人類乳突狀瘤病毒（HPV）於口咽鱗狀細胞癌致癌機轉之角色

Human Papillomavirus and Oropharyngeal Squamous Cell Carcinoma

人類乳突狀瘤病毒（HPV）已被證實與部分的口咽鱗狀細胞癌之致病機轉有關。本文主要回顧近年來相關論文並論述HPV感染與口咽鱗狀細胞癌之關聯性，特別是在其相關之流行病學、危險因子及致病機轉。在搜尋並整理口咽鱗狀細胞癌之相關研究文獻後，僅証實HPV為一口咽鱗狀細胞癌之致病因子，而且，相較於此類HPV陰性腫瘤，HPV陽性腫瘤病患有較佳之預後及較高之平均存活率。在頭頸鱗狀細胞癌中，此類HPV相關之鱗狀細胞癌之病患通常較為年輕，且較少有抽菸及喝酒習慣。此外，近年來大量的HPV相關性口咽鱗狀細胞癌的研究結果，已改變以往臨床醫學對此類頭頸癌的處理模式，對於各種治療選項的反應，HPV陽性口咽癌比陰性口咽癌顯示出明顯的結果，暗示著兩者之致癌機轉應有某種程度上的差異。但是，切確的致癌分子機轉仍卻有待釐清，在這方面，未來仍需更多研究努力投入，以研發出更佳之預防及治療方法。

Human papillomavirus (HPV) has been implicated in the pathogenesis of a subset of oropharyngeal squamous cell carcinoma. This article reviews the current literature on the role of HPV in oropharyngeal squamous cell carcinoma, particularly in relation to epidemiology, risk factors and carcinogenesis. The medical literature on HPV and oropharyngeal squamous cell carcinoma was reviewed with an emphasis on the role of HPV in the pathogenesis of oropharyngeal squamous cell carcinoma, based on the level of available evidence. The results indicate HPV has been established as a causative agent in oropharyngeal squamous cell carcinoma and biologically active HPV can act as a prognosticator with better overall survival than HPV-negative tumors. In addition, a distinct group of younger patients with limited tobacco and alcohol exposure emerged as characteristic of this HPV-related subset of squamous cell carcinoma of the head and neck. However, the exact molecular mechanisms of carcinogenesis are not completely understood and further studies are needed to assist development of optimal prevention and treatment modalities.