Robust Differences in p16-Dependent Oropharyngeal Squamous Cell Carcinoma Distant Metastasis: Implications for Targeted Therapy
Robust Differences in p16-Dependent Oropharyngeal Squamous Cell Carcinoma Distant Metastasis: Implications for Targeted Therapy
复制标题
DOI：
10.1177/0194599815581836
复制
发表时间：
2015-08-01
影响因子：
3.4
通讯作者：
Mehta, Vikas
中科院分区：
文献类型：
--
作者：
Jaber, James J.;Murrill, Lauren;Mehta, Vikas
目的头颈部鳞状细胞癌（HNSCC）历来被认为是淋巴系统恶性肿瘤。最近，这一点受到了质疑。我们的研究旨在（1）说明p16+和p16-口咽鳞状细胞癌（OPSCC）之间在远处转移方面的显著差异，（2）支持p16+ OPSCC具有血管侵袭和血行扩散的倾向。病例系列与图表回顾。设置四个学术机构。主题和方法在一组1113例原发性OPSCC患者中，他们在1979年至1999年期间接受治疗。2013年，根据p16状态将发生远处转移（DM）的患者分为2个队列。结果1058例患者中，89例发生DM，其中11例发生DM，1例发生DM，1例发生DM。30例为p16-，59例为p16+。在p16-DM患者中，只有10%的患者有播散性疾病（2个部位的远处转移），而p16+患者为74%。远处疾病p16+患者包括脑，腹部，和一个独特的模式肺transferation.Conclusion我们的大型，多机构的研究支持发表的报告，p16+ OPSCC转移与一个独特的表型，是血行和广泛传播的非典型终末器官网站。我们的数据表明，p16+ OPSCC有一个倾向于积极的脉管系统入侵的结果和说明性的放射学和病理组织学的例子证明。这些发现可能对未来治疗p16+ OPSCC的靶向治疗产生影响。
Objective Historically, head and neck squamous cell carcinoma (HNSCC) has been earmarked a lymphatic malignancy. Recently, this has been called into question. Our study aims to (1) illustrate the robust differences in distant metastases between p16+ and p16- oropharyngeal squamous cell carcinoma (OPSCC) and (2) provide support that p16+ OPSCC has a predilection toward vasculature invasion and hematogenous spread.Study Design Multi-institutional, case series with chart review.Setting Four academic institutions.Subjects and Methods Within a group of 1113 patients with primary OPSCC who received treatment between 1979 and 2013, those who developed distant metastasis (DM) were divided into 2 cohorts based on p16 status. Intergroup and intragroup univariate analysis was performed as well as descriptive analysis of end-organ sites.Results Of the 1058 patients included, 89 developed DM. Thirty were p16- and 59 were p16+. Of the p16- patients with DM, only 10% had disseminated disease (distant metastases at 2 sites) compared with 74% of p16+ patients. Distant disease in p16+ patients included brain, abdomen, and a distinct pattern of pulmonary metastases.Conclusion Our large, multi-institutional study supports published reports that p16+ OPSCC metastasizes with a unique phenotype that is hematogenous and widely disseminated with atypical end-organ sites. Our data suggest that p16+ OPSCC has a predilection toward active vasculature invasion as evidenced by the results and illustrative radiologic and pathohistologic examples. These findings may have implications for future targeted therapy when treating p16+ OPSCC.