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Yuanbo Z, Tianyi L, Xuejing S, Xinpeng L, Jianqun W, Wenxia X, Jingshu G. Using formalin fixed paraffin embedded tissue to characterize the microbiota in p16-positive and p16-negative tongue squamous cell carcinoma: a pilot study. BMC Oral Health 2024; 24:283. [PMID: 38419008 PMCID: PMC10900712 DOI: 10.1186/s12903-024-04051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Tongue squamous cell carcinoma (TSCC) is the most common oral cavity cancer, and p16 immunohistochemistry is an exact and available tool in the prognostic and predictive characterization of squamous cell cancers in the head and neck. Microorganisms have a close relationship with the development of TSCC. However, the association between oral bacteria and p16 status has not been well defined in the case of TSCC. Compared with traditional clinical microbial collection methods, formalin-fixed paraffin-embedded (FFPE) tissue samples have several advantages. METHODS To compare the microbiota compositions between p16-positive and p16-negative patients with TSCC, we performed a small pilot study of microbiological studies of TSCC by paraffin tissue. DNA from FFPE tissue blocks were extracted and microbiomes were profiled by sequencing the 16 S-rRNA-encoding gene (V1-V2/V3-V4/V4 regions). Alterations in the functional potential of the microbiome were predicted using PICRUSt, Tax4Fun, and BugBase. RESULTS A total of 60 patients with TSCC were enrolled in the study, however, some challenges associated with DNA damage in FFPE tissues existed, and only 27 (15 p16-positive and 12 p16-negative) passed DNA quality control. Nevertheless, we have tentatively found some meaningful results. The p16 status is associated with microbiota diversity, which is significantly increased in p16-positive patients compared with p16-negative patients. Desulfobacteria, Limnochordia, Phycisphaerae, Anaerolineae, Saccharimonadia and Kapabacteria had higher abundances among participants with p16-positive. Moreover, functional prediction revealed that the increase of these bacteria may enhance viral carcinogenesis in p16-positive TSCC. CONCLUSIONS Bacterial profiles showed a significant difference between p16-positive TSCC and p16-negative TSCC. These findings may provide insights into the relationship between p16 status and the microbial taxa in TSCC, and these bacteria may provide new clues for developing therapeutic targets for TSCC.
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Affiliation(s)
- Zhan Yuanbo
- Department of Periodontology and Oral Mucosa, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of pathology, Harbin Medical University Cancer Hospital, Harbin Medical University, Heilongjiang, Harbin, China
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liu Tianyi
- Department of Pathology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Song Xuejing
- Harbin Institute of Technology Hospital, Harbin, China
| | - Liu Xinpeng
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wang Jianqun
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xu Wenxia
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Geng Jingshu
- Department of pathology, Harbin Medical University Cancer Hospital, Harbin Medical University, Heilongjiang, Harbin, China.
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Sridharan N, Nagalingam S, Vidhya P, Viswanathan P. Prevalence and diagnostic significance of p16, p53 expression in lichen planus as a potential premalignant lesion in oral squamous cell carcinoma. J Oral Maxillofac Pathol 2024; 28:56-61. [PMID: 38800439 PMCID: PMC11126256 DOI: 10.4103/jomfp.jomfp_427_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/25/2023] [Accepted: 12/06/2023] [Indexed: 05/29/2024] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) is a prevalent malignancy with significant morbidity and mortality. Identifying potential premalignant lesions is crucial for early detection and effective management. Lichen planus (LP), a chronic inflammatory disorder has been associated with an increased risk of developing OSCC. This study aimed to assess the diagnostic importance of p16 and p53 expression in identifying LP as a potential premalignant lesion for OSCC. Materials and Methods A retrospective analysis was conducted on archived tissue samples from patients diagnosed with LP (n = 80) and OSCC (n = 60) between 2017 and 2022. Immunohistochemistry was performed to evaluate p16 and p53 protein expression levels in both LP and OSCC tissues. Clinical data, including patient demographics and lesion characteristics, were collected and correlated with the immunohistochemical findings. Results and Discussion The results revealed a significantly higher prevalence of p16 and p53 expression in LP tissues compared to normal oral mucosa (P < 0.001). Notably, p16 expression was observed in 70% of LP cases, while p53 was detected in 55% of LP cases. Furthermore, a significant association was established between p53 expression and the presence of dysplasia within LP lesions (P = 0.003). This indicates the potential of p53 as a predictive biomarker for malignant transformation in LP. The correlation between p16 and p53 expression levels in LP and OSCC tissues suggests a potential mechanistic link between LP and OSCC development. Conclusion This study underscores the diagnostic importance of p16 and p53 expression as potential markers for identifying LP as a premalignant lesion in the context of OSCC. The elevated prevalence of these markers in LP tissues suggests a potential role in predicting malignant transformation. The findings contribute to a deeper understanding of the molecular pathways underlying OSCC development from LP and emphasize the need for regular monitoring and early intervention in patients diagnosed with LP. Further prospective studies are warranted to validate these findings and to explore the clinical utility of p16 and p53 as biomarkers for predicting OSCC risk in LP patients.
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Affiliation(s)
- Nivethitha Sridharan
- Department of Pathology, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India
| | - Sangeetha Nagalingam
- Department of Pathology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhuranthagam, Tamil Nadu, India
| | - P. Vidhya
- Department of Pathology, Government Medical College and Hospital, Tiruppur, The Tamil Nadu Dr. MGR Medical University, Tamil Nadu, India
| | - P. Viswanathan
- Department of Pathology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhuranthagam, Tamil Nadu, India
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3
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Sandström K, Ehrsson YT, Sellberg F, Johansson H, Laurell G. Loco-Regional Control and Sustained Difference in Serum Immune Protein Expression in Patients Treated for p16-Positive and p16-Negative Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2023; 24:ijms24043838. [PMID: 36835246 PMCID: PMC9961007 DOI: 10.3390/ijms24043838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
The main prognostic factors for patients with head and neck cancer are the tumour site and stage, yet immunological and metabolic factors are certainly important, although knowledge is still limited. Expression of the biomarker p16INK4a (p16) in oropharyngeal cancer tumour tissue is one of the few biomarkers for the diagnosis and prognosis of head and neck cancer. The association between p16 expression in the tumour and the systemic immune response in the blood compartment has not been established. This study aimed to assess whether there is a difference in serum immune protein expression profiles between patients with p16+ and p16- head and squamous cell carcinoma (HNCC). The serum immune protein expression profiles, using the Olink® immunoassay, of 132 patients with p16+ and p16- tumours were compared before treatment and one year after treatment. A significant difference in the serum immune protein expression profile was observed both before and one year after treatment. In the p16- group, a low expression of four proteins: IL12RB1, CD28, CCL3, and GZMA before treatment conferred a higher rate of failure. Based on the sustained difference between serum immune proteins, we hypothesise that the immunological system is still adapted to the tumour p16 status one year after tumour eradication or that a fundamental difference exists in the immunological system between patients with p16+ and p16- tumours.
