| Abstract | Cilj istraživanja: HPV status orofaringealnog karcinoma do sada nije istraživan u Dalmaciji. Želimo ispitati epidemiološke i histološke pokazatelje na uzorku ispitanika s OPSCC-om i utvrditi ima li razlike u dobi, spolu i histološkim varijablama s obzirom na HPV status OPSCC-a.
Ispitanici i metode: U studiju je uključeno 70 ispitanika kojima je dijagnosticiran OPSCC od 1. siječnja 2013. godine do 31. prosinca 2017. godine. Podatci o dobi, spolu i lokalizaciji tumora prikupljeni su iz Kliničkog zavoda za patologiju, sudsku medicinu i citologiju KBC-a Split. Iz parafinskog bloka tumorskog tkiva izrezan je histološki preparat i obojen HE metodom te mikroskopski analizirani histološki pokazatelji (način rasta, stupanj diferencijacije, dezmoplastična reakcije strome, displazija okolnog epitela). DNA tumora izolirana je iz tumorskog tkiva u parafinskom bloku, izolirana standardnom metodom i uporabom GP5 i GP6 primera za HPV te analizirana RT-PCR-om. Razina statističke značajnosti postavljena je na p<0.05.
Rezultati: 57 (81,43%) je muškog spola i 13 (18,57%) ženskog spola. Srednja dob ispitanika je 63,2710,36 godina, raspon od 40 do 87 godina, medijan 62 godine. Najčešća lokalizacija OPSCC je baza jezika (41,43%). Način tumorskog rasta je lobularni u 40 (57,14%) slučajeva, a infiltrativni u 28 (40%). U 46 (65,71%) ispitanika tumor je bio dobro/srednje diferenciran. U 42 (60%) slučajeva nije nađena dezmoplastična reakcija strome. Displazija okolnog epitela nađena je u 44 (91,43%) slučajeva. U 37 (52,86%) slučajeva nađena je slaba limfocitna reakcija. HPV pozitivan OPSCC imalo je 7/70 (10%) ispitanika i to 5 (71,43%) muškog i 2 (28,57%) ženskog spola. Raspon dobi bio je od 55 do 74 godine, medijan 64 godine i srednja dob 65,146,62 godine. Najčešće sijelo tumora bila je tonzila (71,43%). U pet ispitanika način tumorskog rasta bio je lobularan, a u dvoje infiltrativan. U većine ispitanika, 85,71% tumor je bio dobro/umjereno diferenciran. U 71,43% ispitanika nije nađena dezmoplastična reakcija strome, a u 42,86% nađena je jaka limfocitna infiltracija. Distribucija po dobi ispitanika s HPV pozitivnim i HPV negativnim OPSCC je normalna (P=0,6179). HPV pozitivni OPSCC je češće smješten u tonzili (P=0,0345). Nije utvrđena razlika po spolu niti po praćenim histološkim varijablama.
Zaključci: Udio HPV pozitivnih OPSCC u našem uzorku niži je nego u prethodnoj hrvatskoj studiji. Nismo dokazali statistički značajnu razliku u histološkim varijablama ni po spolu s obzirom na a HPV status OPSCC-a. |
| Abstract (english) | Objectives: The HPV status of patients with oropharyngeal cancer has not been investigated in Dalmatia so far. The aim of this study was to examine epidemiological and histological variables in a sample of patients with OPSCC and to determine whether there were differences in age, sex, morphology and HPV status.
Patients and methods: The study included 70 patients diagnosed with OPSCC from 1 January 2013 to 31 December 2017. Data on age, sex and tumor localization were collected from the Clinical Institute of Pathology, Forensic Medicine and Cytology of the Clinical Hospital Center Split. Histological specimens were cut from paraffin blocks of tumor tissue and stained with HE after which they were microscopically analyzed for certain histological variables (infiltration type, degree of differentiation, desmoplastic stroma reactions, dysplasia of surface epithelium). Tumor DNA was isolated from paraffin embedded tumor tissue using a standard method with HPV specific GP5 and GP6 primers, and analyzed by RT-PCR. The level of statistical significance was set at p<0.05.
Results: 57 (81.43%) are male and 13 (18.57%) are female. The mean age of the subjects was 63.2710.36 years, range 40 to 87 years, median 62 years. The most common localization of OPSCC is the base of the tongue (41.43%). The type of tumor infiltration is lobular in 40 (57.14%) cases, and infiltrative in 28 (40%). In 46 (65.71%) subjects the tumor was well/moderately well differentiated. In 42 (60%) cases, no desmoplastic stroma reaction was found. Surface epithelial dysplasia was found in 44 (91.43%) cases. A weak lymphocyte reaction was found in 37 (52.86%) cases. HPV positive OPSCC was present in 7/70 (10%) subjects, 5 (71.43%) male and 2 (28.57%) female. The age range was 55 to 74 years, the median was 64 years, and the mean age was 65.146.62 years. The tonsil (71.43%) was the most common tumor site. In five patients, the type of tumor infiltration was lobular, and in two it was infiltrative. In most patients, 85.71% the tumor was well/moderately well differentiated. No desmoplastic stroma reaction was found in 71.43% of patients, and strong lymphocyte infiltration was found in 42.86%. The age distribution of patients with HPV positive and HPV negative OPSCC was normal (P=0.6179). HPV positive OPSCC is more commonly located in the tonsils (P=0.0345). No difference was found by sex or by histological variables.
Conclusions: The proportion of HPV-positive OPSCCs in our sample is lower than in the previous Croatian study. We did not prove any statistically significant difference in neither histological variables nor in sex distribution with respect to the HPV status of OPSCC. |
