Cilvēka papilomas vīrusa ietekme uz galvas un kakla audzēju izplatību: ārstēšanas pieejas un klīniskie iznākumi HPV+ un HPV- orofaringeālā vēža pacientiem
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Latvijas Universitāte
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lav
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Ievads: Cilvēka papilomas vīruss (HPV) ir viens no biežākajiem seksuāli transmisīvajiem vīrusiem un būtisks riska faktors galvas un kakla audzēju attīstībā, īpaši orofaringeālajā rajonā – mandelēs un mēles saknē. HPV pozitīviem pacientiem audzēju biežāk diagnosticē agrīni, un prognoze ir labvēlīgāka salīdzinājumā ar HPV negatīviem. Pieaugošais HPV gadījumu skaits jauniešu vidū aktualizē problēmas nozīmi onkoloģijā. DarbaMērķis: Salīdzināt ārstēšanas pieejas un klīniskos iznākumus HPV pozitīviem un negatīviem orofaringeālā vēža pacientiem Latvijas Onkoloģijas centrā (2022–2023), analizējot ārstēšanas efektivitāti un prognozi. MateriāliUnMetodes: Retrospektīva analīze, iekļaujot pacientus ar C04, C05, C06, C09 un C10 diagnozēm, kuri ārstēti Latvijas Onkoloģijas centrā 2021–2022. Analīzē izmantoti SPSS 30.0.0.0 un Excel (16.96.1). Novērtēti audzēja lokalizācija, TNM, HPV statuss, ārstēšanas veids, iznākums. Statistika veikta ar Chi-Square testu un loģistisko regresiju, statistiski nozīmīgi rezultāti pie p < 0,05. Rezultāti: HPV visbiežāk tika konstatēts mandeles vēža gadījumos (57,8%). HPV pozitīvi pacienti biežāk diagnosticēti agrīnās stadijās un saņēma kombinētu ārstēšanu (ST+ĶT vai operācija+ST+ĶT), kas bija saistīta ar augstāku remisijas biežumu. HPV negatīvajiem pacientiem pārsvarā bija vēlīnas stadijas un vienkāršāka terapija. Lai gan ārstēšanas izvēle statistiski neatšķīrās starp grupām (p = 0,224), ārstēšanas veidam bija būtiska ietekme uz klīnisko iznākumu HPV negatīvajiem pacientiem (p = 0,003). HPV pozitīvajiem šī saistība netika novērota, iespējams, nelielā parauga dēļ. Secinājumi: HPV visbiežāk konstatēts mandeles audzējos, saskanot ar zināmo saistību ar orofaringeāliem audzējiem. HPV pozitīviem pacientiem vēzis tika diagnosticēts agrīni, tie biežāk saņēma kombinētu terapiju un sasniedza augstāku remisiju, kamēr HPV negatīvajiem – vēlīnas stadijas un sliktāka prognoze. Lai arī ne visi rezultāti bija statistiski nozīmīgi, vērojamas klīniskas tendences, kas uzsver HPV statusa nozīmi ārstēšanas plānošanā.
Introduction: Human papillomavirus (HPV) is a common sexually transmitted virus and a recognized risk factor in oropharyngeal cancers, especially in the tonsils and base of the tongue. HPV-positive tumors differ biologically and clinically from HPV-negative ones, being more often diagnosed at early stages and linked to better prognosis. Given the aggressive nature and delayed diagnosis of oropharyngeal cancer, understanding HPV’s impact on treatment and outcomes is essential. The increasing incidence of HPV-related cases, especially among younger individuals, highlights its relevance in oncology and public health. Aim: To compare treatment strategies and clinical outcomes in HPV-positive and HPV-negative oropharyngeal cancer patients at the Latvian Oncology Centre (2022–2023), assessing factors influencing treatment success and prognosis. MaterialsandMethods: A retrospective study was conducted at the Latvian Oncology Centre, including patients with C04, C05, C06, C09, and C10 diagnoses (2021–2022), regardless of HPV status. Data were analyzed using SPSS v30.0.0.0 and Excel v16.96.1. Variables included patient age, tumor site, TNM stage, HPV status, treatment type, and outcome. Chi-Square and logistic regression tests were used; p < 0.05 was considered significant. Patient anonymity was maintained. Results: HPV was most prevalent in tonsillar tumors (57.8%). HPV-positive patients were more often diagnosed at early stages and received combined treatments (e.g., RT+CT, surgery+RT+CT), achieving higher remission. HPV-negative patients more often had advanced disease and poorer outcomes after simpler therapies. While treatment selection did not differ significantly between groups (p = 0.224), treatment type significantly influenced clinical outcome only among HPV-negative patients (p = 0.003). No such effect was observed in the HPV-positive group, possibly due to small sample size. Conclusions: HPV was most frequently found in tonsillar cancer, confirming its known link to oropharyngeal tumors. HPV-positive patients were diagnosed earlier and received more complex treatments with better outcomes. Though some results lacked statistical significance, clinical trends showed better prognosis and remission in HPV-positive cases, underscoring the value of HPV status in treatment planning and personalized care.
Introduction: Human papillomavirus (HPV) is a common sexually transmitted virus and a recognized risk factor in oropharyngeal cancers, especially in the tonsils and base of the tongue. HPV-positive tumors differ biologically and clinically from HPV-negative ones, being more often diagnosed at early stages and linked to better prognosis. Given the aggressive nature and delayed diagnosis of oropharyngeal cancer, understanding HPV’s impact on treatment and outcomes is essential. The increasing incidence of HPV-related cases, especially among younger individuals, highlights its relevance in oncology and public health. Aim: To compare treatment strategies and clinical outcomes in HPV-positive and HPV-negative oropharyngeal cancer patients at the Latvian Oncology Centre (2022–2023), assessing factors influencing treatment success and prognosis. MaterialsandMethods: A retrospective study was conducted at the Latvian Oncology Centre, including patients with C04, C05, C06, C09, and C10 diagnoses (2021–2022), regardless of HPV status. Data were analyzed using SPSS v30.0.0.0 and Excel v16.96.1. Variables included patient age, tumor site, TNM stage, HPV status, treatment type, and outcome. Chi-Square and logistic regression tests were used; p < 0.05 was considered significant. Patient anonymity was maintained. Results: HPV was most prevalent in tonsillar tumors (57.8%). HPV-positive patients were more often diagnosed at early stages and received combined treatments (e.g., RT+CT, surgery+RT+CT), achieving higher remission. HPV-negative patients more often had advanced disease and poorer outcomes after simpler therapies. While treatment selection did not differ significantly between groups (p = 0.224), treatment type significantly influenced clinical outcome only among HPV-negative patients (p = 0.003). No such effect was observed in the HPV-positive group, possibly due to small sample size. Conclusions: HPV was most frequently found in tonsillar cancer, confirming its known link to oropharyngeal tumors. HPV-positive patients were diagnosed earlier and received more complex treatments with better outcomes. Though some results lacked statistical significance, clinical trends showed better prognosis and remission in HPV-positive cases, underscoring the value of HPV status in treatment planning and personalized care.