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Affiliation(s)
- Karl Sandström
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden
- Correspondence:
| | | | - Felix Sellberg
- Department of Immunology, Genetics and Pathology, Uppsala University, 751 85 Uppsala, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden
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4
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Kalavacherla S, Sanghvi P, Lin GY, Guo T. Updates in the management of unknown primary of the head and neck. Front Oncol 2022; 12:991838. [PMID: 36185196 PMCID: PMC9521035 DOI: 10.3389/fonc.2022.991838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
Squamous cell carcinoma (SCC) from an unknown primary tumor (SCCUP) accounts for 2.0%–5.0% of all head and neck cancers. SCCUP presents as enlarged cervical lymph nodes without evidence of a primary tumor upon physical examination. Primary site detection is important to target treatment and avoid treatment-related morbidity. In this review, we discuss updates in SCCUP management. Diagnostic workup should focus on localization of the primary tumor in SCCUP. Initial workup centers on neck biopsy to confirm the presence of SCC. Given the increasing incidence of HPV-related SCC in the oropharynx, HPV testing is crucial. An HPV-positive status can localize the tumor to the oropharynx, a common site for occult tumors. Imaging includes neck CT and/or MRI, and PET/CT. After imaging, panendoscopy, palatine tonsillectomy or diagnostic transoral robotic surgery can facilitate high rates of primary tumor localization. Primary tumor localization influences treatments administered. SCCUP has traditionally been treated aggressively with large treatment fields to all potential disease sites, which can induce weight loss and swallowing dysfunction. As a result, primary localization can reduce radiation fields and provide possible de-escalation to primary surgical management. Advances in intensity-modulated radiation therapy and dose management also have the potential to improve functional outcomes in SCCUP patients. Given the improved prognosis associated with HPV-positive SCCs, HPV tumor status may also inform future treatment de-intensification to reduce treatment-related toxicity.
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Affiliation(s)
- Sandhya Kalavacherla
- School of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Parag Sanghvi
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, CA, United States
| | - Grace Y. Lin
- Department of Pathology, University of California, San Diego, San Diego, CA, United States
| | - Theresa Guo
- Department of Otolaryngology – Head & Neck Surgery, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Theresa Guo,
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Ferreira E Costa R, Leão MLB, Sant'Ana MSP, Mesquita RA, Gomez RS, Santos-Silva AR, Khurram SA, Tailor A, Schouwstra CM, Robinson L, van Heerden WFP, Tomasi RA, Gorrino R, de Prato RSF, Taylor AM, Urizar JMA, de Mendoza ILI, Radhakrishnan R, Chandrashekar C, Choi SW, Thomson P, Pontes HAR, Fonseca FP. Oral Squamous Cell Carcinoma Frequency in Young Patients from Referral Centers Around the World. Head Neck Pathol 2022; 16:755-762. [PMID: 35316511 PMCID: PMC9424469 DOI: 10.1007/s12105-022-01441-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/27/2022] [Indexed: 12/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) commonly affects older patients; however, several studies have documented an increase in its incidence among younger patients. Therefore, it is important to investigate if this trend is also found in different geographic regions. The pathology files of diagnostic and therapeutic institutions from different parts of the globe were searched for OSCC cases diagnosed from 1998 to 2018. Data regarding the sex, age, and tumor location of all cases, as well as the histologic grade and history of exposure to risk habits of cases diagnosed as OSCC in young patients (≤ 40 years of age) were obtained. The Chi-square test was used to determine any increasing trend. A total of 10,727 OSCC cases were identified, of which 626 cases affected young patients (5.8%). Manipal institution (India) showed the highest number of young patients (13.2%). Males were the most affected in both age groups, with the tongue and floor of the mouth being the most affected subsites. OSCC in young individuals were usually graded as well or moderately differentiated. Only 0.9% of the cases occurred in young patients without a reported risk habit. There was no increasing trend in the institutions and the period investigated (p > 0.05), but a decreasing trend was observed in Hong Kong and the sample as a whole (p < 0.001). In conclusion there was no increase of OSCC in young patients in the institutions investigated and young white females not exposed to any known risk factor represented a rare group of patients affected by OSCC.
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Affiliation(s)
- Rafael Ferreira E Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Marina Luiza Baião Leão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Maria Sissa Pereira Sant'Ana
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Artysha Tailor
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ciska-Mari Schouwstra
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Romina Gorrino
- Department of Pathology, Dental School, National University of Córdoba, Córdoba, Argentina
| | | | | | | | | | - Raghu Radhakrishnan
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Chetana Chandrashekar
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil.
