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Humane Papillomviren und Oropharynxkarzinome

Molekulare Interaktion und klinische Auswirkung

Human papillomavirus and cancer of the oropharynx

Molecular interaction and clinical implications

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Zusammenfassung

Ein Drittel aller Oropharynxkarzinome (OSCC) enthalten onkogene humane Papillomviren (HR-HPV). Epidemiologische und molekulare Untersuchungen belegen, dass HR-HPV bei diesen Tumoren ursächlich sind; sie können als HPV-assoziierte OSCC bezeichnen werden. Sexuelle Risikofaktoren scheinen von Bedeutung zu sein. Wenig ist bekannt über die natürliche Infektion und Persistenz von HR-HPV im Oropharynx. Die HPV-assoziierten OSCC unterscheiden sich von denen durch die klassischen Noxen verursachten OSCC grundlegend. Dies betrifft das Expressionsmuster verschiedener Zellzyklusproteine sowie genetische Veränderungen. Das unterschiedliche biologische Verhalten zeigt sich klinisch durch eine günstigere Prognose der HPV-assoziierten OSCC. Die Ursachen sind noch unklar, eine höhere Empfindlichkeit für Strahlen- und Chemotherapie ist aber denkbar. Für Studien bei OSCC ist in Zukunft eine Stratifizierung nach dem HPV-Status sinnvoll. Ob zukünftig die Patienten nach Bestimmung ihres HPV-Status einer entsprechenden maßgeschneiderten Therapie zuzuführen sind, muss in Therapiestudien geklärt werden.

Abstract

One-third of the cases of oropharyngeal squamous cell carcinoma (OSCC) contain oncogenic human papillomavirus (HR-HPV). Epidemiologic and molecular evidence underlines the causal role of HR-HPV in these tumors, which can be defined as HPV-related OSCC. These tumors differ from chemical/toxin-induced OSCC in several biological aspects, including specific molecular and genetic alterations. This leads to a characteristic clinical profile of HPV-related OSCC. Sexual risk factors play a role; however, the knowledge about natural infection and the rate of persistence of HR-HPV in the oropharynx is marginal. It is shown that the distinct biological behavior of the HPV-related subset of oropharyngeal tumors results in a more favorable prognosis. This might be the result of a better response to chemotherapy and radiotherapy. However, further studies are needed to show whether it will be possible to reliably select patients for individualized therapy depended on the HPV status of their tumors. Therefore, we think it will be mandatory to consider and stratify HPV status in the design of prospective clinical trials in the future.

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Abbreviations

CGH:

„Comparative genomic hybridization“

CIS:

Carcinoma in situ

DNA:

Desoxyribonukleinsäure

EGFR:

„Epidermal growth factor receptor“, epidermaler Wachstumsfaktorrezeptor

FISH:

Fluoreszenz-in-situ-Hybridisierung

HPV:

Humane Papillomaviren

HR-HPV:

Hochrisiko-HPV

OR:

Odds-Ratio

PCR:

Polymerasekettenreaktion

pRb:

Retinoblastomprotein

URR:

„Upper regulatory region“

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  1. Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Klinikum der Universität zu Köln, Kerpener Straße 62, 50924, Köln, Deutschland

    J.P. Klussmann & S.F. Preuss

  2. Department of Molecular Cell Biology, Research Institute Growth and Development, University of Maastricht, Maastricht, Niederlande

    E.J. Speel

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Klussmann, J., Preuss, S. & Speel, E. Humane Papillomviren und Oropharynxkarzinome. HNO 57, 113–122 (2009). https://doi.org/10.1007/s00106-008-1867-y

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