人乳头状瘤病毒阳性与阴性的低分化口咽鳞状细胞癌临床特征及肿瘤浸润免疫细胞的差异分析OA
Analysis of differences in clinical characteristics and tumor-infiltrating immune cells between human papilloma virus-positive and human papilloma virus-negative poorly differentiated oropharyngeal squamous cell carcinoma
目的 探讨人乳头状瘤病毒(HPV)阳性与阴性的低分化口咽鳞状细胞癌(oropharyngeal squamous cell carcinoma,OPSCC)患者临床特征、预后及肿瘤浸润免疫细胞浸润差异.方法 回顾性分析2010年1月～2022年12月就诊于首都医科大学附属北京同仁医院,符合纳入与排除标准的111例低分化OPSCC患者,依据p16免疫组化结果分为HPV阳性低分化组(简称HPV阳性组,n=63)和HPV阴性低分化组(简称HPV阴性组,n=48).通过卡方检验、Kaplan-Meier法、Log-rank检验及多因素Cox回归模型分析临床特征和预后的关联;经倾向评分匹配(PSM)1∶1配对选取6对标本,采用免疫组化检测肿瘤浸润免疫细胞标志物并进行组间差异对比.结果 HPV阳性组患者具有更年轻、女性占比高、无烟酒暴露史、扁桃体原发、临床分期早期的临床特征,3年总生存率为92.1%、3年无进展生存率为85.7%,均显著优于HPV阴性组的52.1%、41.7%(χ²=24.403,P<0.001).多因素Cox回归分析结果显示,HPV阳性、无吸烟史、T分级早期是低分化OPSCC预后的独立保护因素,其中HPV阳性可使患者死亡风险降低86.3%(HR=0.137,95%CI:0.039～0.477,P=0.002).免疫组化结果显示,HPV阳性组中CD4+T淋巴细胞、CD11b+髓系来源细胞浸润水平显著更高(P<0.05).结论 HPV阳性是低分化OPSCC患者预后的独立保护因素,与肿瘤组织中更高的CD4+T细胞和CD11b+髓系来源细胞浸润水平相关.
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.
胡宏莲;丁一鸣;张洋;黄志刚;李志新;陈晓红
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
口咽肿瘤癌,鳞状细胞肿瘤浸润人乳头状瘤病毒低分化
Oropharyngeal NeoplasmsCarcinoma,Squamous CellLymphocytes,Tumor Infiltratinghuman papilloma viruspoorly differentiated
《中国耳鼻咽喉头颈外科》 2026 (5)
253-259,7
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