title: HPV Infection and Anemia Status Stratify the Survival of Early T2 Laryngeal Squamous Cell Carcinoma.
abstract: OBJECTIVE
  This study was designed to investigate the potentially prognostic indicators of early laryngeal squamous cell carcinomas (LSCCs), including human papillomavirus (HPV) status.
  
  
  METHODS
  A total of 336 patients with T2N0-1M0 LSCC were included in this study. Clinical data were collected from archival documents, and HPV infection and p16(INK4A) expression were detected.
  
  
  RESULTS
  A total of 32/318 cases of high-risk HPV infection and 10/336 cases of p16(INK4A) overexpression were found. Three hundred eighteen tumors were classified into a three-class model according to HPV infection and p16(INK4A) expression: class I, HPV+/p16+; class II, HPV+/p16-; and class III, HPV-/p16-. Class III had a trend of decreased overall survival (OS) (P = 0.076) and a markedly low relapse-free survival (RFS) (P = 0.022) compared with class I and class II. HPV-positive cases (class I plus class II) had a significantly longer OS (P = 0.038) and RFS (P = 0.006). In multivariate analysis, HPV-positive (P = 0.020), nonanemia (P = 0.011), and N0 stage (P = 0.005) were significant predictors for high RFS. But only HPV-positive (P = 0.047) and nonanemia (P < 0.001) were significant predictors for superior OS.
  
  
  CONCLUSIONS
  A trend of discrete survival among HPV+/p16+, HPV+/p16-, and HPV-/p16 classes was found in early LSCCs. We suggest that HPV infection and hemoglobin level are the potential factors that can stratify outcome of early LSCCs.
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China; State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, Guangdong Province, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, China.
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China; State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
authors.forename: Zichen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China; State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, Guangdong Province, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Sun
authors.affiliation: Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
authors.affiliation: Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong Province, China.
authors.forename: Long
authors.initials: L
authors.lastname: Gong
authors.affiliation: Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong Province, China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Fang
authors.affiliation: Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China; State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, Guangdong Province, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, China. Electronic address: huwh@sysucc.org.cn.
authors.forename: Wei-Han
authors.initials: WH
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000401:mortality / Q000821:virology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D006454:Hemoglobins
keywords: Hemoglobin; Human papillomavirus; Laryngeal SCC; N1 stage; p16(INK4A)