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首页> 外文期刊>Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery >Human papillomavirus in metastatic lymph nodes from unknown primary head and neck squamous cell carcinoma.
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Human papillomavirus in metastatic lymph nodes from unknown primary head and neck squamous cell carcinoma.

机译：人乳头瘤病毒在未知原发性头颈部鳞状细胞癌的转移淋巴结中。

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OBJECTIVE: Determine human papillomavirus (HPV) incidence in unknown primary squamous cell carcinomas (SCCa) of the head and neck and assess if HPV status influenced survival. STUDY DESIGN: Historical cohort study. SETTING: Tertiary care center. SUBJECTS: Patients with unknown primary SCCa despite a complete workup who underwent neck dissection or excisional biopsy and postoperative comprehensive +/- chemoradiotherapy between 2002 and 2009. METHODS: HPV fluorescence in situ hybridization (FISH) and p16(INK4a) immunohistochemistry (p16 IHC) were performed. Results were compared with survival, age, race, gender, tobacco use, alcohol use, and nodal stage. RESULTS: Twenty-five patients met the inclusion criteria, of whom 88% were >10 pack year tobacco users. Twenty-eight percent were HPV-positive defined by both p16+ and FISH+. Five-year overall survival was 66.7% in HPV-positive and 48.5% in HPV-negative patients (P = .35). Similarly, 5-year disease-free survival rates were 66.7% in HPV-positive and 48.5% in HPV-negative patients (P = .54). All 3 HPV-positive nonsmokers were survivors, but this was not significant because of the small sample size (P > .05). No other characteristics were associated with survival (P > .05). CONCLUSION: Twenty-eight percent of metastatic lymph nodes from occult primary tumors were HPV positive. There was no survival difference associated with HPV status. Most of the HPV-positive patients in this study were tobacco users who had similar survival to HPV-negative patients, so caution should be used in interpreting HPV status in these patients.
机译：目的：确定人乳头瘤病毒（HPV）在头颈部未知原发性鳞状细胞癌（SCCa）中的发生率，并评估其是否影响生存。研究设计：历史队列研究。地点：三级护理中心。研究对象：2002年至2009年间，尽管完成了完整的检查但仍未完成原发性SCCa的患者进行了颈部解剖或切除活检，并进行了全面的+/-放化疗。方法：HPV荧光原位杂交（FISH）和p16（INK4a）免疫组织化学（p16 IHC）被执行。将结果与生存期，年龄，种族，性别，吸烟，饮酒和结节阶段进行比较。结果：25名患者符合纳入标准，其中88％是> 10包年的烟草使用者。 p16 +和FISH +定义了28％的HPV阳性。 HPV阳性患者的五年总生存率为66.7％，HPV阴性患者为48.5％（P = 0.35）。同样，HPV阳性患者的5年无病生存率为66.7％，HPV阴性患者为48.5％（P = 0.54）。所有3例HPV阳性非吸烟者均为幸存者，但这并不重要，因为样本量较小（P> .05）。没有其他特征与生存相关（P> 0.05）。结论：隐匿性原发肿瘤转移淋巴结中有28％为HPV阳性。 HPV状态没有生存差异。在这项研究中，大多数HPV阳性患者是吸烟者，其存活率与HPV阴性患者相似，因此在解释这些患者的HPV状况时应谨慎行事。

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