【摘 要】
：
背景与目的:人乳头状瘤病毒相关性口咽鳞状细胞癌(human papilloma virus-associated oropharyngeal squamous cell carcinoma,OPSCC-HPV)是一种独立的肿瘤类型,发病率有明显上升趋势.探讨OPSCC-HPV的临床病理学特征.方法:对复旦大学附属肿瘤医院2013年10月—2019年7月诊断的64例OPSCC-HPV患者的临床特征、组织学形态及免疫组织化学表型加以分析,并分别以聚合酶链反应和原位杂交的方法检测肿瘤组织中HPV及Epstein
【机 构】
：
复旦大学附属肿瘤医院病理科,复旦大学医学院肿瘤学系,复旦大学病理研究所,上海 200032
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背景与目的:人乳头状瘤病毒相关性口咽鳞状细胞癌(human papilloma virus-associated oropharyngeal squamous cell carcinoma,OPSCC-HPV)是一种独立的肿瘤类型,发病率有明显上升趋势.探讨OPSCC-HPV的临床病理学特征.方法:对复旦大学附属肿瘤医院2013年10月—2019年7月诊断的64例OPSCC-HPV患者的临床特征、组织学形态及免疫组织化学表型加以分析,并分别以聚合酶链反应和原位杂交的方法检测肿瘤组织中HPV及Epstein-Barr病毒(Epstein-Barr virus,EBV)的感染情况.结果:男性50例,女性14例;发病年龄33～76岁.发病部位以扁桃体最为常见,其次为口咽壁和舌根.36例以进行性增大的颈部包块为首发症状,57例伴颈部淋巴结转移(30例伴囊性变).55例可知美国癌症联合会(American Joint Committee on Cancer,AJCC)临床TNM总分期,与第7版分期相比,第8版分期明显降级,52例系TNM分期Ⅰ～Ⅱ期病变,3例系Ⅲ期病变.Ⅰ～Ⅱ期增加85.4％,Ⅲ期降低52.7％,Ⅳ期降低32.7％,新旧两版临床TNM总分期一致率仅为3.6％(2/55).随访2～77个月,2例局部复发,6例颈部淋巴结转移,3例死亡.63例为非角化性鳞状细胞癌,1例为腺鳞癌.肿瘤细胞核浆比高,核分裂象易见.免疫组织化学染色显示,60例受检患者中,59例P16弥漫强阳性,24例Ki-67增殖指数较高.39例均为高危型HPV感染,HPV-16型占92.3％,35例患者同时行P16和HPV检测,二者一致率达到97.1％.结论:OPSCC-HPV具有独特的临床病理学特征.所有原发性OPSCC及原发部位不明的颈淋巴结转移性鳞状细胞癌均应行P16或HPV检测.
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