HPV-DNA、p16和EGFR在口咽癌诊断中的临床价值分析

Clinical Value of HPV-DNA,p16 and EGFR in Diagnosis of Oropharyngeal Carcinoma

目的:探讨人乳头状瘤病毒感染状态(HPV-DNA)、p16基因和表皮生长因子受体(EGFR)在口咽癌诊断中的临床价值。方法:选取我院2015年5月到2021年10月共收治的口咽癌60患者作为研究对象,进行回顾性分析,分析HPV-DNA、p16和EGFR在口咽癌患者的表达情况,分析HPV-DNA、p16和EGFR与肿瘤病理的关系,之后对所有患者进行随访,应用Cox比例风险回归模型分析患者的生存情况与HPV-DNA、p16和EGFR的关系。结果:HPV-DNA、p16和EGFR在口咽癌患者中的阳性表达对比无明显差异(P<0.05);HPV-DNA阳性患者与阴性患者性别、年龄对比无明显差异(P>0.05),肿瘤分期与淋巴结受累情况对比差异显著(P<0.05);p16阳性患者与阴性患者性别、年龄、肿瘤分期对比无差异(P>0.05),淋巴结受累情况对比差异显著(P<0.05);EGFR阳性患者与阴性患者性别、年龄对比无明显差异(P>0.05),肿瘤分期与淋巴结受累情况对比差异显著(P<0.05);在患者生存分析之中,有20例患者因为随访数据不全被剔除,其中无病生存率之中,P16/EGFR、p16对比差异显著(P<0.05),总生存率中淋巴结转移、P16/EGFR对比差异显著(P<0.05);口咽癌中HPV-DNA水平与p16水平呈现负相关关系,与EGFR呈现正相关关系,p16与EGFR呈现负相关关系(P<0.05)。结论:p16的表达是口咽癌最可靠的预后标志物,而且可能是HPV阳性口咽癌的替代标记物。HPV1/p161肿瘤倾向于减少EGFR的表达,但使用两种免疫组织学标记物对预后有显著影响。

Objective: To investigate the clinical value of HPV-DNA, p16 gene and EGFR in the diagnosis of oropharyngeal carcinoma. Methods: 60 Patients with oropharyngeal cancer admitted to our hospital from May 2015 to October 2021 were selected as the research imagination. The expression of HPV-DNA, p16 and EGFR in oropharyngeal cancer patients was analyzed retrospectively. The relationship between HPV-DNA, p16 and EGFR and tumor pathology was analyzed. All patients were followed up. Cox proportional hazard regression model was used to analyze the survival of patients and HPV-DNA, p16 and E GFR relationship. Results: There was no difference in the positive expression of HPV-DNA, p16 and EGFR in oropharyngeal cancer patients(P<0.05);there was no difference in gender and age between HPV-DNA positive patients and negative patients(P>0.05), tumor stage and lymph node involvement were not different(P>0.05) There was no significant difference in gender, age and tumor stage between p16 positive patients and negative patients(P>0.05), but lymph node involvement was different(P<0.05);there was no difference in gender and age between EGFR positive and negative patients(P>0.05), but there was difference between tumor stage and lymph node involvement(P<0.05);In the survival analysis of patients, 20 patients were excluded because of incomplete follow-up data. Among the disease-free survival rate, the difference between p16/EGFR and p16 was significant(P<0.05), and the difference of lymph node metastasis and p16/EGFR in overall survival rate was significant(P<0.05). The level of HPV-DNA in oropharyngeal carcinoma was negatively correlated with p16 level, positively correlated with EGFR, and negatively correlated with p16 and EGFR(P<0.05). Conclusion: The expression of p16 is the most reliable prognostic marker of oropharyngeal carcinoma, and may be an alternative marker of HPV positive oropharyngeal carcinoma. HPV1/p161 tumors tend to reduce the expression of EGFR, but the use of two immunohistochemical markers has a significant impact on the prognosis.