01) and after adjustment, remained significantly reduced (aHR=0.34, 95%CI=0.24- 0.49). Among non-OP HNSCC, neither p16 (aHR=0.83, 95%CI=0.60-1.14), HPV16 DNA (aHR=1.20, 95%CI=0.89-1.63), or p16+/HPV16+ (aHR=0.59, 95%CI=0.32-1.08) was a significantly predictor of mortality. When interaction was tested, the effect of HPV16/p16 was significantly different in OPSCC than non-OP HNSCC (p-interaction=0.02). HPV-related OPSCCs had similar survival benefits across these three regions. Prognostic utility of HPV among non-OP HNSCC is limited so tumor HPV/p16 testing should not be routinely done among non-OP HNSCC.
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