Impact of human papilloma virus in patients with oral and oropharyngeal squamous cell carcinomas

Med Clin (Barc). 2019 Mar 1;152(5):174-180. doi: 10.1016/j.medcli.2018.05.015. Epub 2018 Jul 7.
[Article in English, Spanish]

Abstract

Background and objectives: Although there is scientific evidence demonstrating causation of human papilloma virus (HPV) on squamous cell carcinoma of head and neck, its percentage of causality on the anatomic region remains in dispute. This study was developed with the objectives of evaluating the relationship between HPV and oral and oropharyngeal squamous cell carcinomas (OOSCC), and of studying the correlation between HPV detection tests (PCR and p16).

Material and method: Retrospective study of patients treated for OOSCC during 2011, with a follow-up of 6 years. The sample was divided into 2 groups according to HPV positivity, detected by 2 techniques: p16 by immunohistochemistry and PCR. Demographic and clinical variables were analysed using SPSS® 22.0, considering P<.05 to be statistically significant.

Results: We analysed 155 patients affected by OOSCC (mean age of 62.7, where 69% were males). Twenty six cases were p16+ (16.8%) and 19 cases PCR+ (12.3%), The HPV+ tumours were located predominantly in the oropharynx (42.1%, P=.017) and demonstrated the tendency to be more frequent in males, with higher incidence in younger patients, lower in smokers and drinkers, and higher when patients have a greater cervical lymph node involvement at the time of diagnosis. The PCR+ patients had higher survival (P=.024), as did the p16+ (P=.005).

Conclusions: The incidence of HPV in OOSCC is low (12.3%), but the clinical presentation and prognosis of the HPV+ patient differs from the classic smoker and/or drinker, which implies assessing the management of these patients independently. The p16 staining has a great diagnostic capacity to predict HPV (95.5%), although the detection of the HPV genome is still the gold standard technique.

Keywords: Carcinoma de células escamosas; Cáncer oral; Cáncer orofaringe; Epidemiology; Epidemiología; HPV; Human papillomavirus; Oral cancer; Oropharyngeal cancer; PCR; Squamous cell carcinoma; Supervivencia; Survival; VPH; Virus papiloma humano; p16.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Cyclin-Dependent Kinase Inhibitor p16 / analysis
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / virology*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Polymerase Chain Reaction
  • Probability
  • Retrospective Studies
  • Sex Distribution
  • Sex Factors
  • Squamous Cell Carcinoma of Head and Neck / mortality
  • Squamous Cell Carcinoma of Head and Neck / virology*

Substances

  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16