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Early-onset oral cancer as a clinical entity: aetiology and pathogenesis. Int J Oral Maxillofac Surg 2022; 51:1497-1509. [PMID: 35487818 DOI: 10.1016/j.ijom.2022.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 01/24/2022] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most important medical and socio-economic problems in many of the developed countries worldwide, due to the high mortality. The incidence of OSCC among individuals under 45 years of age is growing every year; however, the aetiological factors and pathogenetic mechanisms are poorly understood. This review summarizes the available information regarding clinicopathological features, extrinsic and intrinsic aetiological factors, and the molecular and immune landscape of early-onset OSCC. This cancer shows high recurrence rates and is not associated with the aetiological factors specific to adult-onset OSCC. Young adults with OSCC are not infected with human papillomavirus and rarely consume alcohol or tobacco, but more frequently use smokeless tobacco. Data from single studies indicate the hereditary nature of early-onset OSCC: the KIR2DL1+-HLA-C2+ genotype and MMP-1 2 G allele are frequently detected in young patients. Early-onset OSCC shows specific genetic, epigenetic, transcriptomic, and proteomic changes. The tumour microenvironment in early-onset OSCC is tolerogenic rather than immunogenic. All of the data suggest that OSCC in young patients is a separate clinical entity with a specific aetiology and pathogenesis. Further studies are needed to reveal the causes and molecular targets of early-onset OSCC for the development of preventive and therapeutic strategies.
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Csurgay K, Zalatnai A, Benczik M, Csomó BK, Horváth F, Lőrincz Á, Komlós G, Németh Z. A Study of Prognostic Factors in Young Patients With Non-HPV Oral Cancer in Central Europe. Pathol Oncol Res 2021; 27:1609991. [PMID: 35002542 PMCID: PMC8728875 DOI: 10.3389/pore.2021.1609991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
The etiological factors of squamous cell carcinomas of the head and neck have been well known for a long time. It is also well known that the incidence of oral cancer diagnosed in younger patients is on the rise. Due to the young age of these patients, the increase in the number of these cases and the fact that many of them neither smoke nor drink alcohol it has been suggested that other factors might be at play in the carcinogenesis of oral cancer. Thus, along the classic etiological factors of smoking and alcohol abuse certain molecular marker anomalies and the human papilloma virus (HPV) have emerged as potential factors. The aim of the present study is to verify the potential prognostic factors and to map the differences in biomarker expression between the young and the old patient groups. In the present study the immunohistochemical profile of samples obtained from oral squamous cell carcinomas was studied and compared with various clinico-pathological parameters. In 88 samples the expressions of p16, p53, Ki67, EGFR were studied with a tissue microarray technique under standard reaction conditions as well as the detection and typing of HPV infection with the Full Spectrum HPV DNA method. The biomarker expression profile of young patients with oral squamous cell carcinoma was compared to that of older patients (above 50). A significant difference was found between the immunohistochemical profile of the young and old patient groups in p16, Ki67 expression. The overall survival and progression free survival were influenced by p16 expression in young age.
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Affiliation(s)
- Katalin Csurgay
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
| | - Attila Zalatnai
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Márta Benczik
- Synlab Genoid Molecular Diagnostic Laboratory, Budapest, Hungary
| | - Benedek Krisztián Csomó
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Ferenc Horváth
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Ádám Lőrincz
- Department of Oral Surgery, King’s College, London, United Kingdom
| | - György Komlós
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
| | - Zsolt Németh
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
- *Correspondence: Zsolt Németh,
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Low Frequency of Human Papillomavirus in Strictly Site-Coded Oral Squamous Cell Carcinomas, Using the Latest NHI/SEER-ICD Systems: A Pilot Observational Study and Critical Review. Cancers (Basel) 2021; 13:cancers13184595. [PMID: 34572821 PMCID: PMC8472531 DOI: 10.3390/cancers13184595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 01/09/2023] Open
Abstract
Simple Summary The incidence of oropharyngeal squamous cell carcinomas (OPSCCs) has increased in the last decades, and this seems to be correlated to the infectious epidemiological trend of human papillomavirus (HPV). The prevalence of HPV-positive OPSCCs is approximately 70%, with involvement mainly of the tonsillar area. On the role of HPV in oral squamous cell carcinoma (OSCC), very few studies have investigated the prevalence of HPV in strictly site-codified OSCC, excluding the base of the tongue as distinct oropharyngeal entity. As a result, an inappropriate estimation of HPV infection in OSCC has been observed. We investigated HPV status, using a combination of detection methods, in a sample of 40 subjects with OSCC coded by the latest site classifications. Moreover, we performed a critical review of the studies with the same outcomes. The main finding of our investigation was a low frequency of HPV-positive OSCC, suggesting no significant HPV role in strictly oral carcinogenesis. Abstract The aim of this study was to evaluate HPV status in oral squamous cell carcinoma (OSCC), as coded by the latest classifications and applying a combination of detection methods used in clinical practice. Forty-two patients with suspect OSCC were consecutively recruited. Patients underwent an incisional biopsy for histological OSCC diagnosis and HPV identification by PCR DNA and p16 IHC. All lesions were coded by the latest ICD-0-3.2 site/histology classifications, as proposed for OSCC by the National Cancer Institute Surveillance, Epidemiology and End Results Programs. Moreover, a comparative analysis review, critically evaluated by the same site-coded systems and HPV detection methods, was performed. In 40 confirmed cases of OSCC, the frequency of HPV infection was 10% (4/40). Among positive patients, two cases were PCR DNA/p16 IHC positive (high-risk HPV 51, high-risk HPV 67), two cases were PCR DNA positive/p16 IHC negative (high-risk HPV 31 + 68, high-risk HPV 66). Applying the latest site coding systems for OSCC, the frequency of HPV infection in this study and in similar, reviewed investigations was low (from 3.3% to 12.5%). These results suggested no significant HPV role in oral carcinogenesis, particularly where an updated site-coded classification of OSCCs (categorically excluding the base of the tongue) had been performed.
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Molimard C, L’Huillier V, Overs A, Soret C, Algros MP, Mougin C, Guenat D, Mauvais O, Prétet JL. Human papillomavirus DNA and p16 expression in head and neck squamous cell carcinoma in young French patients. J Int Med Res 2021; 49:3000605211022534. [PMID: 34232797 PMCID: PMC8267044 DOI: 10.1177/03000605211022534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 05/13/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) is a risk factor for head and neck squamous cell carcinoma (HNSCC), which is currently increasing worldwide. We evaluated the prevalence of HPV DNA and p16 expression in HNSCC patients age <45 years compared with patients aged ≥45 years. METHODS Thirty-nine patients aged <45 years who presented at Besançon University Hospital with HNSCC since 2005 were included in this retrospective study. HPV DNA was detected by HPV genotyping and p16 expression was determined by immunohistochemistry using paraffin-embedded tissues. A matched-group of 38 patients aged ≥45 years from Besançon University Hospital was included. RESULTS The overall prevalence of HPV infection was 11.7%. HPV16 was the only genotype detected in 4/39 and 5/38 patients, and p16 was expressed in 6/39 and 4/38 patients aged <45 years and ≥45 years, respectively. CONCLUSIONS HPV-positivity and p16 expression were similar in both age groups. The results suggest that p16 immunohistochemistry may provide a prognosis biomarker for all HNSCCs, not only oropharyngeal cancers, and this should be addressed in large clinical trials.
