Human papillomavirus type 16 infection and squamous cell carcinoma of the head and neck in never-smokers: a matched pair analysis.
Human papillomavirus type 16 infection and squamous cell carcinoma of the head and neck in never-smokers: a matched pair analysis.
复制标题
DOI：
--
复制
发表时间：
2003-07
期刊：
影响因子：
--
通讯作者：
Kristina R. Dahlstrom;K. Adler‐Storthz;C. Etzel;Zhensheng Liu;L. Dillon;A. El-Naggar;M. Spitz;J. Schiller;Q. Wei;E. Sturgis
中科院分区：
文献类型：
--
作者：
Kristina R. Dahlstrom;K. Adler‐Storthz;C. Etzel;Zhensheng Liu;L. Dillon;A. El-Naggar;M. Spitz;J. Schiller;Q. Wei;E. Sturgis
16型人乳头瘤病毒（HPV）感染已被认为是头颈部鳞状细胞癌（SCCHN）的一个危险因素，并且与发生在口咽部和从不吸烟者的SCCHN更为常见。我们假设HPV-16暴露，正如血清阳性所证明的那样，是SCCHN的一个危险因素，可能对从不吸烟的人特别重要。为了验证这一假设，我们对120例SCCHN患者（60例不吸烟者和60例匹配吸烟者）和120例无癌匹配对照进行了一项基于医院的病例对照研究。我们比较了年龄（+/-5岁）、性别和肿瘤部位匹配的吸烟和不吸烟患者中HPV-16抗体的存在。每名患者在年龄（+/-5岁）和性别上也与相应的吸烟或不吸烟的无癌对照相匹配。收集研究对象的血清，用ELISA检测IgG对hpv - 16l1病毒样颗粒的反应性。结果120例病例中49例（40.8%）HPV-16抗体阳性，而对照组仅有11例（9.2%）HPV-16抗体阳性（校正优势比为6.69,95%可信区间为3.01 ~ 14.90）。其中，HPV-16血清阳性在口咽癌（70例中有41例，58.6%）和低分化肿瘤（43例中有25例，58.1%）中更为常见。HPV-16血清阳性与口咽癌风险显著增加相关（校正优势比为59.53；95%可信区间为5.71-620.20）。尽管HPV-16血清阳性在从不吸烟的SCCHN患者中比从不吸烟的SCCHN患者更常见（分别为43.3%和38.3%），但这种差异无统计学意义。结论：HPV-16感染与口咽癌风险显著增加相关，但与口腔癌无关。此外，HPV-16感染在不吸烟的SCCHN患者中并不比曾经吸烟的SCCHN患者更常见。
PURPOSE Infection with human papillomavirus (HPV) type 16 has been suggested to be a risk factor for squamous cell carcinoma of the head and neck (SCCHN) and to be more commonly associated with SCCHN occurring in the oropharynx and in never-smokers. We hypothesized that HPV-16 exposure, as evidenced by seropositivity, is a risk factor for SCCHN and may be of particular importance in never-smokers. EXPERIMENTAL DESIGN To test this hypothesis, we conducted a hospital-based case-control study of 120 patients with SCCHN (60 never-smokers and 60 matched smokers) and 120 cancer-free matched controls. We compared the presence of HPV-16 antibodies in ever-smoker and never-smoker patients matched on age (+/-5 years), sex, and tumor site. Each patient was also matched with a corresponding ever-smoker or never-smoker cancer-free control on age (+/-5 years) and sex. Serum was collected from study subjects and assayed for IgG reactivity to HPV-16 L1 virus-like particles by using an ELISA. RESULTS Forty-nine of the 120 case subjects (40.8%) but only 11 (9.2%) of the control subjects tested positive for HPV-16 antibodies (adjusted odds ratio, 6.69; 95% confidence interval, 3.01-14.90). Among cases, HPV-16 seropositivity was more common in those with oropharyngeal cancer (41 of 70, 58.6%) and poorly differentiated tumors (25 of 43, 58.1%). HPV-16 seropositivity was associated with a significantly increased risk of oropharyngeal cancer (adjusted odds ratio, 59.53; 95% confidence interval, 5.71-620.20). Whereas HPV-16 seropositivity was more common in never-smokers with SCCHN than in ever-smokers (43.3% versus 38.3%, respectively), this difference was not statistically significant. CONCLUSIONS HPV-16 infection is associated with a significant increased risk for oropharyngeal cancer but not oral cavity cancer. Furthermore, HPV-16 infection does not appear to be more common in never-smokers than ever-smokers with SCCHN.