Prognosis Study Of HPV-Related Oropharyngeal Squamous Cell Carcinoma

Objectives:This project is to conduct HPV DNA determination on the pathological specimens of oropharyngeal squamous cell carcinoma archived by Yunnan Cancer Hospital to obtain the HPV positive rate,and conduct a retrospective summary analysis in terms of clinicopathological characteristics and prognosis to enrich China’s HPV information Research data related to oropharyngeal squamous cell carcinoma;at the same time,explore the value of AJCC 7th and 8th edition staging on the prognostic evaluation of oropharyngeal squamous cell carcinoma.Methods:129 patients with oropharyngeal cancer who were diagnosed and treated in Yunnan Cancer Hospital from January 2010 to December 2019 and met the enrollment criteria were selected as the research objects,and detailed clinical data and pathological specimens were collected for research.Use HPV16/18 type DNA probe and HPV 6/11 type DNA probe to detect the collected pathological specimens.SPSS 24.0 statistical software was used for data analysis.The measurement data adopts the T test,and the count data adopts the chi-square test or Fisher’s method.The overall survival and the disease-specific survival are the main observation indicators.The Kaplan-Meier method was used to analyze related prognostic factors,and the log-rank test was used for univariate analysis.Cox proportional hazards regression model was used for multivariate analysis.Results:The HPV positive rate in this study was 39.53%,all of which were high-risk HPV 16/18 infections;the HPV positive rate in tonsil area was 52.5%,tongue base 40.6%,oropharyngeal sidewall and posterior wall area 33.3%,and soft palate area 20.0%.In the HPV-positive group,the number of cases with onset age less than 60 years(P=0.041)and early stage(P=0.001)was significantly more than that in the negative group.The number of long-term smoking cases in the negative group was significantly higher than that in the positive group(P=0.012).The 3-year and 5-year overall survival(OS)of the entire group of patients were 64.6%and 47.3%,respectively,and the 3-year and 5-year cumulative disease-specific survival(DSS)of the entire group were 67.6%and 51.1%,respectively.The factors that significantly affected the OS of the entire group of patients were:long-term smoking history,T stage,clinical stage,HPV infection status,and all of these factors were independent prognostic factors;factors that significantly affected the DSS of the entire group of patients were:long-term smoking history,T stage,clinical stage,HPV infection status,and long-term smoking history,T stage and HPV infection status were independent prognostic factors(P<0.05).In the HPV-negative group,the risk factors that significantly affected the OS and the DSS were:long-term smoking history,T stage and clinical stage,among which long-term smoking history and T stage were independent prognostic factors(P<0.05).In the HPV-positive group,the factors that significantly affected the OS and the DSS were:T stage,clinical stage,and clinical stage was an independent prognostic factor(P<0.05).Among the patients receiving chemotherapy and radiotherapy,the effective rate of HPV-positive patients was 80.9%;the effective rate of HPV-negative patients was 63.4%,and there was a statistical difference between the two groups(P=0.002).There was no significant difference in the survival of patients undergoing radiotherapy alone and concurrent radiotherapy and chemotherapy both in two groups.The 7th version of the staging system was used to compare the OS(P=0.011)and the DSS(P=0.012)of early and late stage patients;the 8th version of the staging system was used to compare the OS(P=0.000)and the DSS(P=0.000)of early and late stage patients.Conclusions:1.In this study,the HPV positive rate of oropharyngeal squamous cell carcinoma was 39.53%,all of which were high-risk HPV 16/18 infections,with the highest positive rate in the tonsil area and tongue root area.2.In this study,HPV-positive patients were younger,staged earlier,and had fewer smokers than HPV-negative patients.3.The effective rate of HPV-positive patients receiving radiotherapy and chemotherapy is higher than that of negative patients.4.HPV-positive oropharyngeal squamous cell carcinoma has obvious prognostic advantages compared with negative oropharyngeal squamous cell carcinoma.5.Long-term smoking history can significantly affect the prognosis of patients with HPV-negative oropharyngeal squamous cell carcinoma,but it is not a prognostic factor in patients with HPV-positive oropharyngeal squamous cell carcinoma.