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Affiliation(s)
- Chloé Molimard
- Centre National de Référence Papillomavirus, CHU Besançon, Besançon, France
- Service d'Anatomie et Cytologie Pathologiques, CHU Besançon, Besançon, France
| | | | - Alexis Overs
- Laboratoire de Biochimie, CHU Besançon, Besançon, France
| | - Christine Soret
- Centre National de Référence Papillomavirus, CHU Besançon, Besançon, France
| | - Marie-Paule Algros
- Service d'Anatomie et Cytologie Pathologiques, CHU Besançon, Besançon, France
| | - Christiane Mougin
- Centre National de Référence Papillomavirus, CHU Besançon, Besançon, France
| | - David Guenat
- Centre National de Référence Papillomavirus, CHU Besançon, Besançon, France
- EA3181, UFC, Université Bourgogne-Franche-Comté, LabEx LipSTIC ANR-11-LABEX-0021, Besançon, France
| | - Olivier Mauvais
- Service d'Oto-Rhino-Laryngologie, CHU Besançon, Besançon, France
| | - Jean-Luc Prétet
- Centre National de Référence Papillomavirus, CHU Besançon, Besançon, France
- EA3181, UFC, Université Bourgogne-Franche-Comté, LabEx LipSTIC ANR-11-LABEX-0021, Besançon, France
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10
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Li P, Fang Q, Yang Y, Chen D, Du W, Liu F, Luo R. Survival Significance of Number of Positive Lymph Nodes in Oral Squamous Cell Carcinoma Stratified by p16. Front Oncol 2021; 11:545433. [PMID: 33747901 PMCID: PMC7969991 DOI: 10.3389/fonc.2021.545433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/08/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives: To analyze the significance of the number of positive lymph nodes in oral squamous cell carcinoma (SCC) stratified by p16. Methods: A total of 674 patients were retrospectively enrolled and divided into 4 groups based on their number of positive lymph nodes (0 vs. 1–2 vs. 3–4 vs. ≥5). The Kaplan-Meier method was used to calculate the disease-free survival (DFS) and disease-specific survival (DSS) rates. Cox model was used to evaluate the independent risk factor. Results: p16 showed positivity in 85 patients with a rate of 12.6%. In patients with p16 negativity, the 5-year DFS rates were 52%, 39%, and 21% in patients with 0, 1–2, and 3–4 positive lymph nodes, respectively, in patients with ≥5 positive lymph nodes, all patients developed recurrence within 2 years after operation, the difference was significant; the 5-year DSS rates were 60, 38, and 18% in patients with 0, 1–2, and 3–4 positive lymph nodes, respectively, in patients with ≥5 positive lymph nodes, all patients died within 4-years after operation. The difference was significant. In p16 positivity patients, the 3-year DFS rates were 41% and 17% in patients with 0–2 and ≥3 positive lymph nodes, respectively, the difference was significant; the 3-year DSS rates were 84 and 46% in patients with 0–2 and ≥3 positive lymph nodes, the difference was significant. Conclusions: The number of positive lymph nodes is significantly associated with the survival in oral SCC, its survival effect is not affected by p16 status.
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Affiliation(s)
- Peng Li
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Qigen Fang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yanjie Yang
- Department of Oral Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Defeng Chen
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Wei Du
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Fei Liu
- Department of Oral Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruihua Luo
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
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11
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Chemokine-like factor-like MARVEL transmembrane domain-containing family in autoimmune diseases. Chin Med J (Engl) 2021; 133:951-958. [PMID: 32195671 PMCID: PMC7176445 DOI: 10.1097/cm9.0000000000000747] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The chemokine-like factor (CKLF)-like MARVEL transmembrane domain-containing family (CMTM) is widely expressed in the immune system. Abnormal expression of CMTM is associated with the development of various diseases. This article summarizes the relevant research on the role of the CMTM family in immune disorders. This information will increase our understanding of pathogenesis and identify promising targets for the diagnosis and treatment of autoimmune diseases. The CMTM family is highly expressed in peripheral blood mononuclear cells. CKLF1 may be involved in the development of arthritis through its interaction with C-C chemokine receptor 4. CKLF1 is associated with the pathogenesis of lupus nephritis and psoriasis. Both CMTM4 and CMTM5 are associated with the pathogenesis of systemic lupus erythematosus. CMTM1, CMTM2, CMTM3, and CMTM6 play a role in rheumatoid arthritis, systemic sclerosis, Sjögren syndrome, and anti-phospholipid syndrome, respectively. The CMTM family has been implicated in various autoimmune diseases. Further research on the mechanism of the action of CMTM family members may lead to the development of new treatment strategies for autoimmune diseases.
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12
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Schneider K, Jakobsen KK, Jensen JS, Wessel I, Christensen A, Specht L, Lelkaitis G, Mirian C, Buchwald CV, Grønhøj C. Impact of p16-overexpression on overall and progression-free survival outcomes in oral cavity squamous cell carcinomas: A semi-national, population-based study. Oral Oncol 2020; 111:105031. [PMID: 33069060 DOI: 10.1016/j.oraloncology.2020.105031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/26/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Human papillomavirus infection and p16-overexpression is a principal cause and favorable prognostic factor for oropharyngeal squamous cell carcinomas but the value as prognostic marker in oral cavity squamous cell carcinomas (OSCC) is undetermined. MATERIALS AND METHODS All patients diagnosed with OSCC in Eastern Denmark in the period 2008-2014 were enrolled. Survival estimates were evaluated as overall survival (OS) and progression free survival (PFS) by Kaplan-Meier survival curves and multivariate Cox-regression analyses. RESULTS We included 575 patients from which 13% (n = 69) had p16-positive tumors. The 5-year OS were 55% and 62% for the p16-negative and p16-positive patients, respectively, and the 5-year PFS were 48% and 50%. In a multivariate survival analysis, p16-positivity showed no significant influence on OS (HR: 1.06 [0.67-1.70], p = 0.79) and PFS (HR: 1.11 [0.76-1.63], p = 0.58). CONCLUSION In this population-based cohort of non-selected OSCC patients, we found no difference in survival outcomes when stratified on p16-overexpression status.
