Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press64510.17650/2313-805X-2021-11-2-31-40DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИMolecular and clinical aspects of oropharyngeal squamous cell carcinoma associated with human papillomavirusМолекулярно-клинические аспекты плоскоклеточной карциномы ротоглотки, ассоциированной с вирусом папилломы человекаhttps://orcid.org/0000-0001-8128-2553PolatovaD. Sh.ПолатоваД. Ш.
Uzbekistan

100174 Tashkent, Farobi St., 383

100174 Ташкент, ул. Фароби, 383

https://orcid.org/0000-0003-0064-3746MadaminovA. Yu.МадаминовА. Ю.
Uzbekistan

Akhmad Yuldashevich Madaminov

100174 Tashkent, Farobi St., 383

Ахмад Юлдашевич Мадаминов

100174 Ташкент, ул. Фароби, 383

akhmad.madaminov@inbox.ruNational Cancer Research Center of Uzbekistan, Ministry of Health of Republic of UzbekistanРеспубликанский специализированный научно-практический медицинский центр онкологии и радиологии0808202111231400708202107082021Copyright ©; 2021, Polatova D.S., Madaminov A.Y.Copyright ©; 2021, Полатова Д.Ш., Мадаминов А.Ю.2021Polatova D.S., Madaminov A.Y.Полатова Д.Ш., Мадаминов А.Ю.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/645

Currently, the role of human papillomavirus (HPV) in carcinogenesis is well known: more than 90 % of HPV-positive oropharyngeal squamous cell carcinomas are caused by HPV type 16 (HPV-16). HPV E6 and E7 oncoproteins play a significant role in the development of this tumor. The E6- mediated degradation of suppressor protein p53 results in G2/M-phase checkpoint dysregulation and inhibition of apoptosis. HPV oncoprotein E7 binds to pRb, promoting its degradation and the release of E2F transcription factor. Diagnostic assays for HPV detection include immunohistochemical staining for p16, polymerase chain reaction, in situ hybridization, and next-generation sequencing. Immunohistochemical examination (determination of p16 protein expression) is an economical and very specific way to detect a viral infection. Patients with HPV-positive oropharyngeal squamous cell carcinoma demonstrate significantly better response to treatment and overall survival rates than those with HPV-negative oropharyngeal squamous cell carcinoma. Despite the fact that five-year overall survival rate in patients with HPV-positive oropharyngeal squamous cell carcinoma after treatment exceeds 80 %, some patients have poor survival. Unfortunately, currently available methods of risk stratification still do not endure their timely identification. Further research is needed to address these problems.

На сегодняшний день роль вируса папилломы человека (ВПЧ) в канцерогенезе хорошо известна: более чем в 90 % случаев возникновение ВПЧ-положительной плоскоклеточной карциномы ротоглотки обусловлено наличием ВПЧ 16-го генотипа. Большую роль в канцерогенезе этой опухоли, связанной с ВПЧ, играют онкопротеины ВПЧ E6 и E7. Деградация белков-супрессоров p53 под воздействием Е6 приводит к дерегуляции контрольной точки клеточного цикла G2 / M и ингибированию клеточного апоптоза. Онкопротеин E7 ВПЧ связывается с pRb, способствует его деградации и высвобождению фактора транскрипции E2F. Диагностическими тестами для обнаружения ВПЧ являются иммуногистохимический метод определения экспрессии белка p16, полимеразная цепная реакция, гибридизация in situ и секвенирование нового поколения. Иммуногистохимическое исследование (определение экспрессии белка p16) является экономичным и очень специфичным способом выявления вирусной инфекции.

Пациенты с ВПЧ-положительной плоскоклеточной карциномой ротоглотки имеют значительно лучшие ответ на лечение и показатели общей выживаемости, чем пациенты с ВПЧ-отрицательной плоскоклеточной карциномой ротоглотки. Несмотря на то что показатель 5-летней общей выживаемости у больных с ВПЧ-положительной плоскоклеточной карциномой ротоглотки после лечения составляет более 80 %, для некоторых пациентов характерны низкие показатели выживаемости, и, к сожалению, современные методы стратификации риска до сих пор не позволяют выделить данную группу больных. Для поиска решений обозначенных проблем необходимы дальнейшие научные исследования.

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