КлиничесКие реКомендаЦии. диагностиКа и лечение раКа ротоглотКи е.л. чойнзонов, с.о. подвязников, а.у. минкин, а.м. мудунов, р.и. азизян, и.н. пустынский, т.д. таболиновская, в.ж. бржезовский, с.б. алиева Клинические рекомендации подготовлены на основании материалов научно-практической конференции Проблемной комиссии «Опухоли головы и шеи» Научного совета по злокачественным новообразованиям Отделения медицинских наук Российской академии наук и Министерства здравоохранения РФ, посвященной памяти профессора Александра Ильича Пачеса, «Актуальные вопросы диагностики и лечения рака ротоглотки» (25 июня 2015 г., г. Архангельск) 83
The study objective is to evaluate the prevalence of Epstein—Barr virus (EBV), herpes virus, human papillomavirus (HPV), and cytomegalovirus (CMV) infection among patients with cancer of the nasal cavity and paranasal sinuses in the Arkhangelsk Region.Materials and methods. We examined surgical specimens from 100 patients treated in the Arkhangelsk Clinical Oncology Dispensary between 2010 and 2015. Tissue homogenates were used for DNA isolation. DNA amplification with subsequent detection was performed using polymerase chain reaction.Results and conclusion. The 36 % of study participants were infected with EBV; the second most common viral pathogens were CMV and human herpes virus type 6 (HHV-6), both found in 21 % of cases. Monoinfection was observed in less than one-third of patients (20 % — EBV, HPV type 16 — 6 %), whereas the remaining participants had mixed infections: EBV + HHV-6 (2 %), CMV + EBV (5 %), EBV + herpes simplex virus types 1 and 2 (HSV-1,2) (1 %), EBV + CMV + HHV-6 (3 %), HPV type 16 + HSV-1,2 (3 %), and HPV type 6 + HPV type 16 (7 %). None of the patients with stage I cancer had mixed infections, whereas participants with stage II, III, and IV cancer demonstrated mixed infections in 1 %, 11 %, and 9 % of cases respectively.After specific treatment, 11 patients (30.5 %) infected with EBV developed regional metastases and 5 patients (13.9 %) had relapses. All patients simultaneously infected with EBV and HHV-6 had distant metastases. Combination of EBV, CMV, and HHV-6 resulted in relapses in 100 % of cases and distant metastasis in 75 % of cases.
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