{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T06:54:15Z","timestamp":1668581655019},"reference-count":55,"publisher":"Hogrefe Publishing Group","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Praxis"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p> Zusammenfassung. In den vergangenen Jahren konnte auch in der Schweiz eine Zunahme von Plattenepithelkarzinomen im Oropharynx festgestellt werden. Schon seit mehr als zwanzig Jahren wird ein Zusammenhang zwischen einer Infektion mit Hochrisikotypen des humanen Papillomvirus (HR-HPV) und der Entstehung von Oropharynxkarzinomen (OPSCC) vermutet. Vor allem bei j\u00fcngeren Patienten ohne die Risikofaktoren Rauchen und Alkoholkonsum wird eine erh\u00f6hte Pr\u00e4valenz dieser Tumoren festgestellt. HPV-assoziierte Karzinome entstehen haupts\u00e4chlich im lymphatischen Gewebe des Oropharynx und stellen klinisch und molekularbiologisch eine eigenst\u00e4ndige Entit\u00e4t dar. Sie zeigen ein signifikant besseres Therapieansprechen und haben eine bessere Prognose im Vergleich zu den noxenassoziierten Tumoren, unabh\u00e4ngig von der durchgef\u00fchrten Therapie. Vermutet wird eine vergleichbare Tumorentstehung wie beim Zervixkarzinom \u00fcber Vorstufenl\u00e4sionen bis zum invasiven Karzinom. Bisher wurden aber im Pharynx keine HPV-assoziierten Vorstufen gefunden. Das in der Zervix etablierte weltweite Screeningprogramm hat zu einer signifikanten Reduktion der Inzidenz von Zervixkarzinomen gef\u00fchrt, sodass der Anteil HPV-assoziierter Tumoren im Oropharynx die Zahl derer in der Zervix \u00fcberschreiten wird. Seit 2017 ist eine immunhistochemisch nachweisbare \u00dcberexpression des Zellzyklusproteins p16 als Surrogatmarker f\u00fcr HPV ein entscheidender Faktor bei der Tumor-Klassifikation des Oropharynxkarzinoms. Eine klare, international g\u00fcltige Definition eines HPV-assoziierten Tumors fehlt aber bisher. Die alleinige Detektion von HPV-DNA oder der isolierte Einsatz der p16-Immunhistochemie im Tumorgewebe weisen eine ungen\u00fcgende Sensitivit\u00e4t und Spezifit\u00e4t auf. Die Kombination dieser Parameter erh\u00f6ht die Zuverl\u00e4ssigkeit im Vergleich zum Goldstandard RNA. Eine f\u00fcr die Diagnostik valide Alternative ist der serologische Nachweis von Antik\u00f6rpern gegen HPV-Onkoproteine, der sich auch als pr\u00e4diktiver und prognostischer Marker zu bew\u00e4hren scheint. <\/jats:p>","DOI":"10.1024\/1661-8157\/a003484","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T04:00:28Z","timestamp":1594180828000},"page":"697-703","source":"Crossref","is-referenced-by-count":2,"title":["HPV-assoziierte Oropharynxkarzinome: Update zu Diagnose und                     Management"],"prefix":"10.1024","volume":"109","author":[{"given":"Martina A.","family":"Broglie D\u00e4ppen","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Ohren-, Nasen-, Hals- und Gesichtschirurgie,                     Universit\u00e4tsspital Z\u00fcrich"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"101","reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.50.3870"},{"key":"c2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn025"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.36.4596"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2013.12.019"},{"key":"c5","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.05.115"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.78.21.11451-11460.2004"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011201)92:11<2875::AID-CNCR10130>3.0.CO;2-7"},{"key":"c8","volume-title":"The pathology of HPV-related head and neck cancer: implications for the diagnostic pathologist. 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