Morphologic and topographic radiologic features of human papillomavirus-related and -unrelated oropharyngeal carcinoma

作者：Chan Michael W; Yu Eugene^*; Bartlett Eric; O'Sullivan Brian; Su Jie; Waldron John; Ringash Jolie; Bratman Scott V; Chen Yingming Amy; Irish Jonathan; Kim John; Gullane Patrick; Gilbert Ralph; Chepeha Douglas; Perez Ordonez Bayardo; Weinreb Ilan; Hansen Aaron; Tong Li; Xu Wei; Huang Shao Hui^*

来源：Head and Neck-Journal for the Sciences and Specialties of the Head and Neck, 2017, 39(8): 1524-1534.

DOI：10.1002/hed.24764

• human papillomavirus (HPV)
• human papillomavirus (HPV)-associative models
• nomograms
• oropharyngeal carcinoma
• radiologic features

Background: The purpose of this study was to compare the clinicoradiologic characteristics of human papillomavirus (HPV)-related (HPV-positive) and HPV-unrelated (HPV-negative) oropharyngeal carcinoma (OPC).
Methods: Primary tumor and lymph node features of HPV-positive and HPV-negative OPCs from 2008 to 2013 were compared on pretreatment CT/MRI. Intrarater/interrater concordance was assessed. Multivariable analyses identified factors associated with HPV-positivity to be used in nomogram construction.
Results: Compared to HPV-negative (n 5 194), HPV-positive (n = 488) tumors were more exophytic (73% vs 63%; p = .02) with well-defined border (58% vs 47%; p = .033) and smaller axial dimensions; lymph node involvement predominated (89% vs 69%; p < .001) with cystic appearance (45% vs 32%; p = .009) but similar topography. Intrarater/interrater concordance varied (fair to excellent). Nomograms combining clinical (age, sex, smoking pack-years, subsite, T/N classification) and/or radiologic (nonnecrotic tumor and cystic lymph node) features were used to weigh the likelihood of HPV-driven tumors (area under the curve [AUC] = 0.84).
Conclusion: HPV-positive OPC has different radiologic tumor (exophytic/well-defined border/smaller axial dimension) and lymph node (cystic) features but similar lymph node topography.

• 出版日期2017-8