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Affiliation(s)
- Katrine Schneider
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark.
| | - Kathrine K Jakobsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Jakob S Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Anders Christensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Giedrius Lelkaitis
- Department of Pathology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Christian Mirian
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Christian V Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark
| | - Christian Grønhøj
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, University of Copenhagen, Denmark.
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13
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Girardi FM, Wagner VP, Martins MD, Abentroth AL, Hauth LA. Prevalence of p16 expression in oropharyngeal squamous cell carcinoma in southern Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:681-691. [PMID: 32981865 DOI: 10.1016/j.oooo.2020.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/16/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Our aim was to evaluate the prevalence of human papillomavirus (HPV)-positive tumors in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) at a single center in southern Brazil and determine the short-term prognostic factors in this sample. STUDY DESIGN Ninety-one consecutive patients with newly diagnosed primary OPSCC between January 2017 and December 2019 were retrospectively included. Demographic, clinical, pathologic, and survival data were collected. HPV status was determined by using p16 immunohistochemistry. RESULTS The overall prevalence of HPV-positive (HPV+) OPSCC was 20.9%. Patients with HPV+ tumors presented a nodal metastasis as the first clinical sign (P = .02); reported less alcohol (P < .001) and tobacco use (P < .001); exhibited lower tumor stages (P < .001) and higher microscopic grades (P = .01); and had higher chances of having resectable tumors (P = .008). p16-negative status (P = .01); unresectable/inoperable tumors (P < .001); presence of nodal metastasis (P = .005); and higher American Joint Committee on Cancer (AJCC) stage (P = .002) were significantly associated with worse disease-specific survival. CONCLUSIONS The prevalence of HPV+ OPSCC in southern Brazil is relatively low, and p16-positive status was associated with Better prognosis. Higher AJCC stage, nodal metastasis, and unresectability/inoperability were associated with the highest hazard ratios for death resulting from OPSCC.
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Affiliation(s)
| | - Vivian P Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Medicine, Porto Alegre Clinics Hospital (HCPA/UFRGS), Porto Alegre, RS, Brazil
| | | | - Luiz Alberto Hauth
- Integrated Oncology Center of Ana Nery Hospital, Santa Cruz do Sul, RS, Brazil
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14
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Dougherty MI, Dougherty W, Kain JJ, Hughley BB, Shonka DC, Fedder KL, Jameson MJ. Non-HPV-Related Head and Neck Squamous Cell Carcinoma in a Young Patient Cohort. EAR, NOSE & THROAT JOURNAL 2020; 100:1101S-1106S. [PMID: 32584613 DOI: 10.1177/0145561320935839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Head and neck squamous cell carcinoma (HNSCC) is rare in patients younger than 40 years. Many practitioners suspect HNSCC is a more aggressive disease in this age group, and perhaps increasing in incidence; however, there are scant and conflicting data to support this assertion. We sought to compare outcomes for young patients with non-human papillomavirus (HPV)-related HNSCC to those of older patients. METHODS A retrospective chart review of patients with HNSCC treated from 2004 to 2016 at 2 tertiary referral centers. Patients aged 18 to 40 with p16-negative HNSCC were included in the young patient cohort (n = 59). A randomly selected stage- and subsite-matched cohort aged 55 to 65 was analyzed for comparison (n = 114). RESULTS When considering all patients with HNSCC, patients younger than 40 were more likely to have oral tongue cancer (62.7%) compared to patients age 55 to 65 (16.9%). When an older patient cohort was stage- and subsite-matched to the young patient cohort, there were more never smokers (49.2% vs 17.5% of older patients, P < .01) and females (40.7% vs 24.6% of older patients, P = .028) in the young patient group. The young patient cohort had better average overall survival than the older group (14.4 vs 8.1 years, respectively, P = .02), but similar average disease-free survival (6.2 years vs 6.6 years, respectively, P = .67); 50.9% of young patients had tumors with adverse histologic features versus 42.0% of older patients (P = .28). The young patients demonstrated a superior average conditional survival after recurrence (9.8 years vs 3.2 years for older patients, P < .01). CONCLUSIONS Despite the limitations of study design, these data suggest that young patients who develop non-HPV-related HNSCC tend to have similarly aggressive disease, but longer overall survival and better survival after recurrence. These findings may be attributable to better overall health as evidenced by fewer comorbidities.
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Affiliation(s)
- Michael I Dougherty
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - William Dougherty
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Joshua J Kain
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brian B Hughley
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David C Shonka
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Katherine L Fedder
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA
| | - Mark J Jameson
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, USA
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15
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Special Issue about Head and Neck Cancers: HPV Positive Cancers. Int J Mol Sci 2020; 21:ijms21093388. [PMID: 32403287 PMCID: PMC7246980 DOI: 10.3390/ijms21093388] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 12/15/2022] Open
Abstract
The oropharynx has become the leading primary site for Human Papilloma Virus (HPV)-associated head and neck cancer. HPV positive oropharyngeal squamous cell carcinoma (HPV+ OSCC) has emerged as an epidemic not easily recognized by many physicians, resulting in delays in diagnosis and management. HPV+ OSCC traditionally refers to younger, healthier patients with high economic status and high-risk sexual behavior and is related to improved prognosis. De-intensification strategies are being evaluated in ongoing clinical trials and if validated, might help spare severe morbidity associated with current cisplatin-based chemoradiotherapy, which is the standard of care for all patients with locally advanced head and neck cancer. On the other hand, whether HPV status represents an important prognostic factor for non-oropharyngeal sites remains to be elucidated.
