Human papillomavirus infection as a prognostic factor in carcinomas of the oral cavity and oropharynx

被引:298
作者
Ritchie, JM [1 ]
Smith, EM
Summersgill, KF
Hoffman, HT
Wang, DH
Klussmann, JP
Turek, LP
Haugen, TH
机构
[1] Univ Iowa, Coll Publ Hlth, Dept Biostat, Iowa City, IA 52242 USA
[2] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA 52242 USA
[3] Univ Pittsburgh, Dept Oral Med & Pathol, Pittsburgh, PA USA
[4] Univ Iowa, Coll Med, Dept Otolaryngol Head & Neck Surg, Iowa City, IA USA
[5] Vet Affairs Med Ctr, Iowa City, IA 52242 USA
[6] Univ Iowa, Coll Med, Dept Pathol, Iowa City, IA 52242 USA
[7] Univ Cologne, Dept Otorhinolaryngol, Cologne, Germany
关键词
human papillomavirus; survival; oral cancer; oral cavity; oropharynx;
D O I
10.1002/ijc.10960
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Although studies have established human papillomaviruses (HPVs) as a risk factor for oral and oropharyngeal cancer, it is not clear whether viral infection affects survival in head and neck malignancies. This investigation examined the relationship between HPV and survival in carcinomas of the oral cavity and oropharynx. Formalin-fixed, paraffin-embedded tumor specimens from 139 newly diagnosed cases were tested for HPVs by PCR and DNA sequencing. Patient and tumor characteristics were obtained from questionnaires, pathology reports and cancer registries. Odds ratios (ORs) and relative risks (RRs) were based on logistic and Cox regression models, respectively. HPVs were detected in 21% of the tumors; 83% were HPV-16. Greater risk of HPV infection was associated with males (OR = 2.9, 95% CI = 1.0-8.6), a history of oral-genital sex (OR = 4.2, 95% CI 1.5-11.7), and oropharyngeal tumors (OR = 10.4, 95% CI 3.5-31.2). As tobacco usage increased, the odds of HPV detection decreased (OR = 0.97/pack-year, 95% CI = 0.96-0.99). HPV infected patients had better overall survival (RR = 0.3, 95% CI = 0.1-0.8) than those with HPV-negative tumors. There was an interaction between gender and HPV for overall (p = 0.05) and disease-specific (p = 0.03) survival that suggested that HPV infected males had better prognosis than HPV-negative males, but this was not the case among females. HPV status was identified as an independent prognostic factor in oral and oropharyngeal cancers. This result appeared to be gender-specific, suggesting the need for further study of the interaction between HPV and gender on survival. (C) 2003 Wiley-Liss, Inc.
引用
收藏
页码:336 / 344
页数:9
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