ABSTRACT
Purpose@#High rate of false-positive tests is a major obstacle to use human papillomavirus (HPV) detectionas a diagnostic tool for high-grade squamous intraepithelial lesions or cervical cancer(HSIL+). We investigated whether type-specific viral load or physical state of HPV 16, 18,and 58 are useful biomarkers for HSIL+. @*Materials and Methods@#Type-specific viral loads of E6 and E2 genes in cervical cells from 240, 83, and 79 HPV 16–,18–, and 58–infected women, respectively, were determined using real-time polymerasechain reaction. Viral loads were normalized to cellular DNA (copy/cell). Total and integratedviral loads and physical state were compared between HSIL+ and controls, and diagnosticvalue was determined using receiver operating characteristic analysis. @*Results@#Viral loads of HPV 16, 18, and 58 were significantly different in lesions in the same pathologicgrade. High type-specific total viral loads were significantly associated with HSIL+ (oddsratio [OR], 14.065, 39.472, and 7.103 for HPV 16, 18, and 58, respectively). High integratedviral load was related to HSIL+ in women with HPV 16 (OR, 8.242), and integrated statewas associated with HSIL+ in women with HPV 18 (OR, 9.443). Type-specific total viral loadwas significantly associated with HSIL+ (area under curve, 0.914, 0.937, and 0.971 forHPV 16, 18, and 58, respectively), indicating an excellent performance in detecting HSIL+. @*Conclusion@#Type-specific total viral load may be a powerful diagnostic marker for HSIL+ in HPV 16–,18–, and 58–infected HSIL+ lesions. If demonstrated in all other high-risk HPV types, thismethod can lead to a paradigm shift in the strategy of equivocal cytologic abnormalities.
ABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study was to determine the efficacy of induction chemotherapy with docetaxel and platinum in patients with hypopharyngeal carcinoma. SUBJECTS AND METHOD: The medical records of 66 patients who were diagnosed with hypopharyngeal carcinoma at our department from January 1996 to December 2008 were reviewed and retrospectively analyzed. The patients were divided into four groups according to treatment method: Group I was treated with radiation and induction chemotherapy consist of docetaxel and platinum (27); Group II was treated with surgery and induction chemotherapy consist of docetaxel and platinum (28), Group III was treated with radiation and induction chemotherapy consist of 5-FU and platinum (9) and Group IV was treated with surgery and induction chemotherapy consist of 5-FU and platinum (2). A total of 186 chemotherapy cycles were administered to patients and most of the patients received at least 2 cycles. RESULTS: The T-stage distribution at diagnosis was 7.5%, 42.4%, 28.8%, and 21.2% for T1, T2, T3, and T4, respectively. The N-stage distribution at diagnosis was 48.5%, 22.7%, 10.6%, 15.2%, and 9.1% for N0, N1, N2a, N2b, and N2c, respectively. The overall 3-year survival rate was 44.3%. The 3-year survival rate of each group was 42.6% in Group I, 54.8% in Group II, and 11.1% in Group III. There was no significant difference in survival between Groups I and III (p=0.074). There was no difference in sex, age, and N stage for 3-year survival rate. CONCLUSION: Although any valid conclusions could not be drawn because of the small number of patients examined here, induction chemotherapy consisting of docetaxel and platinum may improve the outcome of patients with hypopharyngeal carcinoma.