肿瘤内 HPV-16 病毒载量对口咽鳞状细胞癌预后的影响。

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2024-10-28 DOI:10.1016/j.oraloncology.2024.107082

Agathe Villarmé , Nathalie Ebran , Tanguy Pace-Loscos , Renaud Schiappa , Audrey Mignot , Alexandre Bozec , Anne Sudaka-Bahadoran , Esma Saada-Bouzid , Dorian Culié

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引用次数: 0

摘要

目的：HPV引起的口咽鳞状细胞癌（OSCC）的发病率在不断上升。虽然HPV相关OSCC的预后较好，但大多数HPV阳性OSCC患者都有吸烟等其他预后因素，这使得治疗降级方法不那么精确。在这种情况下，我们的研究旨在评估肿瘤内 HPV-16 病毒载量（VL）对 OSCC 预后的影响：我们对2012年至2019年间接受治疗的p16阳性OSCC患者样本进行了回顾性分析。病毒载量（VL）通过数字液滴聚合酶链式反应（ddPCR）测定，并按照3个亚组进行描述：低（85拷贝/细胞）、高（1.5拷贝/细胞）、中（1.5拷贝/细胞）和高（1.5拷贝/细胞）。我们采用 Kaplan-Meier 法评估了 VL 与无复发生存率（RFS）、特异性生存率（SS）和总生存率（OS）之间的相关性：共纳入 192 例患者，其中男性 148 例（77%），平均年龄 65 岁。平均年龄为 65 岁。在 189/192 份样本中检测到 HPV-16（98%）。T3-4阶段（p = 0.002）、转移（p = 0.007）和吸烟（p = 0.01）预示着较低的OS。高VL与较高的RFS（HR = 0.2，p = 0.01）、SS（HR = 0.32，p = 0.02）和OS（HR = 0.39，p = 0.03）相关。调整烟草消费和肿瘤分期后，高VL仍与较高的RFS（HR = 0.1，95 %CI [0.04-0.7]，p = 0.01）和SS（HR = 0.20，95 %CI [0.05-0.75]，p = 0.01）相关：结论：在我们的研究中，瘤内高HPV VL与生存率密切相关。我们的研究结果表明，HPV VL有助于完善HPV阳性OSCC患者的预后，但还需在独立的前瞻性队列中进一步验证。

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Prognostic impact of intra tumoral HPV-16 viral load in oropharyngeal squamous cell carcinomas

Objectives

The incidence of HPV-induced oropharyngeal squamous cell carcinoma (OSCC) is constantly increasing. Although HPV-related OSCC carry a better prognosis, the majority of patients with an HPV-positive OSCC have other prognostic factors such as tobacco smoking, making therapeutic de-escalating approaches less precise. In this context, our study aims to evaluate the prognostic impact of intra-tumoral HPV-16 viral load (VL) in OSCC.

Material and methods

We conducted a retrospective analysis of p16-positive OSCC samples from patients treated between 2012 and 2019. Viral load (VL) was determined using digital droplet Polymerase Chain Reaction (ddPCR) and described according to 3 subgroups: low (<0.9 copies/cell), medium (0.9–85 copies/cell), and high (>85 copies/cell). We assessed the correlation between VL and recurrence-free survival (RFS), specific survival (SS), and overall survival (OS) using the Kaplan-Meier method.

Results

In total, 192 patients were included; 148 (77 %) were male. The mean age was 65. HPV-16 was detected in 189/192 samples (98 %). T3-4-stage (p = 0.002), metastasis (p = 0.007), and tobacco consumption (p = 0.01) predicted lower OS. High VL was associated with higher RFS (HR = 0.2, p = 0.01), SS (HR = 0.32, p = 0.02), and OS (HR = 0.39, p = 0.03). After adjusting for tobacco consumption and tumor stage, high VL remained associated with higher RFS (HR = 0.1, 95 %CI [0.04–0.7], p = 0.01) and SS (HR = 0.20, 95 %CI [0.05–0.75], p = 0.01).

Conclusion

In our study, high intra-tumoral HPV VL was independently associated with survival. Subject to further validation in independent and prospective cohorts, our findings suggest that HPV VL could help to refine the prognosis of HPV positive OSCC patients.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.