头颈部鳞癌患者HPV DNA、E6/E7 mRNA的分布及其在预后中的作用

Detection of Human Papilloma Virus DNA and E6/E7 mRNA in Patients with Head and Neck Squamous Cell Carcinoma and Their Relation with Prognosis

[目的]检测头颈部鳞癌组织标本人乳头瘤病毒(HPV)DNA、E6/E7 mRNA感染情况,并分析HPV感染对预后的影响。[方法]收集2016—2018年头颈部鳞癌手术标本121例,采用MassARRAY?HPV基因分型技术和RT-qPCR方法分别进行HPV DNA和HPV E6/E7 mRNA检测,比较不同肿瘤部位检出率差异。采用多因素Cox比例风险回归模型分析HPV E6/E7 mRNA对头颈部鳞癌预后的影响,计算HR值及其95%可信区间。[结果]121例头颈部鳞癌患者HPV阳性率为66.94%(81/121),其中口腔癌阳性率为70.37%(19/27),喉癌为65.79%(50/76),口咽癌为66.67%(12/18),HPV DNA阳性率在不同肿瘤部位无统计学差异(P>0.05)。HPV16阳性率为4.13%(5/121),HPV18阳性率为6.61%(8/121)。头颈部鳞癌HPV E6/E7 mRNA阳性率为28.93%(35/121),HPV E6/E7mRNA阳性率在不同肿瘤部位中无统计学差异(P>0.05)。多因素分析结果显示,与HPV E6/E7 mRNA阴性组相比,HPV E6/E7 mRNA阳性组预后较好(HR=0.13,95%CI:0.04~0.46)。[结论]头颈部鳞癌患者HPV DNA阳性率高,但HPV E6/E7 mRNA阳性率明显降低。HPV感染为头颈部鳞癌独立的预后因素。

[Objective]To detect human papilloma virus(HPV)DNA and E6/E7 mRNA in head and neck squamous cell carcinoma(HNSCC),and their relation with the prognosis of patients.[Methods]Surgical specimens were collected from 121 patients with HNSCC from 2016 to 2018.The MassARRAY?HPV genotyping was used to detect HPV DNA and RT-qPCR was used to detect HPV E6/E7 mRNA,respectively.The detection rates of different cancer sites were compared.Multivariate Cox proportional hazards regression model was used to analyze the association of HPV E6/E7 mRNA expression with the prognosis of HNSCC patients,and the hazard ratio with 95%confidence interval were calculated.[Results]The overall positive rate of HPV DNA in 121 HNSCC patients was 66.94%(81/121),among which 70.37%(19/27)in oral cancer,65.79%(50/76)in laryngeal cancer and 66.67%(12/18)in oropharyngeal cancer,the distribution was not statistical significance(P>0.05).The positive rate of HPV16 and 18 was 4.13%(5/121)and 6.61%(8/121),respectively.The overall detection rate of HPV E6/E7 mRNA in HNSCC was 28.93%(35/121),among which 33.33%(9/27)in oral cancer,26.32%(20/76)in laryngeal cancer and 33.33%(6/18)in oropharyngeal cancer,the distribution was not statistical significance(P>0.05).Multivariate analysis showed that HNSCC patients with positive HPV E6/E7 mRNA had a better survival than those with negativeHPV E6/E7 mRNA(HR=0.13,95%CI:0.04~0.46).[Conclusion]The positive rate of HPV DNA in HNSCC patients is high,while the positive rate of E6/E7 mRNA is decreased significantly.HPV infection is an independent prognostic factor for HNSCC.