一例年轻女性声门原位鳞状细胞癌的HPV18 DNA检测与病理性咽喉反流：简要报告

文献信息

中文摘要

背景： 喉癌主要影响有长期吸烟和饮酒史的老年男性，在年轻女性中极为罕见。我们报告一例26岁女性声门原位鳞状细胞癌患者，表现为持续性声音嘶哑。她无吸烟、饮酒或放射暴露史。评估时，通过Lcn PCR在FFPE肿瘤组织中检测到高危HPV18 DNA，24小时MII-pH监测提示病理性咽喉反流。535个基因的靶向测序显示无驱动突变、肿瘤突变负荷升高或微卫星不稳定。患者接受了经口激光切除术，术后进行抗反流管理。随访时，她保持无复发。本病例提示HPV18和咽喉反流可能对一名年轻非吸烟女性的声门原位癌癌变过程有促进作用。这些发现支持在临床非典型喉鳞状病变中进行选择性病毒学评估和个体化反流评估。

英文摘要

Laryngeal cancer predominantly affects elderly males with long-term smoking and alcohol histories, and its occurrence in young females is extremely rare. We report a 26-year-old woman with glottic squamous cell carcinoma in situ who presented with persistent hoarseness. She had no history of smoking, alcohol use, or radiation exposure. Upon evaluation, high-risk HPV18 DNA was detected in FFPE tumor tissue by Lcn PCR, and 24-hour MII-pH monitoring indicated pathological laryngopharyngeal reflux. Targeted sequencing of 535 genes showed no driver mutations, tumor mutation burden elevation, or microsatellite instability. The patient underwent transoral laser resection followed by postoperative anti-reflux management. At follow-up, she remained recurrence-free. This case suggests a possible contribution of HPV18 and laryngopharyngeal reflux to carcinogenesis in a young non-smoking woman with glottic carcinoma in situ. The findings support selective virologic evaluation and individualized reflux assessment in clinically atypical laryngeal squamous lesions.