A Preliminary Real-World Study Of EBV And HPV Infection In Patients With Nasopharyngeal Carcinoma

Objective:To analyze the infection status and clinical significance of human papillomavirus(HPV)and EBV in NPC patients in the real world.Methods:Paraffin embedded tissues of patients with nasopharynx cancer and chronic inflammation of nasopharynx confirmed by pathological biopsy of nasopharynx in the Affiliated Hospital of North Sichuan Medical College from January 2018 to may 2019 were collected.EBV-DNA and HPV typing were detected by molecular hybridization and PCR fluorescence.The correlation of HPV and EBV infection with demographic characteristics,clinical stages,radiosensitivity,treatment-related side effects,short-term efficacy and other indicators was analyzed.Results:A total of 60 cases of NPC and 20 cases of nasopharynx inflammatory tissue were included.All 80 cases were detected by 37 kinds of HPV typing,while NPC cases were detected by EBV-DNA.(1)The total EBV infection rate of NPC patients was 81.7%;The infection rates of patients with and without lymph node metastasis(N-,N+)were 87.3%and 20.0%,respectively,with statistical significance(P=0.002);the infection rates of early stage(?+?),middle and late stage(?+?)were 44.4%and 88.2%,respectively,with statistical significance(P=0.008);the myelosuppression rates of patients with EBV(+and EBV(-)were 96.2%and 33.3%,respectively,with statistical significance(P=0.022),there was no difference in the degree of myelosuppression;EBV infection was not correlated with gender,age,smoking status,T-stage,N-stage,radiosensitivity,radiation-induced oral mucosal response and short-term efficacy(P>0.05).(2)The overall infection rate of HPV in patients with NPC was 40%,most of which were HPV16 and HPV18;the infection rates of NPC and nasopharynx were 35.5%and 0%,respectively,with a statistically significant difference(P=0.003);the infection rates of ? 60 years old and<60 years old were 13.3%and 50.0%,respectively,with a statistically significant difference(P=0.033);HPV infection and gender,smoking situation,stage,radiosensitivity,synchronous radiotherapy There was no correlation between chemotherapy-related side effects(radiation-induced oral mucosal reaction,myelosuppression)and short-term efficacy(P>0.05).(3)28.3%of NPC patients had HPV and EBV co infection,58.8%,29.4%,7.8%,and 3.9%of NPC patients had EBV and EBV co infection,and 58.8%,29.4%,7.8%,and 3.9%of NPC patients had EBV single infection,EBV/HPV co infection,HPV single infection,and double negative rates,respectively(P=0.017)55.6%,31.5%,7.4%,5.6%,with statistical difference(P=0.008);The CR rate of EBV patients with single infection was 29.4%,that of HPV patients with single infection and EBV/HPV co infection was 63.6%,the difference was close to statistical difference(P=0.074);the incidence of myelosuppression in EBV/HPV co infection,EBV single infection,HPV single infection and double negative patients during concurrent radiotherapy and chemotherapy was 100%,94.4%,50%and 0%,respectively,the difference was statistically significant(P=0.004),but bone was found There was no difference in the degree of myelosuppression,and there was no difference in gender,age,smoking status,T-stage,radiation-induced oral mucosal response among the four infection states(P>0.05).Conclusion:(1)The infection rate of EBV in NPC is higher than that of HPV,and the infection rate of EBV is higher in middle and late stage patients,and HPV infection is more common in patients younger than 60 years old.(2)There is a certain proportion of EBV/HPV co infection in NPC.(3)Under the background of EBV infection in NPC,HPV infection may be a molecular marker with good prognosis.