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Humane Papillomavirusinfektionen bei Plattenepithelkarzinomen des Kopf- und Halsbereichs

Eine Untersuchung am Krankengut des Bundeswehrkrankenhauses Ulm

Human papillomavirus in squamous cell cancer of the head and neck

A study at the Ulm Military Hospital, Germany

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Zusammenfassung

Humane Papillomaviren (HPV) gewinnen als Risikofaktor für die Entstehung von Plattenepithelkarzinomen des oberen Atmungs- und Verdauungstrakts weltweit zunehmend an Bedeutung. Für Deutschland liegen bislang nur wenige epidemiologische Untersuchungen zu dieser Fragestellung vor. Im Rahmen der vorliegenden Untersuchung wurde die Prävalenz von HPV-Infektionen bei 223 Patienten mit Plattenepithelkarzinomen im Bereich von Mundhöhle, Oropharynx, Hypopharynx und Larynx untersucht. In 17,5 % der Fälle wurde DNA des HPV-Genotyps 16 (HPV16) nachgewiesen. Bei allen HPV16-positiven Tumoren fand sich eine Überexpression von p16INK4a im Tumorgewebe. Weitere High-Risk-HPV waren im untersuchten Tumorkollektiv nicht nachweisbar. Am häufigsten wurde HPV16 bei Tonsillenkarzinomen nachgewiesen (37,5 %), während lediglich 2,4 % der Larynxkarzinome HPV16-positiv waren. Bei HPV-positiven Tonsillenkarzinomen fanden sich signifikant häufiger Halslymphknotenmetastasen im Vergleich zu HPV-negativen Tumoren (85,7 % vs. 54,3 %; p < 0,016). Der Tabak- und Alkoholkonsum war bei Patienten mit HPV-positiven Tumoren signifikant geringer (p < 0,0001).

Abstract

There is increasing evidence worldwide that human papillomavirus is a major risk factor for head and neck cancer. Only few studies on this association have been performed in Germany to date. For the purposes of the present study, tumor specimens from 223 patients with squamous cell cancer of the oral cavity, oropharynx, hypopharynx and larynx were analyzed for HPV DNA and p16INK4a expression. The prevalence of HPV genotype 16 (HPV16) DNA in the study population was 17.5 %. Further high-risk HPV types were not detected. All HPV16-positive tumors showed intense p16INK4a expression. HPV16 prevalence was highest in tonsillar carcinoma (37.5 %) and lowest in laryngeal cancer (2.8 %). We observed a significantly higher incidence of cervical lymph node metastases in patients with HPV16-positive tonsillar carcinoma in comparison to HPV-negative tumors (p < 0.016). Tobacco and/or alcohol consumption was significantly lower in patients with HPV-positive tumors (p < 0.0001).

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Authors and Affiliations

  1. Univ.-HNO-Klinik Heidelberg, Heidelberg, Deutschland

    M. Maier

  2. Abteilung Pathologie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland

    K. Kraft & K. Steinestel

  3. Klinik für MKG-Chirurgie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland

    A. Schramm

  4. Klinik für HNO-Heilkunde/Kopf-und Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland

    K.J. Lorenz, M. Tisch &  H. Maier

  5. Abteilung V, Flugmedizinisches Institut der Luftwaffe, Fürstenfeldbruck, Deutschland

    M. Schwerer

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  1. M. Maier
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  2. K. Kraft
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  3. K. Steinestel
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  4. A. Schramm
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Correspondence to H. Maier.

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Maier, M., Kraft, K., Steinestel, K. et al. Humane Papillomavirusinfektionen bei Plattenepithelkarzinomen des Kopf- und Halsbereichs. HNO 61, 593–601 (2013). https://doi.org/10.1007/s00106-013-2676-5

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  • DOI: https://doi.org/10.1007/s00106-013-2676-5

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