人乳头状瘤病毒感染对头颈部肿瘤的影响

Infection of human papillomavirus and head and neck cancer

高危型人乳头状瘤病毒(HPV)感染导致的恶性肿瘤包括宫颈癌、肛门癌、阴茎癌、外阴癌、阴道癌和头颈部肿瘤等,其中头颈部肿瘤的疾病负担仅次于宫颈癌。头颈部肿瘤多源于鳞状上皮细胞的恶性病变,主要包括口腔癌、咽癌(包括鼻咽癌、口咽癌和下咽癌)和喉癌。头颈部肿瘤的主要危险因素是吸烟、频繁饮酒和HPV感染。近年来,全球HPV相关头颈部肿瘤发病率处于上升趋势,且在高收入国家中尤为显著。中国HPV相关头颈部肿瘤的疾病负担和变化趋势尚未明确,一些小样本单中心的研究提示了可能存在的高HPV感染率和上升趋势,但研究间存在HPV检测方法学的不同和地区差异性。头颈部肿瘤部位中已证实由HPV感染导致的是口咽癌,HPV与其他部位的关系尚未明确,相关研究较为匮乏。文章将从HPV感染与头颈部肿瘤的关系研究入手,比较全球研究和中国研究的头颈部肿瘤中HPV感染的差异,深入探讨HPV感染与不同类别头颈部肿瘤之间的关系,旨在总结目前最新的研究进展,以期深入推进相关研究。

High-risk human papillomavirus(HPV)-related cancers consist of cervical cancer,anal cancer,penile cancer,vulvar cancer,vaginal cancer,and head and neck cancer(HNC).Of these,the disease burden of HNC is second only to cervical cancer.HNC mostly originates from malignant lesions of squamous epithelial cells and mainly includes oral cavity cancer,pharyngeal cancer(including nasopharyngeal cancer,oropharyngeal cancer,and hypopharyngeal cancer),and laryngeal cancer.Tobacco use,alcohol abuse,and HPV infection are three primary risk factors.Recently,there is an upward trend of HNC incidence globally,especially in high-income countries.In China,the disease burden and trends of HPV-related HNC are still not clear.A few small sample size and single-center studies suggest a high HPV prevalence and increasing trend in HNC.Methodological differences in HPV testing and regional variabilities still exist among these studies.Among the anatomic sites,oropharyngeal cancer has been shown to be caused by HPV infection,but the association of HPV with other sites is still under debate.In addition,there is a paucity of relevant studies.Here,this review narrates the association between HPV infection and HNC,compares the differences between global and Chinese studies,and then explores the importance of HPV infection in various anatomical sites.The main objective is to highlight the research on HPV-related HNC and promote relevant prevention and treatment programs.