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16
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A Molecular Implicatory Propositioning Roles for Human Cytomegalovirus and P16 Gene Expression in Oral Squamous Cellular Carcinogenesis. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.4.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Choi G, Song JS, Choi SH, Nam SY, Kim SY, Roh JL, Lee BK, Cho KJ. Comparison of Squamous Cell Carcinoma of the Tongue between Young and Old Patients. J Pathol Transl Med 2019; 53:369-377. [PMID: 31602967 PMCID: PMC6877439 DOI: 10.4132/jptm.2019.09.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/16/2019] [Indexed: 12/20/2022] Open
Abstract
Background The worldwide incidence of squamous cell carcinoma of the tongue (SCCOT) in young patients has been increasing. We investigated clinicopathologic features of this unique population and compared them with those of SCCOT in the elderly to delineate its pathogenesis. Methods We compared clinicopathological parameters between patients under and over 45 years old. Immunohistochemical assays of estrogen receptor, progesterone receptor, androgen receptor, p53, p16, mdm2, cyclin D1, and glutathione S-transferase P1 were also compared between them. Results Among 189 cases, 51 patients (27.0%) were under 45 years of age. A higher proportion of women was seen in the young group, but was not statistically significant. Smoking and drinking behaviors between age groups were similar. Histopathological and immunohistochemical analysis showed no significant difference by age and sex other than higher histologic grades observed in young patients. Conclusions SCCOT in young adults has similar clinicopathological features to that in the elderly, suggesting that both progress via similar pathogenetic pathways.
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Affiliation(s)
- Gyuheon Choi
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Ho Choi
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Yoon Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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18
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Li H, Torabi SJ, Yarbrough WG, Mehra S, Osborn HA, Judson B. Association of Human Papillomavirus Status at Head and Neck Carcinoma Subsites With Overall Survival. JAMA Otolaryngol Head Neck Surg 2019; 144:519-525. [PMID: 29801040 DOI: 10.1001/jamaoto.2018.0395] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance Data are limited on the prognostic value of human papillomavirus (HPV) status for head and neck carcinoma subsites. Objective To determine whether HPV positivity at each head and neck subsite is associated with improved overall survival. Design, Setting, and Participants This retrospective population-based cohort study used the National Cancer Database to identify patients diagnosed with head and neck squamous cell carcinomas from January 1, 2010, to December 31, 2014. Patients were classified according to the location of their primary malignancy into 1 of the 6 main subsites of the upper aerodigestive tract: oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, and sinonasal tract. Patients were also classified by their HPV status. Data collection for this study took place from January 1, 2010, to December 31, 2014. Data analysis was conducted from August 1, 2017, to September 30, 2017. Main Outcomes and Measures The difference in 5-year overall survival between patients with HPV-positive status and those with HPV-negative status in various head and neck carcinoma subsites; the role of HPV status in an unadjusted Cox multivariate regression model. Results Of the 175 223 total number of patients identified (129 634 [74.0%] male; 45 589 [26.0%] female; mean [SD] age, 63.1 [11.9] years), 133 273 (76.1%) were ineligible and 41 950 (23.9%) were included in the sample. This sample included 16 644 patients (39.7%) with HPV-positive tumors and 25 306 (60.3%) with HPV-negative tumors. Patients with an HPV-positive status were more likely to be younger, be white, be male, present with local T category tumors, and have poor differentiation on histologic examination. HPV-positive status was associated with survival at 4 tumor subsites: oral cavity (hazard ratio [HR], 0.76; 95% CI, 0.66-0.87), oropharynx (HR, 0.44; 95% CI, 0.41-0.47), hypopharynx (HR, 0.59; 95% CI, 0.45-0.77), and larynx (HR, 0.71; 95% CI, 0.59-0.85). The HPV status was the greatest factor in survival outcome between the HPV-positive and -negative cohorts at the oropharynx subsite (77.6% vs 50.7%; survival difference, 26.9%; 95% CI, 25.6%-28.2%) and hypopharynx subsites (52.2% vs 28.8%; survival difference, 23.4%; 95% CI, 17.5%-29.3%). For the nasopharynx (HR, 1.03; 95% CI, 0.75-1.42) and sinonasal tract (HR, 0.63; 95% CI, 0.39-1.01) subsites, HPV-positive status was not an independent prognostic factor. Conclusions and Relevance Human papillomavirus positivity was associated with improved survival in 4 subsites (oropharynx, hypopharynx, oral cavity, and larynx), and the largest survival difference was noted in the oropharynx and hypopharynx subsites. In the nasopharynx and sinonasal tract subsites, HPV positivity had no association with overall survival. Given these results, routine testing for HPV at the oropharynx, hypopharynx, oral cavity, and larynx subsites may be warranted.
