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Abstract：
Current clinical practice algorithms for HPV testing make no effort to discern the impact of genotypes for patients with head and neck squamous cell carcinoma (HNSC). Data was collected for all patients with HNSCs that had undergone HPV testing at an academic hospital as part of clinical care (2012-2019). Screening was performed using real-time PCR targeting L1 of low and high-risk HPV types, followed by genotyping of positive cases. Genotype status was correlated with age, site and histologic parameters. Of the 964 patients tested, 68% had HPV-positive cancers. Most arose from the oropharynx (OP) (89%) and sinonasal tract (5%). The most frequent genotype was 16 (84.4%) followed by 35 (5.6%), 33 (4.1%), 18 (2.7%), 45 (1.1%), 69 (0.8%) and others (1.3%). There was an association between genotype (16 vs non-16) and tumor origin (OP vs non-OP) (p < 0.0001). HPV18 was associated with transformation to an aggressive small cell phenotype, but HPV16 was not (22% vs 0%, p < 0.0001). Patients with HPV-non-16 OP carcinomas were older than patients with HPV16 OP carcinomas, but the difference was not significant. HPV genotypes are variable and unevenly distributed across anatomic sites of the head and neck. The association of HPV18 with small cell transformation suggests that variants can track with certain phenotypes in ways that may account for differences in clinical behavior. This study challenges the prevailing assumption of HPV equivalency across all high-risk genotypes in ways that may inform preventive, diagnostic, therapeutic and surveillance strategies.
摘要：
目前用于HPV检测的临床实践算法没有努力辨别基因型对头颈部鳞状细胞癌(HNSC)患者的影响。收集了所有在学术医院接受HPV检测的HNSC患者的数据，作为临床护理的一部分（2012-2019）。使用实时PCR靶向低和高危HPV类型的L1进行筛选，其次是阳性病例的基因分型。基因型状态与年龄相关,部位和组织学参数。在964名患者中，68%的人患有HPV阳性癌症。大多数来自口咽（OP）（89％）和鼻窦（5％）。最常见的基因型是16（84.4%），其次是35（5.6%），33（4.1%），18（2.7%），45（1.1%），69（0.8%）和其他（1.3%）。基因型（16vs非16）和肿瘤起源（OPvs非OP）之间存在关联（p<0.0001）。HPV18与转化为侵袭性小细胞表型有关，但HPV16不是(22%对0%，p<0.0001)。HPV-non-16OP癌患者的年龄大于HPV16OP癌患者，但差异不显著。HPV基因型是可变的并且在头颈部的解剖部位分布不均。HPV18与小细胞转化的关联表明变体可以以可能解释临床行为差异的方式追踪某些表型。这项研究挑战了所有高危基因型HPV等效性的普遍假设，这可能有助于预防，诊断,治疗和监测策略。
