Human papillomavirus-active head and neck cancer and ethnic health disparities
| Autor: | Amanda Psyrri, Lana Jackson, Paul M. Weinberger, William S. Dynan, Sunny S. Khichi, Jeffrey R. Lee, Mark A. Merkley |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty White People Article symbols.namesake Internal medicine Carcinoma medicine Humans Papillomaviridae Healthcare Disparities neoplasms Fisher's exact test Survival analysis Aged biology business.industry Head and neck cancer virus diseases Cancer Retrospective cohort study Middle Aged biology.organism_classification medicine.disease Head and neck squamous-cell carcinoma Survival Analysis female genital diseases and pregnancy complications United States Black or African American Tumor Virus Infections Otorhinolaryngology Head and Neck Neoplasms Immunology symbols Carcinoma Squamous Cell Female business |
| Zdroj: | The Laryngoscope. 120(8) |
| ISSN: | 1531-4995 |
| Popis: | Objectives/Hypothesis: Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16INK4a expression, is associated with decreased mortality. We hypothesized that prevalence of this HPV-active disease class would be lower in black HNSCC patients compared to white patients. Study Design: Multi-institutional retrospective cohort analysis. Methods: Real-time polymerase chain reaction was used to evaluate for high-risk HPV DNA presence. Immunohistochemistry for p16INK4a protein was used as a surrogate marker for HPV oncoprotein activity. Patients were classified as HPV-negative (HPV DNA-negative, p16INK4a low), HPV-inactive (HPV DNA-positive, p16INK4a low), and HPV-active (HPV DNA-positive, p16INK4a high). Overall survival and recurrence rates were compared by Fisher exact test and Kaplan-Meier analysis. Results: There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16INK4a expression were determined, and the results were used to classify these patients as HPV-negative (44), HPV-inactive (33), and HPV-active (25). Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P = .003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%) (P = .017). Conclusions: The favorable HPV-active disease class is less common in black than in white patients with HNSCC, which appears to partially explain observed ethnic health disparities. Laryngoscope, 2010 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text