中国头颈癌患者HPV感染的临床特征和预后影响：一项全国性多中心研究。

IF 3.1 2区医学 Q3 IMMUNOLOGY

Infectious Agents and Cancer Pub Date : 2025-07-18 DOI:10.1186/s13027-025-00680-0

Qi-Jian Zheng, Hong-Hao Wang, Chao Ding, Guang Han, Li Li, Xiao-Li Cui, Shao-Kai Zhang, Hong-Ying Yang, Yan Wang, Yong-Zhen Zhang, Wen-Jun Wang, Yu-Ting Hong, Mei-Wen Yuan, Xue-Lian Zhao, Shang-Ying Hu, Jun-Ling Wang, Fang-Hui Zhao

{"title":"中国头颈癌患者HPV感染的临床特征和预后影响：一项全国性多中心研究。","authors":"Qi-Jian Zheng, Hong-Hao Wang, Chao Ding, Guang Han, Li Li, Xiao-Li Cui, Shao-Kai Zhang, Hong-Ying Yang, Yan Wang, Yong-Zhen Zhang, Wen-Jun Wang, Yu-Ting Hong, Mei-Wen Yuan, Xue-Lian Zhao, Shang-Ying Hu, Jun-Ling Wang, Fang-Hui Zhao","doi":"10.1186/s13027-025-00680-0","DOIUrl":null,"url":null,"abstract":"Background: Human papillomavirus (HPV) has emerged as a major cause of head and neck cancer (HNC), yet nationwide HPV-stratified disease data are still lacking in China. The literature remains divided on the prognostic impact of HPV infection.Methods: The HNC patients treated from 1 January 2017 to 30 June 2021 were retrospectively identified at nine tertiary A centers representing the seven geographic regions of China. Event-free survival (EFS) and cancer-specific survival (CSS) were estimated with the Kaplan-Meier method and compared using the log-rank test. Early survival differences by subsite and HPV status were assessed using restricted mean survival time differences for EFS (ΔRMEFST) and CSS (ΔRMCSST), adjusting for confounders with pseudo-value regression.Results: The study included 345 cases. Most of the Chinese HNC patients in this study were male (84.64%), and more than one-third were already at clinical Tumor-Node-Metastasis (cTNM) stage IV at diagnosis. Among the 237 patients who underwent HPV testing, 18.99% were HPV-positive, with the highest prevalence in oropharyngeal cancers (37.29%) and the lowest in laryngeal cancers (7.48%; p < 0.001). A higher proportion of HPV‑positive patients consumed alcohol (44.44%), received radiotherapy (53.33%) and chemotherapy (88.89%), whereas a lower proportion underwent surgery (62.22%) (all p < 0.001). In oral cancer, EFS was higher in the HPV-positive group (log-rank p = 0.002); after adjustment for confounders, the 12-month ΔRMEFST was 1.576 months (95%CI = 0.157, 2.996; p = 0.029). Among patients with oropharyngeal cancer, both EFS and CSS were higher in the HPV-positive group than in the HPV-negative group (all log-rank p < 0.050). After multivariable adjustment, the 12-month ΔRMCSST was 0.629 months (95%CI = 0.019, 1.238; p = 0.043). Laryngeal cancer patients showed no HPV-related differences in EFS or CSS (all p > 0.050). A 24-month landmark sensitivity analysis confirmed the survival advantage in oral and oropharyngeal cancer.Conclusions: Demographics, risk profiles, presentation, and treatment patterns differ sharply by HPV status. Early survival is better for HPV-positive oral and oropharyngeal cancers but not for laryngeal cancer.","PeriodicalId":13568,"journal":{"name":"Infectious Agents and Cancer","volume":"20 1","pages":"47"},"PeriodicalIF":3.1000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273054/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical characteristics and prognostic impact of HPV infection in head and neck cancer patients in china: a nationwide multicenter study.\",\"authors\":\"Qi-Jian Zheng, Hong-Hao Wang, Chao Ding, Guang Han, Li Li, Xiao-Li Cui, Shao-Kai Zhang, Hong-Ying Yang, Yan Wang, Yong-Zhen Zhang, Wen-Jun Wang, Yu-Ting Hong, Mei-Wen Yuan, Xue-Lian Zhao, Shang-Ying Hu, Jun-Ling Wang, Fang-Hui Zhao\",\"doi\":\"10.1186/s13027-025-00680-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Human papillomavirus (HPV) has emerged as a major cause of head and neck cancer (HNC), yet nationwide HPV-stratified disease data are still lacking in China. The literature remains divided on the prognostic impact of HPV infection.Methods: The HNC patients treated from 1 January 2017 to 30 June 2021 were retrospectively identified at nine tertiary A centers representing the seven geographic regions of China. Event-free survival (EFS) and cancer-specific survival (CSS) were estimated with the Kaplan-Meier method and compared using the log-rank test. Early survival differences by subsite and HPV status were assessed using restricted mean survival time differences for EFS (ΔRMEFST) and CSS (ΔRMCSST), adjusting for confounders with pseudo-value regression.Results: The study included 345 cases. Most of the Chinese HNC patients in this study were male (84.64%), and more than one-third were already at clinical Tumor-Node-Metastasis (cTNM) stage IV at diagnosis. Among the 237 patients who underwent HPV testing, 18.99% were HPV-positive, with the highest prevalence in oropharyngeal cancers (37.29%) and the lowest in laryngeal cancers (7.48%; p < 0.001). A higher proportion of HPV‑positive patients consumed alcohol (44.44%), received radiotherapy (53.33%) and chemotherapy (88.89%), whereas a lower proportion underwent surgery (62.22%) (all p < 0.001). In oral cancer, EFS was higher in the HPV-positive group (log-rank p = 0.002); after adjustment for confounders, the 12-month ΔRMEFST was 1.576 months (95%CI = 0.157, 2.996; p = 0.029). Among patients with oropharyngeal cancer, both EFS and CSS were higher in the HPV-positive group than in the HPV-negative group (all log-rank p < 0.050). After multivariable adjustment, the 12-month ΔRMCSST was 0.629 months (95%CI = 0.019, 1.238; p = 0.043). Laryngeal cancer patients showed no HPV-related differences in EFS or CSS (all p > 0.050). A 24-month landmark sensitivity analysis confirmed the survival advantage in oral and oropharyngeal cancer.Conclusions: Demographics, risk profiles, presentation, and treatment patterns differ sharply by HPV status. Early survival is better for HPV-positive oral and oropharyngeal cancers but not for laryngeal cancer.\",\"PeriodicalId\":13568,\"journal\":{\"name\":\"Infectious Agents and Cancer\",\"volume\":\"20 1\",\"pages\":\"47\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273054/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infectious Agents and Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13027-025-00680-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Agents and Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13027-025-00680-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：人乳头瘤病毒（HPV）已成为头颈癌（HNC）的主要病因，但中国仍缺乏全国性的HPV分层疾病数据。关于HPV感染的预后影响，文献仍然存在分歧。方法：回顾性分析2017年1月1日至2021年6月30日在代表中国7个地理区域的9个三级A中心治疗的HNC患者。使用Kaplan-Meier法估计无事件生存期（EFS）和癌症特异性生存期（CSS），并使用log-rank检验进行比较。使用EFS （ΔRMEFST）和CSS （ΔRMCSST）的限制性平均生存时间差异评估亚位点和HPV状态的早期生存差异，并通过伪值回归调整混杂因素。结果：纳入病例345例。在本研究中，中国HNC患者以男性为主（84.64%），超过三分之一的患者在诊断时已处于临床肿瘤-淋巴结-转移（cTNM） IV期。237例接受HPV检测的患者中，HPV阳性的比例为18.99%，其中口咽癌最高（37.29%），喉癌最低（7.48%）；p 0.050)。一项为期24个月的里程碑敏感性分析证实了在口腔癌和口咽癌中的生存优势。结论：人口统计学、风险概况、表现和治疗模式因HPV状态而有很大差异。hpv阳性的口腔癌和口咽癌的早期生存率较高，而喉癌则不然。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Clinical characteristics and prognostic impact of HPV infection in head and neck cancer patients in china: a nationwide multicenter study.

