吸烟、饮酒行为差异口腔癌患者HPV感染和PTEN表达情况及临床意义  

THE POSITIVE RATE AND PRIDICTIVE SIGNIFICANCE OF HPV AND PTEN EXPRESSION IN ORAL CAVITY CANCER WITH DIFFERENT LIFE-STYLE OF SMOKING AND DRINKING

作　　者：范新昊 郝建清[1] 李冠娥[1] 惠新宇[1] 曹俊华[1] 李金源 Fan Xinhao;Hao Jianqing;Li Guan'e(Department of Stomatology ,Kailuan General HospitaL,Tangshan ,063000)

机构地区：[1]开滦总医院口腔科,河北省唐山市063000 [2]华北理工大学口腔医学院颌面外科

出　　处：《中国煤炭工业医学杂志》2018年第6期616-620,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究重点课题(编号:20150849);河北省科技厅重点研发计划(编号:182777101D)

摘　　要：目的探讨比较吸烟饮酒口腔癌患者与非吸烟饮酒患者HPV感染情况及PTEN表达情况,并分析其与患者预后的相关性。方法收集2005年1月-2017年2月207例口腔癌患者,183例纳入实验。根据有无吸烟饮酒嗜好,分为吸烟饮酒组和非吸烟饮酒组,通过PCR技术检测所有患者中HPV感染情况,免疫组化染色检测PTEN的表达,经x^2检验比较二组患者HPV感染率和PTEN阳性率,并经Cox回归生存分析探讨其与患者生存时间的关系。结果二组患者比较,吸烟饮酒组患者中发病部位在口底或唇的比例显著高于非吸烟饮酒组,发生于上牙龈患者比例显著低于非吸烟饮酒组(P<0.05)。吸烟饮酒组患者病理分期在Ⅳ期的比例显著高于非吸烟饮酒组。吸烟饮酒组患者HPV感染率显著高于非吸烟饮酒组(P<0.001)及PTEN阳性表达率显著低于非吸烟饮酒组(P<0.001)。经Cox多因素分析,PTEN表达阴性患者预后更差(P<0.05);在非吸烟饮酒患者中感染HPV患者与生存时间呈负相关,危害比显著高于未感染HPV患者(P<0.05)。结论PTEN表达阴性是口腔癌患者的不良预后因素,而在非吸烟饮酒患者中,HPV阳性患者预后较HPV阴性患者预后更差。Objective To compare HPV and PTEN expression in,as well as their relationship with outcome of oral squamous cell cancers between non-smokers non-drinkers(NSND)and smokers drinkers(SD).Methods A total of 207 patients with oral squamous cell cancer treated with surgery from 2005 to 2017 were screened out and 185 patients were included in the study,and were divided into SD and NSND group according the history of smoking and/or drinking.HPV presence was determined from paraffin embedded blocks investigated by PCR analysis.PTEN expression was analyzed by immunohistochemistry staining.Enumeration data including gender,pathological stage and HPV-positive rate were analyzed by χ~2 test,Cox regression analysis was used to identify the factors influence the survival.Results By χ~2 test,tumor site located in sublingual gland or lip in the SD patients was more than NSND patients,while of which in the upper gum was more in NSND patients than SD patients(P<0.05).There were significant higher infection ratio of HPV and lower PTEN positive ratio in SD group than NSND group(P<0.001).In Cox mulμltivariate analysis,HPV infection was negatively correlated with survival time in non-smokers and non-drinkers,and the hazard ratio was higher than that in uninfected HPV patients(P<0.05).Conclusion In oral squamous cell cancer,PTEN expression is a positive predictive factors,while HPV expression is negative predictive factors,especially in NSND patients.

关 键 词：口腔癌 HPV PTEN 吸烟 饮酒 COX回归分析 

分 类 号：R739.8[医药卫生—肿瘤]