在鼻窦癌中，关于人乳头瘤病毒（HPV）独立预后角色的证据出现了矛盾。本研究旨在评估临床患者生存是否会受到不同HPV病毒状态的影响，包括HPV阴性、高危型HPV-16和HPV-18（HPV16/18）阳性以及其他高危和低危的HPV病毒亚型。我们从全国癌症数据库中提取了2010年至2017年初次确诊的鼻窦癌患者的数据（N = 12,009），以HPV病变状态为基础的总体生存率作为观察指标。研究中分析了1070例鼻窦癌患者的数据，其中732例（68.4%）为HPV阴性，280例（26.2%）为HPV16/18阳性，40例（3.7%）为其他高危HPV阳性，18例（1.7%）为低危HPV阳性。在确保协变量控制后，我们发现HPV阴性患者的五年总生存率概率最低（0.50），而与HPV阴性患者相比，HPV16/18阳性患者的死亡风险降低了37%（校正风险比为0.63；95%置信区间[CI]为0.48-0.82）。数据还表明，64-72岁和73岁及以上的患者患有的HPV16/18阳性鼻窦癌比40-54岁的患者更低。此外，与非西班牙裔白人患者相比，西班牙裔患者无HPV16/18阳性的鼻窦癌情况发生率提高了2.36倍。这些数据表明，在鼻窦癌患者中，HPV16/18阳性疾病可能比HPV阴性疾病具有明显的生存优势。其他高危和低危HPV亚型的生存率与HPV阴性疾病相似。因此，HPV病毒状态可能是鼻窦癌的一个重要独立预后因素，并可以用于患者的选择和临床决策中。此研究版权归2023年美国癌症学会所有。

There has been conflicting evidence on the independent prognostic role of human papillomavirus (HPV) status in sinonasal cancer. The objective of this study was to assess whether the survival of patients with sinonasal cancer differs based on various HPV statuses, including HPV-negative, positive for the high-risk HPV-16 and HPV-18 (HPV16/18) subtypes, and positive for other high-risk and low-risk HPV subtypes.In this retrospective cohort study, data from the National Cancer Database were extracted from the years 2010-2017 for patients who had primary sinonasal cancer (N = 12,009). The outcome of interest was overall survival based on HPV tumor status.Study included an analytic cohort of 1070 patients with sinonasal cancer who had confirmed HPV tumor status (732 [68.4%] HPV-negative; 280 [26.2%] HPV16/18-positive; 40 [3.7%] positive for other high-risk HPV; and 18 [1.7%] positive for low-risk HPV). HPV-negative patients had the lowest all-cause survival probability at 5 years postdiagnosis (0.50). After controlling for covariates, HPV16/18-positive patients had a 37% lower mortality hazard than HPV-negative patients (adjusted hazard ratio, 0.63; 95% confidence interval [CI], 0.48-0.82). Patients aged 64-72 years (crude prevalence ratio, 0.66; 95% CI, 0.51-0.86) and 73 years and older (crude prevalence ratio, 0.43; 95% CI, 0.31-0.59) presented with lower rates of HPV16/18-positive sinonasal cancer than those aged 40-54 years. In addition, Hispanic patients had a 2.36 times higher prevalence of non-HPV16/18 sinonasal cancer than non-Hispanic White patients.These data suggest that, for patients with sinonasal cancer, HPV16/18-positive disease may confer a significant survival advantage compared with HPV-negative disease. Other high-risk and low-risk HPV subtypes have survival rates similar to the rates for HPV-negative disease. HPV status might be an important independent prognostic factor in sinonasal cancer that could be used in patient selection and clinical decisions.© 2023 American Cancer Society.