Background: Human papillomavirus (HPV) has emerged as a major cause of head and neck cancer (HNC), yet nationwide HPV-stratified disease data are still lacking in China. The literature remains divided on the prognostic impact of HPV infection.

Methods: The HNC patients treated from 1 January 2017 to 30 June 2021 were retrospectively identified at nine tertiary A centers representing the seven geographic regions of China. Event-free survival (EFS) and cancer-specific survival (CSS) were estimated with the Kaplan-Meier method and compared using the log-rank test. Early survival differences by subsite and HPV status were assessed using restricted mean survival time differences for EFS (ΔRMEFST) and CSS (ΔRMCSST), adjusting for confounders with pseudo-value regression.

Results: The study included 345 cases. Most of the Chinese HNC patients in this study were male (84.64%), and more than one-third were already at clinical Tumor-Node-Metastasis (cTNM) stage IV at diagnosis. Among the 237 patients who underwent HPV testing, 18.99% were HPV-positive, with the highest prevalence in oropharyngeal cancers (37.29%) and the lowest in laryngeal cancers (7.48%; p < 0.001). A higher proportion of HPV‑positive patients consumed alcohol (44.44%), received radiotherapy (53.33%) and chemotherapy (88.89%), whereas a lower proportion underwent surgery (62.22%) (all p < 0.001). In oral cancer, EFS was higher in the HPV-positive group (log-rank p = 0.002); after adjustment for confounders, the 12-month ΔRMEFST was 1.576 months (95%CI = 0.157, 2.996; p = 0.029). Among patients with oropharyngeal cancer, both EFS and CSS were higher in the HPV-positive group than in the HPV-negative group (all log-rank p < 0.050). After multivariable adjustment, the 12-month ΔRMCSST was 0.629 months (95%CI = 0.019, 1.238; p = 0.043). Laryngeal cancer patients showed no HPV-related differences in EFS or CSS (all p > 0.050). A 24-month landmark sensitivity analysis confirmed the survival advantage in oral and oropharyngeal cancer.

Conclusions: Demographics, risk profiles, presentation, and treatment patterns differ sharply by HPV status. Early survival is better for HPV-positive oral and oropharyngeal cancers but not for laryngeal cancer.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

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.