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

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.

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.

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.

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.