唐山地区头颈部癌组织HPV与肿瘤复发相关性

Analysis of human papillomavirus detection rate in head and neck carcinoma tissues and its relationship with tumor recurrence in Tangshan area

目的人乳头状瘤病毒(human papillomavirus,HPV)相关头颈部癌构成了头颈部肿瘤一个独特亚组,本研究分析唐山地区头颈部癌组织中HPV检出情况、HPV阳性头颈癌患者的临床病理特征及与肿瘤复发的相关性。方法选取2003-01-01-2013-12-31唐山市头颈疾病病理研究基地头颈部癌手术切除标本418例,采用PCR反向斑点杂交技术检测肿瘤组织中HPV-DNA,分析HPV阳性头颈癌患者的临床病理特征及与肿瘤复发的相关性。结果唐山地区头颈部癌组织中HPV平均检出率为20.8%(87/418),多数为HPV16型,少数为HPV11、HPV35和HPV58型。其中,喉癌、口腔癌、下咽癌和口咽癌组织检出率分别为19.0%(19/100)、29.3%(24/82)、26.1%(12/46)和28.6%(32/112),涎腺腺样囊性癌组织中无一例HPV检出(0/78),不同部位肿瘤组织中HPV检出差异有统计学意义,z=25.245,P<0.001;吸烟组HPV检出率为13.1%,低于非吸烟组33.3%,差异有统计学意义,χ2=17.675,P<0.001;复发组HPV检出率为3.9%,低于未复发组30.7%,差异有统计学意义,χ2=30.164,P<0.001。HPV检出率与患者性别、年龄、肿瘤分级和分期无明显相关性,均P>0.05。多因素Logistic回归分析显示,肿瘤分化程度(OR=1.549,95%CI:1.131~2.122)和HPV感染(OR=0.089,95%CI:0.038~0.210)是影响复发的主要因素,均P<0.01。结论唐山地区头颈部癌组织中HPV检出率低,HPV阳性者多为非吸烟患者;肿瘤分化程度低及HPV阴性的头颈癌患者复发率高;常规HPV检测对头颈癌患者的肿瘤复发有预警作用。

OBJECTIVE Human papillomavirus-related carcinoma is an unique subgroup of head and neck squamous cell cancer.The aim of this study was to analyze the detection rate of HPV in head and neck carcinoma tissues and clinical features of HPV positive patients as well as its correlation with tumor recurrence in Tangshan area.METHODS Totally418 cases of head and neck carcinoma specimens were selected from January 1 st,2003 to December 31 st,2013 in Tangshan Union Hospital.PCR-reverse dot blot hybridization was used to detect HPV DNA.The clinical pathological features of HPV positive patients with head and neck cancer and its relationship with tumor recurrence were analyzed.RESULTS The detection rate of HPV in head and neck carcinoma tissues was 20.8%（87/418）in Tangshan area.Most subtypes were HPV16,few were HPV11,HPV35 or HPV58.Among them,The detection rates in the carcinoma tissues of larynx,oral,hypopharynx and oropharynx were 19.0%（19/100）,29.3%（24/82）,26.1%（12/46）and 28.6%（32/112）,respectively.There was no HPV detection in the adenoid cystic carcinoma of salivary glands（0/78）.The difference of HPV detection in different tumor tissues was statistically significant（z=25.245,P〈0.001）.The detection rate of HPV in smoking group was13.1%,which was lower than that of non-smoking group（33.3%）,and the difference was statistically significant（χ^2=17.675,P〈0.001）.The detection rate of HPV in recurrent group was 3.9%,which was lower than that in non recurrence group（30.7%）,and the difference was statistically significant（χ^2=30.164,P〈0.001）.There was no significant correlation between HPV detection rate with patients＇ gender,age,classification and staging,and the P values were all more than 0.05.Multiple factor Logistic regression analysis showed that tumor differentiation and HPV detection were the main factors affecting the recurrence.The P values were all less than 0.01,OR values and 95%CI were 1.549,1.131-2.122 and 0.089,0.038-0.210,respectively.CONCLUSIONS The detection rate of HPV is low in the head and neck carcinoma tissues in Tangshan area.HPV positive patients are mostly non smoking ones.The recurrence rate is high in patients with poorly differentiation and HPV negative detection.Routine HPV detection is necessary for patients with head and neck cancer in order to warn tumor recurrence early.