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Affiliation(s)
- Hong Li
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Sina J Torabi
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Wendell G Yarbrough
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut.,Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Saral Mehra
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
| | - Heather A Osborn
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
| | - Benjamin Judson
- Yale University School of Medicine, New Haven, Connecticut.,Section of Otolaryngology, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
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Vidal Loustau AC, Dulguerov N, Curvoisier D, McKee T, Lombardi T. Low prevalence of HPV‐induced oral squamous cell carcinoma in Geneva, Switzerland. Oral Dis 2019; 25:1283-1290. [DOI: 10.1111/odi.13084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Ana C. Vidal Loustau
- Department of Surgery, Faculty of Medicine, Division of Oral Maxillofacial Surgery, Oral Maxillofacial Pathology Unit Geneva University Hospitals Geneva Switzerland
| | - Nicolas Dulguerov
- Department of Oto‐Rhino‐Laryngology – Head and Neck Surgery, Faculty of Medicine Geneva University Hospitals Geneva Switzerland
| | - Delphine Curvoisier
- Department of Surgery, Faculty of Medicine, Biostatistician, Division of Oral and Maxillofacial Surgery Geneva University Hospitals Geneva Switzerland
| | - Thomas McKee
- Faculty of Medicine, Division of Clinical Pathology Geneva University Hospitals Geneva Switzerland
| | - Tommaso Lombardi
- Department of Surgery, Faculty of Medicine, Division of Oral Maxillofacial Surgery, Oral Maxillofacial Pathology Unit Geneva University Hospitals Geneva Switzerland
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20
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Panarese I, Aquino G, Ronchi A, Longo F, Montella M, Cozzolino I, Roccuzzo G, Colella G, Caraglia M, Franco R. Oral and Oropharyngeal squamous cell carcinoma: prognostic and predictive parameters in the etiopathogenetic route. Expert Rev Anticancer Ther 2019; 19:105-119. [PMID: 30582397 DOI: 10.1080/14737140.2019.1561288] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Oral and oropharyngeal squamous cell carcinoma (OSCC and OPSCC) represents an increasing problem in the global public health. Indeed, squamous cell carcinoma is the most frequent malignancy in oral cavity and 1 of the 10 most common cancers worldwide. According to the most recent GLOBOCAN estimate in Europe between 2012 and 2015, there was an overall increasing incidence and mortality for oral cancer, mostly HPV-related in the oropharyngeal region with evidence of significant differences from the prognostic and therapeutic point of view. Areas covered: Until now, the management of the patients is based on classical histologic parameters such as TNM and tumor grading, but new molecular and cell markers have been investigated to improve patients' treatment and survival. Therefore, there is a need for new biomarkers characterizing the cancer diversity, with the consequent possibility of patient stratification for specific treatment. Expert commentary: This review aims to discuss some of the most relevant and novel genetic, epigenetic, and histological prognostic biomarkers in oral cancer, highlighting the main differences between HPV-unrelated oral squamous cell carcinoma (OSCC) and HPV-related oropharyngeal squamous cell carcinoma (OPSCC) that may aid in stratifying prognostic subgroups and rationalizing treatment decisions.
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Affiliation(s)
- Iacopo Panarese
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Gabriella Aquino
- b Pathology Unit , Istituto dei Tumori 'Fondazione G. Pascale', IRCCS , Naples , Italy
| | - Andrea Ronchi
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Francesco Longo
- c Head and Neck Surgery Unit , Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale", IRCCS , Naples , Italy
| | - Marco Montella
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Immacolata Cozzolino
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Giuseppe Roccuzzo
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Giuseppe Colella
- d Maxillo-Facial Unit, Multidisciplinary Department of Medical, Surgical and Dental Specialties , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
| | - Michele Caraglia
- e Department of Precision Medicine , University of Campania "L. Vanvitelli" , Naples , Italy
| | - Renato Franco
- a Pathology Unit, Mental and Physical Health and Preventive Medicine Department , Università degli Studi della Campania 'Luigi Vanvitelli' , Naples , Italy
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Miller C, Shay A, Tajudeen B, Sen N, Fidler M, Stenson K, Gattuso P, Al-Khudari S. Clinical features and outcomes in young adults with oral tongue cancer. Am J Otolaryngol 2019; 40:93-96. [PMID: 30472130 DOI: 10.1016/j.amjoto.2018.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate outcomes and survival in young patients with oral tongue cancer (OTC). METHODS Retrospective chart review of patients aged 18-40 with OTC treated between 2000 and 2016. Tumor characteristics of p16 expression, perineural invasion (PNI), and lymph-vascular invasion (LVI) were evaluated. Recurrence-free (RFS) and overall survival (OS) data were analyzed according to Kaplan-Meier method with univariate analysis. RESULTS A total of 23 patients were identified: 12 with early stage disease (ESD, stage I), and 11 with advanced stage disease (ASD, stage III or IV), (17 men and 6 women). Mean age at presentation was 34.5 years (±5 months) and mean follow-up was 46.6 months. For all patients, 5-year RFS was 62% and OS 66%. RFS for ESD was 73% and ASD 25% (log rank p = 0.011). OS for ESD was 100% and ASD 55% (log rank p = 0.012). 22% indicated tobacco use >5 pack-years and 9% heavy alcohol use. Factors associated with worse OS were neck disease (log rank p = 0.073), positive margins (log rank p = 0.001), and LVI (log rank p = 0.002). Factors associated with worse RFS were chemotherapy or radiation therapy prior to surgery (log rank p = 0.002), neck disease (log rank p = 0.047), positive margins (log rank p = 0.039), and PNI (log rank p = 0.001). Expression of p16 was observed in five cases and was not significantly associated with OS or RFS. CONCLUSION In young patients with OTC, factors associated with worse outcomes are similar to known predictors in older patients. Expression of p16 was not statistically associated with improved OS. OS in patients with ESD was excellent (100%), and significantly worse for ASD.
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Affiliation(s)
- Courtney Miller
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Aryan Shay
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Bobby Tajudeen
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Neilayan Sen
- Department of Radiation Oncology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Mary Fidler
- Department of Medicine, section of Medical Oncology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Kerstin Stenson
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, 1653 w congress pkwy, Chicago, IL 60612, United States of America
| | - Samer Al-Khudari
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, 1611 W. Harrison St., Suite 550, Chicago, IL 60612, United States of America.
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Mohideen K, Krithika C, Jeddy N, Bharathi R, Thayumanavan B, Sankari SL. Meta-analysis on risk factors of squamous cell carcinoma of the tongue in young adults. J Oral Maxillofac Pathol 2019; 23:450-457. [PMID: 31942130 PMCID: PMC6948024 DOI: 10.4103/jomfp.jomfp_118_19] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Tongue squamous cell carcinoma (TSCC) generally affects the older age group exposed to tobacco for an extended period. However, recent research points out that there is an increased incidence of TSCC in the younger age group without any traditional risk factors making TSCC as a distinct biological entity in this group. This study aims to assess the prevalence and risk factors of tongue carcinoma in the younger group of patients. This article included studies that addressed the TSCC involving young patients and that which are PubMed indexed. Initially, 390 articles were considered; but after refined evaluation, 123 articles had their titles and abstracts matching to this present work. After the extraction of the case reports, review articles and the articles without the assessment of the parameter of harmful habits, we have included only 23 articles in the sample matching the title. The statistical analysis was formed by using chi-square tests using IBM SPSS ver. 20.0. The cohort of the younger population in these studies was mostly in the 35- to the 45-year age group. The majority of reports (64%) classified the patients below 40 years of age as a young group. Though male predominance is reported to be 55%, female patients are also more affected (40%) in the younger age group compared with, the more typical and usual group of head and neck carcinoma patients. TSCC in older adults predominantly reported in tobacco users (70%) whereas in young adults, TSCC was associated with a higher incidence in nonsmokers (53%); the causes of these cancers in young adults remain unclear. The identification of the potential risk factors aside from traditional factors is vital to control the incidence of TSCC in young patients.
