Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population.

IF 2.8 2区医学 Q3 IMMUNOLOGY

Infectious Agents and Cancer Pub Date : 2025-06-09 DOI:10.1186/s13027-025-00657-z

Jieying Li, Kai Zhou, Xiaohong Zhan, Haijun Lu, Dapeng Hao, Kai Song, Shuangyi Wang, Yuanyong Feng, Haoyue Xu, Zongxuan He, Xiaochen Yang, Wei Shang, Lin Wang

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引用次数: 0

Abstract

Background: The aim of this study was to investigate the effect of inconsistent expression of p16 and HPV on the prognosis of patients with Oropharyngeal squamous cell carcinoma (OPSCC) in Chinese/Asian populations.

Methods: The study included 130 patients. Inclusion criteria were primary OPSCC. The primary outcome was the proportion of cohort patients showing different combinations of p16 and HPV outcomes, as well as overall survival (OS) and progression-free survival (PFS). Patients with relapsed or metastatic disease or palliative care were excluded from the survival analysis. A multivariate analysis model was used to calculate the adjusted hazard ratio for overall survival for different p16 and HPV tests, adjusted for pre-specified confounders.

Results: Among the 130 patients, 25 (19.2%) demonstrated inconsistency between HPV and p16 expressions. The inconsistency in HPV/p16 status was significantly associated with patient age, smoking history, and alcohol consumption, leading to significant differences in tumor site, TNM staging, and differentiation, thereby influencing treatment decisions. There were significant differences in OS (P = 0.04) and PFS (P = 0.011) among the three groups, with the inconsistent group falling between the HPV+/p16 + group and the HPV-/p16- group but closer to the latter. Out of 54 p16-positive patients, only 33 (61.1%) were HPV-positive, indicating a lower predictive value of p16 for HPV positivity in OPSCC than observed in Western populations. Moreover, the study suggested a potential positive correlation between p16 expression intensity and improved patient prognosis.

Conclusion: In the China/Asia region, where HPV infection rates are relatively low, the predictive power of p16 for HPV-related OPSCC is low. We recommend additional HPV testing in patients with p16 + OPSCC to improve diagnostic accuracy, thereby enabling the selection of the best de-escalation treatment strategy, increasing treatment response rates, and ultimately improving the overall prognosis in these patients.

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中国/亚洲口咽鳞状细胞癌人群中HPV和p16不一致组合的预后分析

背景：本研究的目的是探讨p16和HPV不一致表达对中国/亚洲人群口咽鳞状细胞癌（OPSCC）患者预后的影响。方法：研究对象为130例患者。纳入标准为原发性OPSCC。主要结果是显示p16和HPV结果不同组合的队列患者的比例，以及总生存期（OS）和无进展生存期（PFS）。复发或转移性疾病或姑息治疗的患者被排除在生存分析之外。使用多变量分析模型计算不同p16和HPV检测的总生存率的校正风险比，并根据预先指定的混杂因素进行校正。结果：在130例患者中，25例（19.2%）HPV与p16表达不一致。HPV/p16状态的不一致性与患者年龄、吸烟史和饮酒显著相关，导致肿瘤部位、TNM分期和分化的显著差异，从而影响治疗决策。三组间OS （P = 0.04）和PFS （P = 0.011）差异有统计学意义，不一致组介于HPV+/p16 +组和HPV-/p16-组之间，但更接近后者。在54例p16阳性患者中，只有33例（61.1%）为HPV阳性，这表明p16对OPSCC中HPV阳性的预测价值低于西方人群。此外，该研究提示p16表达强度与患者预后改善之间可能存在正相关。结论：在HPV感染率相对较低的中国/亚洲地区，p16对HPV相关OPSCC的预测能力较低。我们建议对p16 + OPSCC患者进行额外的HPV检测，以提高诊断准确性，从而能够选择最佳的降级治疗策略，提高治疗反应率，最终改善这些患者的整体预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Agents and Cancer ONCOLOGY-IMMUNOLOGY

CiteScore

5.80

自引率

2.70%

发文量

期刊介绍： Infectious Agents and Cancer is an open access, peer-reviewed online journal that encompasses all aspects of basic, clinical, epidemiological and translational research providing an insight into the association between chronic infections and cancer. The journal welcomes submissions in the pathogen-related cancer areas and other related topics, in particular: • HPV and anogenital cancers, as well as head and neck cancers; • EBV and Burkitt lymphoma; • HCV/HBV and hepatocellular carcinoma as well as lymphoproliferative diseases; • HHV8 and Kaposi sarcoma; • HTLV and leukemia; • Cancers in Low- and Middle-income countries. The link between infection and cancer has become well established over the past 50 years, and infection-associated cancer contribute up to 16% of cancers in developed countries and 33% in less developed countries. Preventive vaccines have been developed for only two cancer-causing viruses, highlighting both the opportunity to prevent infection-associated cancers by vaccination and the gaps that remain before vaccines can be developed for other cancer-causing agents. These gaps are due to incomplete understanding of the basic biology, natural history, epidemiology of many of the pathogens that cause cancer, the mechanisms they exploit to cause cancer, and how to interrupt progression to cancer in human populations. Early diagnosis or identification of lesions at high risk of progression represent the current most critical research area of the field supported by recent advances in genomics and proteomics technologies.