喉鳞状细胞癌中RT-PCR检测HPV：与p16表达、组织病理学及预后的相关性

文献信息

中文摘要

目的： 本研究旨在通过HPV E6/E7 mRNA RT-PCR确定喉鳞状细胞癌（LSCC）中HPV的发病率，并比较p16免疫组化与其诊断能力。根据所收集的数据，将评估HPV状态与病理及临床参数之间的关系。
材料和方法： 这项回顾性、单中心研究纳入了112例喉切除术病例，使用RT-PCR检测HPV E6/E7 mRNA，该方法可检测14种高危HPV类型的转录本，并额外识别HPV 16和18/45特异性转录本的存在。还进行了p16蛋白免疫组化，并将总体结果与临床和病理数据进行比较。
结果： 在18例（16%）中观察到p16免疫反应性。在1例中，超过70%的肿瘤细胞表现出强染色。5例（占p16阳性病例的28%，占所有病例的4%）的p16免疫组化（IHC）评分高于6/9。尽管存在p16反应性，但没有任何病例通过RT-PCR检测显示转录活跃的HPV。RT-PCR分析结果在1例中为HPV 16型阳性，而肿瘤细胞中未观察到p16免疫反应性。
结论： 在我们的研究中，研究结果表明HPV对土耳其的LSCC癌变影响极小。我们的研究结果表明，p16免疫组化可能不是HPV检测的合适替代标志物。此外，p16 IHC阳性与生存率降低相关。这表明p16表达可能潜在地用作预后标志物，尽管其临床意义需要进一步验证。

英文摘要

OBJECTIVE: The aim of the study was to determine HPV incidence among laryngeal squamous cell carcinomas (LSCC) using HPV E6/E7 mRNA RT-PCR and to compare diagnostic capabilities of p16 immunohistochemistry against it. With the data gathered, the relationship between HPV status, pathological and clinical parameters will be assessed.
MATERIAL AND METHODS: This retrospective, single-centred study included 112 laryngectomy cases tested for HPV E6/E7 mRNA using RT-PCR, which detects transcripts of 14 high-risk HPV types, and additionally identifies the presence of HPV 16 and 18/45-specific transcripts. p16 protein immunohistochemistry was also performed, and overall results were compared with clinical and pathological data.
RESULTS: p16 immunoreactivity was observed in 18 cases (16%). In one case, more than 70% of the tumour cells exhibited strong staining. The p16 immunohistochemistry (IHC) score was above 6/9 in 5 cases (28% of p16-positive cases, 4% of all cases). Despite p16 reactivity, none of the cases demonstrated transcriptionally active HPV with RT-PCR tests. The RT-PCR analysis result was positive for HPV type 16 in one case, with no p16 immunoreactivity observed in the tumour cells.
CONCLUSION: In our study, the findings suggest that HPV has a minimal effect on LSCC carcinogenesis in Türkiye. Our findings suggest that p16 immunohistochemistry may not be a suitable surrogate marker for HPV detection in LSCC. Additionally, p16 IHC positivity was associated with decreased survival. This suggests that p16 expression could potentially be used as a prognostic marker, although its clinical significance requires fur-ther validation.