336例HPV相关性与非相关性口咽鳞癌患者生存分析  

Survival analysis of 336 patients with HPV-mediated and non-mediated oropharyngeal squamous cell carcinoma

作　　者：李恒勇 杨宋 周凯 孔钰 李洁莹 李贵忠 葛胜优 杨小琛 冯元勇[1,2] 宋凯[1,2] 尚伟[1,2] LI Heng-yong;YANG Song;ZHOU Kai;KONG Yu;LI Jie-ying;LI Gui-zhong;GE Sheng-you;YANG Xiao-chen;FENG Yuan-yong;SONG Kai;SHANG Wei(Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Qingdao University.Qingdao 266003;College of Stomatology,Qingdao University.Qingdao 266003;Department of Stomatology,Qingdao Third People's Hospital.Qingdao 266041,Shandong Province,China)

机构地区：[1]青岛大学附属医院口腔颌面外科,山东青岛266003 [2]青岛大学口腔医学院,山东青岛266003 [3]青岛市第三人民医院口腔科,山东青岛266041

出　　处：《中国口腔颌面外科杂志》2022年第4期378-383,共6页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:分析比较HPV相关性与非相关性口咽鳞癌(oropharyngeal squamous cell carcinoma,OPSCC)患者在新、旧版TNM不同分期情况下,患者生存及预后差异,为OPSCC的治疗策略与预后评估提供临床依据。方法:收集2010年1月—2016年12月青岛大学附属医院手术治疗的原发OPSCC患者,采用p16免疫组织化学检测方法对病理标本重新进行评估,统计患者生存信息,并分别运用第7版、第8版TNM分期系统对肿瘤进行分期,记录新、旧版的降级情况,分析、比较HPV相关性与非相关性OPSCC患者两版不同分期对生存率及预后的影响。采用SPSS 25.0软件包对数据进行统计学分析。结果:最终纳入336例OPSCC患者,其中HPV相关性OPSCC患者101例(30.1%),5年生存率为47.5%(48/101),中位生存时间58个月;非相关性OPSCC患者5年生存率为34.0%(80/235),中位生存时间37个月。HPV相关性OPSCC患者第8版TNM分期与第7版TNM分期对比,其总体降级率为77.2%(78/101),晚期患者降级率为100%(69/69),晚期患者中降至早期的患者占比69.6%(48/69)。结论:HPV相关性OPSCC患者的生存率和生存中位时间明显优于非相关性OPSCC患者,第8版TNM分期手册的OPSCC分期相比第7版更符合临床实际,预后分层更加清晰,能更好指导临床决策。PURPOSE:To analyze and compare the difference in survival and prognosis of patients with HPV-mediated and non-mediated oropharyngeal squamous cell carcinoma(OPSCC)in different stages of new and old TNM,so as to pro-vide clinical basis for the treatment strategy and prognosis evaluation of OPSCC.METHODS:Clinical data of primary OPSCC patients treated at Affiliated Hospital of Qingdao University between January 2010 and December 2016 were collected.Immunohistochemical staining of the pathological specimens was used to detect p16 expression level.Patients’sur-vival information was evaluated using version 7,8 edition of TNM staging system for tumor staging.The effects of different stages of HPV-mediated and non-mediated OPSCC on survival and prognosis were analyzed and compared.SPSS 25.0software package was used for data analysis.RESULTS:Among 336 OPSCC patients,one hundred and one patients(30.1%)were HPV-mediated OPSCC.The 5-year survival rate of HPV-mediated OPSCC patients was 47.5%(48/101),and the median survival time was 58 months.The 5-year survival rate of patients with non-mediated OPSCC was 34.0%(80/235),with a median survival time of 37 months.In HPV-mediated OPSCC patients with version 8 TNM stage and ver-sion 7 TNM stage,the overall rate of degradation was 77.2%(78/101),100%(69/69)in patients with advanced stage,and69.6%(48/69)in patients with advanced stage degraded to early stage.CONCLUSIONS:The survival rate and median survival time of HPV-mediated OPSCC patients are significantly better than those of non-mediated OPSCC patients.The OPSCC stage in the 8th edition of TNM staging manual is more consistent with clinical reality than that in the 7th edition,and the prognosis stratification is more clear,which can better guide clinical decision-making.

关 键 词：口咽鳞癌 HPV AJCC第8版 TNM分期 生存率 

分 类 号：R739.8[医药卫生—肿瘤]