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Abstract：
To find if an association could be established between Human Papilloma Virus (HPV) infection and oropharyngeal cancers (OPCs) in a group of patients known to be regular users of tobacco, and to determine the impact of HPV status on clinical outcomes.Case records of 212 patients with AJCC-7 (The American Joint Committee on Cancer 7th edition) stages II-IVB non metastatic squamous cell carcinoma of the oropharynx treated using radical radiotherapy with or without chemotherapy during the years 2015-2018 were retrieved. Formalin-fixed, paraffin-embedded blocks from oropharyngeal biopsies were available for 177 patients and were evaluated for p16 expression by immunohistochemical (IHC) staining. More than 50% nuclear staining with or without cytoplasmic staining was considered HPV+ . The association between tobacco use and HPV, as well as the influence of HPV status on survival outcomes were assessed. p16 expression was found to be positive in 23(13%) patients. Significant association was found between chewable tobacco usage and HPV positivity (p = 0.051). The median follow up was 20.5 months (range: 3-80). 5-year Overall Survival was 43.4% and 29.8% (p = 0.044) in HPV+ and HPV- patients, respectively. Local control was significantly better in HPV+ patients (38.6% vs. 25.3%, p = 0.049). There was also a trend towards improved Disease-free Survival in HPV+ patients (31 months vs. 15 months, p = 0.078). Though less in prevalence among the Indian population, improved outcomes in HPV+ OPC patients and widely available IHC HPV assays signifies the routine implementation of p16 testing in day-to-day clinical practice.
摘要：
为了确定在一组已知是经常使用烟草的患者中，人乳头瘤病毒（HPV）感染与口咽癌（OPCs）之间是否可以建立关联，并确定HPV状态对临床结局的影响。检索了在2015-2018年期间使用根治性放疗伴或不伴化疗治疗的212例AJCC-7（美国癌症联合委员会第7版）II-IVB期非转移性口咽鳞状细胞癌患者的病例记录。福尔马林固定，177例患者获得了来自口咽活检的石蜡包埋块,并通过免疫组织化学(IHC)染色评估了p16的表达.有或没有细胞质染色的超过50%的核染色被认为是HPV+。烟草使用与HPV之间的关联，以及HPV状态对生存结局的影响进行了评估.在23例(13%)患者中发现p16表达为阳性。在咀嚼烟草使用与HPV阳性之间发现显著关联(p=0.051)。中位随访时间为20.5个月（范围：3-80）。HPV+和HPV患者的5年总生存率分别为43.4％和29.8％（p=0.044），分别。HPV+患者的局部控制明显更好（38.6％vs.25.3%,p=0.049)。HPV+患者的无病生存期也有改善的趋势（31个月与15个月,p=0.078)。尽管在印度人口中患病率较低，HPV+OPC患者结局的改善和广泛使用的IHCHPV检测表明在日常临床实践中常规实施p16检测.
