HPV感染及p16基因、EGFR表达水平与扁桃体鳞状细胞癌患者预后的相关性研究

目的探讨人乳头瘤病毒(HPV)感染状态及p16基因、表皮生长因子受体(EGFR)表达水平检测对扁桃体鳞状细胞癌(TSCC)患者预后判断的价值。方法对2008年1月至2011年5月于武汉大学人民医院确诊的TSCC初诊患者96例进行HPV DNA分型检测及肿瘤组织p16基因、EGFR表达水平检测,采用Cox比例风险回归模型分析各指标与TSCC患者预后的相关性。结果 96例患者中,28%的患者检出高危型HPV DNA,p16基因表达阳性率为30%。高危型HPV DNA阳性患者p16基因表达阳性率高于HPV DNA阴性患者,差异有统计学意义(P0.05)。Cox比例风险回归模型分析显示,经治疗后p16基因阳性表达患者5年无病生存率(DFS)大于p16基因阴性表达患者,差异有统计学意义(P0.05);p16基因阳性表达、EGFR阴性表达患者5年DFS及总生存率(OS)均高于p16基因阴性表达、EGFR阳性表达患者,差异均有统计学意义(P0.05)。结论 TSCC患者HPV感染状态与p16基因表达水平有一定的相关性。p16基因表达检测对TSCC患者的预后判断价值优于HPV DNA检测。p16基因和EGFR联合检测对TSCC患者的预后评估意义更大。

Correlation of HPV infection,p16 and EGFR expression levels with prognosis in patients with squamous cell carcinoma

Objective To investigate the correlation between human papillomavirus (infection of HPV ) infection ,p16 and and ep‐idermal growth factor receptor(EGFR) expression level and the prognosis of EGFR expression with tonsillar squamous cell carcino‐ma carcinoma(TSCC) .Methods A total of 96 patients with TSCC ,treated in this hospital from January 2008 to May 2011were en‐rolled ,the HPV DNA ,p16 ,EGFR were detected .Cox proportional hazards model was used to analyze the correlation between HPV DNA ,p16 ,EGFR and the prognosis of TSCC .Results Among 96 patients ,the positive rate of high‐risk HPV DNA was 28% ,and that of p16 was 30% .Positive rate of p16 in HPV DNA positive patients was higher than HPV DNA negative patients (P<0 .05) . The five years disease free survival rate(DFS) of p16 positive patients was higher than p16 negative patients(P<0 .05) .The five years DFS and overall survival rate(OS)of p16 positive and EGFR negative patients were higher than p16 negative and EGFR posi‐tive patients(P<0 .05) .Conclusion There was a certain correlation between HPV infection status and p16 expression level in TSCC patients .The prognostic value of p16 expression detection in TSCC patients is better than that of DNA HPV detection .The significance of combined detection of p16 and EGFR in the prognosis of patients with TSCC is more significant .