The rising incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) necessitates advancements in risk stratification to optimize treatment outcomes and improve the quality of life for patients. Despite its favorable prognosis compared to HPV-negative OPSCC, current clinical staging and biomarkers, such as p16 status, are limited in their ability to distinguish between high- and low-risk patients within HPV-associated OPSCC. This limitation results in the overtreatment of low-risk patients, exposing them to unnecessary toxicity, and the undertreatment of high-risk patients who require more aggressive interventions. This review critically evaluates current stratification methods, including clinical assessments, de-escalation trials, and candidate molecular biomarkers for risk stratification. Emerging approaches such as immune markers, viral genomic integration patterns, and other molecular markers offer promising avenues for enhanced prognostic accuracy. By integrating advanced risk stratification methods, tailored treatment approaches may one day be developed to balance oncologic efficacy with reduced treatment-related morbidity. This review underscores the need for continued research into predictive biomarkers and adaptive treatment strategies to better address the diverse risk profiles of HPV-associated OPSCC patients.
人乳头瘤病毒（HPV）相关口咽鳞状细胞癌（OPSCC）的发病率不断上升，亟需推进风险分层研究以优化治疗结果并改善患者生活质量。尽管相较于HPV阴性OPSCC，HPV相关OPSCC预后较好，但当前临床分期及p16状态等生物标志物在区分HPV相关OPSCC患者高危与低危风险方面存在局限。这种局限性导致低危患者接受过度治疗而承受不必要的毒副作用，而需要更强干预措施的高危患者却面临治疗不足。本文系统评述了当前风险分层方法，包括临床评估、降级治疗试验及候选分子生物标志物。免疫标志物、病毒基因组整合模式及其他分子标志物等新兴方法为提高预后判断准确性提供了新途径。通过整合先进的风险分层方法，未来有望制定个体化治疗方案，在保证肿瘤疗效的同时降低治疗相关并发症。本文强调需要持续研究预测性生物标志物和适应性治疗策略，以更好地应对HPV相关OPSCC患者多样化的风险特征。
肿瘤(癌症)患者之家