Cene Jerele (Author), Katarina Šurlan Popović (Author)

Abstract

Karcinomi glave in vratu predstavljajo pomemben zdravstveni problem in so šesti najpogostejši karcinom na svetu. Okoli 90 % karcinomov glave in vratu je ploščatoceličnih karcinomov, ki predstavljajo globalno letno incidenco okoli 650.000, v Sloveniji pa okoli 440 primerov (2015). V zadnjih desetletjih strmo raste incidenca karcinomov orofarinksa. Vzrok je epidemija okužb s humanim papiloma virusom (HPV), visokorizični tip 16 izoliramo kar iz 40%60 % ploščatoceličnih karcinomov orofarinksa. Bolniki s HPV-pozitivnimi PCKGV imajo občutno boljše preživetje in odzivnost na zdravljenje v primerjavi s HPV-negativnimi, zaradi česar je postalo določanje HPV statusa karcinoma ključno pri načrtovanju zdravljenja in napovedi preživetja. Trenutni zlati standard za dokaz HPV predstavlja pomnoževanje virusne RNA z verižno reakcijo s polimerazo, čedalje večjo veljavo pa dobivajo tudi radiološke slikovno preiskovalne metode. Zaenkrat izključno s pomočjo tovrstnih metod ne moremo rutinsko razlikovati med HPV-pozitivnimi in HPV-negativnimi karcinomi. Kljub temu pa raziskave kažejo na specifične, tudi radiološke lastnosti HPV-pozitivnih karcinomov, ki jih poleg rezultatov ostalih preiskav lahko uporabimo pri določanju HPV statusa. Vrednotimo tako primarni karcinom kot zasevke v bezgavkah. Primarni HPV-pozitivni karcinomi so v primerjavi s HPV-negativnimi običajno manjši, bolje zamejeni, metabolno manj aktivni in z manj nekrozami ter ulceracijami. Značilno se pojavljajo v tonzilarni regiji in na bazi jezika. Zasevki v bezgavkah so pri HPV-pozitivnih karcinomih zgodnejši in pogostejši kot pri HPV-negativnih, poleg tega imajo pogosteje cističen videz.

Keywords

karcinom glave in vratu;ploščatocelični karcinom orofarinksa;humani papiloma virus;HPV;radiološke značilnosti;slikovno preiskovalne metode;

Data

Language: Slovenian
Year of publishing:
Typology: 1.04 - Professional Article
Organization: OI - Institute of Oncology
UDC: 616-006
COBISS: 3140731 Link will open in a new window
ISSN: 1408-1741
Parent publication: Onkologija
Views: 3129
Downloads: 637
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Other data

Secondary language: English
Secondary title: ǂThe ǂuse of radiographic imaging techniques in determining HPV status of head and neck squamous cell carcinoma
Secondary abstract: Head and neck cancer presents a serious health issue and is the sixth most common cancer in the world. With an estimated annual burden of 650,000 incident cases worldwide and approximately 440 incident cases in Slovenia, squamous cell carcinoma accounts for about 90 % of head and neck cancer (2015). In the last few decades, the number of oropharyngeal carcinoma cases has notably increased. The reason lies in the human papillomavirus (HPV) epidemic, with high-risk HPV type 16 being isolated from 40%60 % cases of oropharyngeal squamous cell carcinoma. Patients with HPV-positive HNSCC have a notably higher survival rate as well as better treatment response opposed to their HPV-negative counterparts. Therefore, the evaluation of HPV status in these patients has become the main factor in treatment planning and outcome prediction. The current golden standard for determining the viral aetiology of carcinoma is amplifying viral RNA with PCR. While recent studies indicate that radiographic imaging techniques are useful in determining HPV status, there is not enough evidence for them to be used as the sole method for HPV status determination. However, certain radiographic parameters were proven to be specific for HPV-related carcinomas and can be, when combined with other methods, used for determining HPV status. Primary HPV-positive carcinomas are generally smaller, less metabolically active, cause less necrosis and ulcerations, and have well-defined borders. They are usually found in the tonsillar region and at the base of the tongue. HPV-positive HNSCC presents with more frequent and earlier nodal metastases than HPV-negative HNSCC. HPV-positive HNSCC nodal metastases typically have a cystic appearance.
Secondary keywords: head and neck carcinoma;oropharyngeal squamous cell carcinoma;human papillomavirus;radiographic features;radiographic imaging;
URN: URN:NBN:SI
Pages: str. 12-19
Volume: ǂLetn. ǂ22
Issue: ǂšt. ǂ2
Chronology: dec. 2018
DOI: 10.25670/oi2018-017on
ID: 11009748