Ľudský papilomavírus v etiopatogenéze orofaryngeálneho karcinómu
Tomáš Kovačič 1
Patrik Štefanička 2
1 Lekárska fakulta Univerzity Komenského v Bratislave, Bratislava 2 Klinika otorinolaryngológie a chirurgie hlavy a krku LFUK a UNB, Bratislava
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Infection by human papillomavirus (HPV) stands for the most frequent viral carcinogenesis in the world (2). Overexpression of cell oncoprotein p16 is routinely diagnosed by immunohistochemistry (IHC) as the surrogate marker of viral activity (1).
The aim of this retrospective survey was to investigate the association of HPV status in patients with oropharyngeal cancer with tumour staging and other clinical features.
Records from the oropharyngeal cancer patients treated in the Department of Otorhinolaryngology-Head and Neck Surgery in Bratislava from January 2013 to December 2016 were retrospectively analysed. Patients were divided, according to IHC results on oncoprotein p16, into p16 positive, considered HPV-positive, and p16 negative as HPV-negative. The incidence of oropharyngeal carcinoma, location, T and N staging, age, gender of patients was compared based on HPV status.
From 129 oropharyngeal cancer patients with p16 examination were 52 (40%) considered as HPV positive. HPV positive group consisted of 45 (86.5%) men and 7 (13.5%) women. The primary tumour in HPV-positive patients originated from the palatine tonsil and base of the tongue in 96% of cases. The peak of occurrence of HPV-associated carcinoma was found between 50 – 59 years of age. HPV positive tumours were diagnosed in early T stage (T1/2) in 52%. Both HPV positive and negative patients were predominantly diagnosed with advanced-stage cancer, 90.4% in HPV-positive and 87% in HPV-negative group.
Early T stage in HPV positive carcinomas was approved, as well as more advanced regional spreading and prevalence of men and non-smokers (2,3). Wide variations in numbers of diagnosed patients during years of study may be caused by relatively small size of the studied group. Survey is focusing at HPV status as the most important prognostic factor in oropharyngeal cancer (1) and systematized introduction of HPV status examination as progressive approach to effective and targeted therapy.
(2) Gillison ML, Castellsaqué X, Chaturvedi A. Eurogin Roadmap: comparative epidemiology of HPV infection and associated cancers of the head and neck and cervix. Int J Cancer. 2014;134(3):497-507.
(3) Dahlstrom K, Bell D, Hanby D. Socioeconomic characteristics of patients with oropharyngeal carcinoma according to tumor HPV status, patient smoking status, and sexual behavior. Oral Oncol. 2015 September ; 51(9): 832–838.