胡宏莲 1丁一鸣 1张洋 1黄志刚 1李志新 1陈晓红1
作者信息
- 1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京 100730
- 折叠
摘要
Abstract
OBJECTIVE To investigate the differences in clinical features,prognosis and tumor-infiltrating immune cells between human papilloma virus(HPV)-positive and HPV-negative poorly differentiated oropharyngeal squamous cell carcinoma(OPSCC).METHODS A retrospective analysis was performed on 111 poorly differentiated OPSCC patients who met the inclusion and exclusion criteria in Beijing Tongren Hospital,Capital Medical University from January 2010 to December 2022.According to the p16 immunohistochemical(IHC)results,patients were divided into HPV-positive group(n=63 cases)and HPV-negative group(n=48 cases).Chi-square test,Kaplan-Meier method,Log-rank test and multivariate Cox regression model were used to analyze the association between clinical characteristics and prognosis.After propensity score matching(PSM)1:1,6 pairs of specimens were selected for immunohistochemical detection of tumor immune infiltration cell markers,and the differences between the groups were compared.RESULTS HPV-positive group had clinical characteristics of younger age,higher proportion of women,no history of tobacco and alcohol exposure,primary tonsil,and early clinical stage.The 3-year overall survival(OS)rate was 92.1%,and the 3-year progression-free survival(PFS)rate was 85.7%,both significantly higher than the corresponding rates of 52.1%and 41.7%in the HPV-negative group(χ²=24.403,P<0.001).Multivariate Cox regression analysis revealed that HPV positivity,non-smoking history,and early T-stage were independent protective factors for prognosis in poorly differentiated OPSCC,with HPV positivity reducing the risk of death by 86.3%(HR=0.137,95%CI:0.039-0.477,P=0.002).IHC analysis showed significantly higher infiltration levels of CD4+T lymphocytes and CD11b+myeloid-derived cells in the HPV-positive group(P<0.05).CONCLUSION HPV positivity is an independent protective factor for the prognosis of poorly differentiated OPSCC and is associated with increased infiltration of CD4+T cells and CD11b+myeloid-derived cells in tumor tissues.关键词
口咽肿瘤/癌,鳞状细胞/肿瘤浸润/人乳头状瘤病毒/低分化Key words
Oropharyngeal Neoplasms/Carcinoma,Squamous Cell/Lymphocytes,Tumor Infiltrating/human papilloma virus/poorly differentiated
