За последните 20 години се установи, че високорисковите инфекции с човешки папиломавирус (HPV) са рисков фактор за развитие на плоскоклетъчен карцином в областта на главата и шията, независимо от употребата на тютюн и алкохол. По-специално, HPV се асоциира силно с развитието на орофарингеален рак и малка част от раковите образувания на устната кухина. В този преглед ние обобщихме това, което е известно досега за биологията на HPV, механизмите, по които той повлиява малигнената трансформация, и потенциалното влияние на HPV статуса върху клиничното обработване на пациенти с рак в областта на главата и шията.
Целта на този преглед е да представи досега известната информация за статуса и значението на HPV при тонзиларен рак. Описано е увеличаване на честотата на тонзиларен рак и последните данни предполагат, че това увеличаване се дължи на увеличаване на дяла на HPV в тези тумори. Освен това, установено е, че пациентите с HPV-позитивен рак имат по-нисък риск от рецидив и по-добра преживяемост в сравнение с пациенти с HPV-негативен тонзиларен рак. Съставяне на индивидуална схема на лечение на тонзиларния рак може да бъде важно, за да се намали страданието на пациента, а също и да се повиши преживяемостта. Накрая превантивна ваксинация при тези пациенти трябва да бъде обсъдена.
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Over the past 20 years, high-risk human papilloma-virus (HPV) infection has been established as a risk factor for developing head and neck squamous cell carcinoma, independent of tobacco and alcohol use. In particular, HPV is strongly associated with the development of oropharyngeal cancer and a small minority of oral cavity cancers. In this review, we summarize what is currently known about the biology of HPV, the mechanisms by which it effects malignant transformation, and the potential impact of HPV status on the clinical management of persons with head and neck cancer.
The aim of this review is to present the current knowledge on the status and significance of human papillomavirus (HPV) in tonsillar cancer. An increase in the incidence of tonsillar cancer has been reported and recent data suggest that this increase is due to an increased proportion of HPV in these tumours. Furthermore, patients with HPV positive cancer have been shown to have a lower risk of relapse and longer survival compared to patients with HPV-negative tonsillar cancer. Tailoring individual treatment in tonsillar cancer may be of importance in order to reduce patient suffering as well as to increase patient survival. Finally preventive vaccination for this patient group should be discussed.
Bonnez W. Papillomavirus. In: Clinical Virology. Ed Richman DD, Whitely RJ, Hayden FG, 2nd ed., Washington DC: ASM Press: 2002: 557-597
Bothwell M. Human papilloma virus papilloma. Otolaryngol Head Neck Surg 2005; 133: 308-9
Chung YL, Lee MY, Horng CE, Jian JJ, Cheng SH, Tsai SY, Hsieh CI, Yen LK, Lin CY, Use of combined molecular biomarkers for prediction of clinical outcomes in locally advanced tonsillar cancers treated with chomoradiotherapy alone, Head & Neck, 31 (1) : 9-20, 2009
Dillner J. The serological response to papillomaviruses. Smin Cancer Biol 1999; 9: 423-430
Erisen HA, Gelfand D, Shinsky JJ. Recent advances in the polymerase chain reaction. Science 1991; 252: 1643-1651
Ernster JA, Sciotto CG, O’Brien MM, Robinson LJ, Willson T. Prevalence of oncogenic human papillomavirus 16 and 18 in the palatine tonsils of the general adult population, Archives of Otolaryngology, Head & Neck Surgery, 135 (6): 5547, 2009
Gillison ML, Human papillomavirus – related diseases: oropharynx cancers and potential implications for adolescenent HPV vaccination, Journal of Adolescent Health, 43 (4 suppl): S 52-60, 2008
Haddad R, Crum C, Chen Z, Krane J, Posner M, Li Y, Burk R, HPV 16 Transmission between a couple with HPV – related head and neck cancer, Oral Oncology, 44 (8): 812-5, 2008
Klussman JP, Mooren JJ, Lehnen M, Claessen SM, Stenner M, Huebbers CU, Weissenborn SJ, Wedemeyer I, Preuss SF, Stretmans JM, Manni
JJ, Hopman AH, Speel EJ, Genetic Signatures of HPV – related and unrelated oropharyngeal carcinoma and their prognostic implications, Clinical Cancer Research, 15 (5): 1779-86, 2009
Lavergne D, deVilliers EM. Papillomavirus in oesophageal papillomas and carcinomas. Int J Cancer 1999; 80: 681-684
Nasman A, Atter P, Hammarstedt L, Du J, Eriksson M, Giraud G, Ahrlund – Richter S, Marklund L, Romanitan M, Lindquist D, Ramqvist T, Lindholm J, Sparen P, Ye W, Dahlstrand H, Munck – Wikland E, Dalianis T, Incidence of human papillomavirus positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral – induced carcinoma. International Journal of Cancer, 125 (2) : 362-6, 2009
Nichols AC, Faquin WC, Wesra WH, Mroz EA, Begum S, Clark JR, Rocco JW, HPV – 16 infection predicts treatment outcome in oropharyngeal
squamous cell carcinoma, Otolaryngology, Head & Neck Surgery, 140 (2): 228-34, 2009
Rampias T, Sasiki C, Weinberger P, Psyrri A, E6 and E7 gene silencing and transformed phenotype of human papillomavirus 16 – positive
oropharyngeal cancer cells, Journal of the National Cancer Institute, 101 (6): 412-23, 2009
Romanitan M, Nasman A, Ramqvist T, Dahlstrand H, Polykretis L, Vogiatzis P, Vamvakas P, Tasopoulos G, Valavanis C, Arapantoni – Dadioti
P, Banis K, Dalianis T, Human papillomavirus frequency in oral and oropharyngeal cancer in Greece, Anticancer Research, 28 (4B): 2077-80,
Sisk J, Schweinfurth J, Wang XT, Chong K. Presens of human papillomavirus DNA in tonsillectomy speciments. Triological society papers.
Laryngoscope 2006; 116: 1372-74
Tachezy R, Klozar J, Rubenstein L, Smith E, Salakova M, Smahelova J, Ludvikova V, Rotnaglova E, Kodet R, Hamsikova E, Demographic and risk factors in patients with head and neck tumors, Journal of Medical Virology, 81(5): 878-87, 2009
Ukpo OC, Pritchett CV, Lewis JE, Weaver AL, Smith DI, Moore EJ, Human papillomavirus – associated orophryngeal squamous cell carcinomas:
primary tumor burden and survival in surgical patients, Annals of Otology, Rhinology & Laryngology, 118 (5): 368-73, 2009
Worden FP, Ha H, Controversies in the management of oropharynx cancer. Journal of the National Comprehensive Cancer Network, 6(7): 707-14, 2008
ZurHausen H. Human papillomaviruses and their possible role in squamous cell carcinomas. Curr Top Microbiol Immunol. 1977; 78: 1-30
