上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (4): 413-419.doi: 10.19439/j.sjos.2026.04.011

• 论著 • 上一篇    下一篇

HPV状态与辅助治疗的交互作用对口腔鳞癌术后复发的预测价值

高小茜1, 柏金喜1, 何悦2#, 林璐1#   

  1. 1.上海交通大学医学院附属第九人民医院 病案管理办公室,上海 200011;
    2.上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院, 国家口腔医学中心,口腔疾病国家临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011
  • 收稿日期:2025-11-25 修回日期:2026-01-22 出版日期:2026-08-25 发布日期:2026-09-01
  • 通讯作者: 林璐,E-mail: sammy_lu1986@126.com;何悦,E-mail: william5218@126.com。#共同通信作者
  • 作者简介:高小茜（1997—）,女,硕士,E-mail: 572424557@qq.com
  • 基金资助:
    上海交通大学医学院附属第九人民医院医院管理研究项目(YGB202310)

Prognostic impact of HPV and adjuvant therapy interaction in oral squamous cell carcinoma

Gao Xiaoqian1, Bai Jinxi1, He Yue2, Lin Lu1   

  1. 1. Department of Medical Records Management, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    2. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2025-11-25 Revised:2026-01-22 Online:2026-08-25 Published:2026-09-01

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摘要： 目的: 探讨人乳头瘤病毒（human papillomavirus,HPV）感染对口腔鳞癌（oral squamous cell carcinoma,OSCC）患者术后复发的影响,并分析其与辅助放疗、化疗的交互作用及对复发的预测价值。方法: 选取上海交通大学医学院附属第九人民医院168例OSCC术后患者,构建回顾性病例对照研究,分别使用单因素和多因素logistic回归分析HPV感染及混杂因素与OSCC术后复发的关系,使用交互作用分析HPV和放化疗的交互作用对OSCC患者术后复发的影响。结果: 单因素分析显示,HPV阳性与复发的关系呈负相关（OR=0.46,95%CI: 0.21~0.98）,辅助放疗与复发的关系呈负相关（OR=0.48,95%CI: 0.24~0.93）。多因素分析证实,HPV阳性（OR=0.37,95%CI: 0.16~0.88）、辅助放疗（OR=0.30,95%CI: 0.13~0.67）仍为复发保护因素,而辅助化疗则增加复发风险（OR=3.76,95%CI: 1.50~9.41）。HPV阳性与辅助放疗存在显著加性交互作用,联合干预可进一步降低复发风险（OR=0.06,95%CI: 0.01~0.38）,与辅助化疗无显著交互效应。预测模型显示,基础临床特征模型AUC为0.859,加入HPV状态后提升至0.887,引入HPV与放疗交互项后预测效能最佳（AUC=0.894,与基础模型相比,P=0.031 6）。变量重要性分析显示,HPV感染状态与放疗的交互作用具有最高预测价值。结论: HPV阳性状态是OSCC患者术后复发的显著保护因素,且与辅助放疗联合时展现出协同效应;整合了HPV状态与放疗交互作用的预测模型显示出最佳的复发预测效能。

关键词: 人乳头瘤病毒, 口腔鳞癌, 放疗, 化疗, 交互作用, 复发预测

Abstract: PURPOSE: To investigate the impact of human papillomavirus (HPV) infection on postoperative recurrence in patients with oral squamous cell carcinoma(OSCC), and to analyze its interaction with adjuvant radiotherapy and chemotherapy as well as the predictive value for recurrence. METHODS: A retrospective case-control study was conducted involving 168 postoperative OSCC patients from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Univariate and multivariate logistic regression analyses were used to assess the association between HPV infection, confounding factors and postoperative recurrence. Interaction analysis was performed to clarify the synergistic effect of HPV with radiotherapy and chemotherapy, and recurrence prediction models were constructed and validated. RESULTS: Univariate analysis showed that HPV positivity (OR=0.46, 95%CI: 0.21-0.98) and adjuvant radiotherapy (OR=0.48, 95%CI: 0.24-0.93) were negatively correlated with recurrence risk. Multivariate analysis confirmed that HPV positivity (OR=0.37, 95%CI: 0.16-0.88) and adjuvant radiotherapy (OR=0.30, 95%CI: 0.13-0.67) remained protective factors against recurrence, while adjuvant chemotherapy increased recurrence risk (OR=3.76, 95%CI: 1.50-9.41). A significant additive interaction was observed between HPV positivity and adjuvant radiotherapy, and combined intervention further reduced recurrence risk (OR=0.06, 95%CI: 0.01-0.38), with no significant interaction with adjuvant chemotherapy. Prediction models showed that the AUC of the basic clinical feature model was 0.859, which increased to 0.887 after adding HPV status, and achieved the best predictive performance after introducing the HPV-radiotherapy interaction term (AUC=0.894, compared with the basic model, P=0.031 6). The interaction term was the variable with the highest predictive value in the model. CONCLUSIONS: HPV positivity is an important protective factor against postoperative recurrence in OSCC patients, and exhibits a synergistic effect when combined with adjuvant radiotherapy. The prediction model integrating HPV status and its interaction with radiotherapy has the optimal recurrence predictive efficacy.

Key words: Human papillomavirus, Oral squamous cell carcinoma, Radiotherapy, Chemotherapy, Interaction, Recurrence prediction

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