Clara H Pinborg, Amanda-Louise F Carlander, Joachim Hansen, Christian Grønhøj, Kathrine K Jakobsen, Christian von Buchwald
{"title":"p16和HPV不一致对未知原发癌预后的影响：一项系统综述和荟萃分析。","authors":"Clara H Pinborg, Amanda-Louise F Carlander, Joachim Hansen, Christian Grønhøj, Kathrine K Jakobsen, Christian von Buchwald","doi":"10.1080/00016489.2025.2509655","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Discordance between human papillomavirus (HPV) and its surrogate marker, p16INK4a (p16), raises concerns about the reliability of p16 as a sole prognostic marker.</p><p><strong>Objectives: </strong>To investigate the impact of HPV, p16, and discordant HPV/p16 status on survival in squamous cell carcinoma of unknown primary in the head and neck (SCCUPHN).</p><p><strong>Materials and methods: </strong>PubMed and EMBASE were searched for relevant studies that used a strict definition of SCCUPHN and reported survival outcomes stratified by HPV/p16 status. A meta-analysis assessed the prevalence and overall survival (OS).</p><p><strong>Results: </strong>Twelve studies (<i>n</i> = 864) were included. The pooled prevalence rates were: 23% HPV+/p16+ SCCUPHN (95% CI: 14-33%); 50% HPV-/p16- (95% CI: 32-67%); 13% HPV-/p16+ (95% CI: 6-19%); and 6% HPV+/p16- (95% CI: 1-10%). OS hazard ratios were: 0.37 (95% CI: 0.17-0.78) for p16+ vs. p16-, 0.35 (95% CI: 0.19-0.64) for HPV+ vs. HPV-, and 0.24 (95% CI: 0.12-0.50) for HPV+/p16+ vs. HPV-/p16-. Only one study (<i>n</i> = 103) compared survival in the four HPV/p16 subgroups individually.</p><p><strong>Conclusions: </strong>HPV and p16 are individual positive prognostic markers in SCCUPHN. Although significant discordance exists, the current literature does not provide sufficient evidence to support risk stratifying SCCUPHN patients into four distinct HPV/p16 subgroups.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.2000,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic impact of p16 and HPV discordance in cancer of unknown primary: a systematic review and meta-analysis.\",\"authors\":\"Clara H Pinborg, Amanda-Louise F Carlander, Joachim Hansen, Christian Grønhøj, Kathrine K Jakobsen, Christian von Buchwald\",\"doi\":\"10.1080/00016489.2025.2509655\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Discordance between human papillomavirus (HPV) and its surrogate marker, p16INK4a (p16), raises concerns about the reliability of p16 as a sole prognostic marker.</p><p><strong>Objectives: </strong>To investigate the impact of HPV, p16, and discordant HPV/p16 status on survival in squamous cell carcinoma of unknown primary in the head and neck (SCCUPHN).</p><p><strong>Materials and methods: </strong>PubMed and EMBASE were searched for relevant studies that used a strict definition of SCCUPHN and reported survival outcomes stratified by HPV/p16 status. A meta-analysis assessed the prevalence and overall survival (OS).</p><p><strong>Results: </strong>Twelve studies (<i>n</i> = 864) were included. The pooled prevalence rates were: 23% HPV+/p16+ SCCUPHN (95% CI: 14-33%); 50% HPV-/p16- (95% CI: 32-67%); 13% HPV-/p16+ (95% CI: 6-19%); and 6% HPV+/p16- (95% CI: 1-10%). OS hazard ratios were: 0.37 (95% CI: 0.17-0.78) for p16+ vs. p16-, 0.35 (95% CI: 0.19-0.64) for HPV+ vs. HPV-, and 0.24 (95% CI: 0.12-0.50) for HPV+/p16+ vs. HPV-/p16-. Only one study (<i>n</i> = 103) compared survival in the four HPV/p16 subgroups individually.</p><p><strong>Conclusions: </strong>HPV and p16 are individual positive prognostic markers in SCCUPHN. Although significant discordance exists, the current literature does not provide sufficient evidence to support risk stratifying SCCUPHN patients into four distinct HPV/p16 subgroups.</p>\",\"PeriodicalId\":6880,\"journal\":{\"name\":\"Acta Oto-Laryngologica\",\"volume\":\" \",\"pages\":\"1-9\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Oto-Laryngologica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/00016489.2025.2509655\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Oto-Laryngologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/00016489.2025.2509655","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Prognostic impact of p16 and HPV discordance in cancer of unknown primary: a systematic review and meta-analysis.
Background: Discordance between human papillomavirus (HPV) and its surrogate marker, p16INK4a (p16), raises concerns about the reliability of p16 as a sole prognostic marker.
Objectives: To investigate the impact of HPV, p16, and discordant HPV/p16 status on survival in squamous cell carcinoma of unknown primary in the head and neck (SCCUPHN).
Materials and methods: PubMed and EMBASE were searched for relevant studies that used a strict definition of SCCUPHN and reported survival outcomes stratified by HPV/p16 status. A meta-analysis assessed the prevalence and overall survival (OS).
Results: Twelve studies (n = 864) were included. The pooled prevalence rates were: 23% HPV+/p16+ SCCUPHN (95% CI: 14-33%); 50% HPV-/p16- (95% CI: 32-67%); 13% HPV-/p16+ (95% CI: 6-19%); and 6% HPV+/p16- (95% CI: 1-10%). OS hazard ratios were: 0.37 (95% CI: 0.17-0.78) for p16+ vs. p16-, 0.35 (95% CI: 0.19-0.64) for HPV+ vs. HPV-, and 0.24 (95% CI: 0.12-0.50) for HPV+/p16+ vs. HPV-/p16-. Only one study (n = 103) compared survival in the four HPV/p16 subgroups individually.
Conclusions: HPV and p16 are individual positive prognostic markers in SCCUPHN. Although significant discordance exists, the current literature does not provide sufficient evidence to support risk stratifying SCCUPHN patients into four distinct HPV/p16 subgroups.
期刊介绍：
Acta Oto-Laryngologica is a truly international journal for translational otolaryngology and head- and neck surgery. The journal presents cutting-edge papers on clinical practice, clinical research and basic sciences. Acta also bridges the gap between clinical and basic research.
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