Human papillomavirus-associated squamous cell carcinoma of the larynx or hypopharynx: Clinical outcomes and implications for laryngeal preservation
Human papillomavirus-associated squamous cell carcinoma of the larynx or hypopharynx: Clinical outcomes and implications for laryngeal preservation
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DOI：
10.1016/j.oraloncology.2019.09.008
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发表时间：
2019-11-01
期刊：
影响因子：
4.8
通讯作者：
Greven, Kathryn M.
中科院分区：
文献类型：
--
作者：
Hughes, Ryan T.;Beuerlein, William J.;Greven, Kathryn M.
目的：人乳头瘤病毒（HPV）可在约25%的喉和下咽部鳞状细胞癌（SCC）中检测到。虽然HPV是与改善生存和疾病控制口咽部鳞状细胞癌患者，HPV作为一个良好的治疗结果在喉和下咽cancer.Materials和方法标记的作用尚不清楚：治疗喉或下咽鳞状细胞癌的患者进行了审查。从病历中提取p16和/或HPV DNA PCR检测的HPV状态。回顾性检测了一部分样本（接受初次放疗的III-IV期）的p16和HPV DNA。总生存期（OS），无病生存期（DFS），和局部控制（LRC）之间的HPV阳性（p16 +，PCR +或两者）和HPV阴性（p16-或PCR-）patients.Results：在总的，279例患者被确定，其中94人进行了HPV检测。82例（87%）HPV阴性，12例（13%）HPV阳性。3年时，OS（72% v. 83%）、DFS（60% v. 71%）和LRC（80% v. 89%）无显著差异。体力状态、吸烟史和分期预测OS，体力状态和分期预测DFS。初步放疗治疗的患者的分析显示，在3年（75%对100%）的喉保存率不显着较高。结论：HPV检测在13%的测试喉/下咽癌。HPV似乎对喉或下咽部SCC患者的生存率或疾病控制没有显著影响。在HPV阳性患者中观察到喉保护的非显著改善。
Objectives: Human papillomavirus (HPV) can be detected in approximately 25% of squamous cell carcinomas (SCC) of the larynx and hypopharynx. Though HPV is associated with improved survival and disease control in patients with oropharyngeal SCC, the role of HPV as a marker of favorable treatment outcomes in laryngeal and hypopharyngeal cancer is unclear.Materials and Methods: Patients treated for laryngeal or hypopharyngeal SCC were reviewed. HPV status detected by p16 and/or HPV DNA PCR were abstracted from the medical record. A subset of samples (stage III-IV treated with primary radiotherapy) was retrospectively tested for p16 and HPV DNA. Overall survival (OS), disease-free survival (DFS), and locoregional control (LRC) were determined and compared between HPV-positive (p16 + , PCR + or both) and HPV-negative (p16- or PCR-) patients.Results: In total, 279 patients were identified, 94 of which were tested for HPV. Eighty-two (87%) were negative and 12 (13%) were positive for HPV. At 3 years, there were no significant differences in OS (72% v. 83%), DFS (60% v. 71%) and LRC (80% v. 89%). Performance status, smoking history and stage predicted for OS, while performance status and stage predicted for DFS. Analysis of patients treated with primary radiotherapy revealed non-significantly higher rates of laryngeal preservation at 3 years (75% v. 100%).Conclusion: HPV was detected in 13% of tested laryngeal/hypopharyngeal cancers. HPV does not appear to significantly impact survival or disease control in patients with SCC of the larynx or hypopharynx. Non-significant improvements in laryngeal preservation were observed in HPV-positive patients.