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Affiliation(s)
- Khadijah Mohideen
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Chennai, Tamil Nadu, India
| | - C Krithika
- Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nadeem Jeddy
- Department of Oral Pathology and Microbiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Bharathi
- Department of Oral Pathology and Microbiology, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Thayumanavan
- Department of Oral Pathology and Microbiology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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23
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Campbell BR, Netterville JL, Sinard RJ, Mannion K, Rohde SL, Langerman A, Kim YJ, Lewis JS, Lang Kuhs KA. Early onset oral tongue cancer in the United States: A literature review. Oral Oncol 2018; 87:1-7. [PMID: 30527223 PMCID: PMC7039330 DOI: 10.1016/j.oraloncology.2018.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 12/11/2022]
Abstract
The incidence of early onset oral tongue squamous cell carcinoma (OTC) has been increasing in the United States, and no clear etiology has been identified. Studies on this topic have generally been small and presented varied results. The goal of this review is to analyze and synthesize the literature regarding early onset OTC risk factors, outcomes, and molecular analyses within the US. To date, studies suggest that early onset OTC patients tend to have less heavy cigarette use than typical onset patients, but there may be an association between early onset OTC and smokeless tobacco (chewing tobacco and snuff) use. Early onset OTC is associated with similar or possibly improved survival compared to typical onset OTC. There has been no evidence to support a significant role for human papillomavirus in development of early onset OTC. Further research with larger cohorts of these patients is needed to better characterize this disease entity.
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Affiliation(s)
- Benjamin R Campbell
- Vanderbilt University School of Medicine, 1161 21st Ave S #D3300, Nashville, TN 37232, USA.
| | - James L Netterville
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Robert J Sinard
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Kyle Mannion
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Sarah L Rohde
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Alexander Langerman
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - Young J Kim
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA.
| | - James S Lewis
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA; Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Krystle A Lang Kuhs
- Vanderbilt University Medical Center, Department of Otolaryngology, 1215 21st Ave S, Nashville, TN 37232, USA; Vanderbilt University Medical Center, 2525 West End Ave, Suite 300, Nashville, TN, 37203, USA.
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24
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Valls-Ontañón A, Hernández-Losa J, Somoza Lopez de Haro R, Bellosillo-Paricio B, Ramón Y Cajal S, Bescós-Atín C, Munill-Ferrer M, Alberola-Ferranti M. Impact of human papilloma virus in patients with oral and oropharyngeal squamous cell carcinomas. Med Clin (Barc) 2018; 152:174-180. [PMID: 30777194 DOI: 10.1016/j.medcli.2018.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/10/2018] [Accepted: 05/17/2018] [Indexed: 01/23/2023]
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.
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Affiliation(s)
- Adaia Valls-Ontañón
- Departamento de Cirugía Oral y Maxilofacial, Hospital Vall d'Hebron, Barcelona, España.
| | - Javier Hernández-Losa
- Servicio de Anatomía Patológica, Hospital Vall d'Hebron, Barcelona, España; Grupo de Patología Molecular Translacional, Institut de Recerca, Hospital Vall d'Hebron, Barcelona, España; Centro de Investigación Biomedica en Red CIBERONC, Barcelona, España
| | - Rosa Somoza Lopez de Haro
- Grupo de Patología Molecular Translacional, Institut de Recerca, Hospital Vall d'Hebron, Barcelona, España
| | | | - Santiago Ramón Y Cajal
- Servicio de Anatomía Patológica, Hospital Vall d'Hebron, Barcelona, España; Grupo de Patología Molecular Translacional, Institut de Recerca, Hospital Vall d'Hebron, Barcelona, España; Centro de Investigación Biomedica en Red CIBERONC, Barcelona, España
| | - Coro Bescós-Atín
- Departamento de Cirugía Oral y Maxilofacial, Hospital Vall d'Hebron, Barcelona, España
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25
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Zhan KY, Morgan PF, Neskey DM, Kim JJ, Huang AT, Garrett-Mayer E, Day TA. Preoperative predictors of occult nodal disease in cT1N0 oral cavity squamous cell carcinoma: Review of 2623 cases. Head Neck 2018; 40:1967-1976. [DOI: 10.1002/hed.25178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 12/24/2017] [Accepted: 02/20/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Kevin Y. Zhan
- Department of Otolaryngology - Head and Neck Surgery; The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Patrick F. Morgan
- Department of Otolaryngology - Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
| | - David M. Neskey
- Department of Otolaryngology - Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
| | - Joanne J. Kim
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences; Medical University of South Carolina; Charleston South Carolina
| | - Andrew T. Huang
- Department of Otolaryngology - Head & Neck Surgery; Baylor College of Medicine; Houston Texas
| | - Elizabeth Garrett-Mayer
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences; Medical University of South Carolina; Charleston South Carolina
| | - Terry A. Day
- Department of Otolaryngology - Head and Neck Surgery; Medical University of South Carolina; Charleston South Carolina
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26
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Burr AR, Harari PM, Ko HC, Chen S, Yu M, Baschnagel AM, Kimple RJ, Witek ME. HPV impacts survival of stage IVC non-oropharyngeal HNSCC cancer patients. ACTA ACUST UNITED AC 2018; 3. [PMID: 30271885 PMCID: PMC6157736 DOI: 10.15761/ohns.1000160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives Human papillomavirus (HPV) status is a favorable prognostic marker for patients with oropharyngeal squamous cell carcinoma (OPSCC) and non-metastatic head and neck non-OPSCC. We evaluated the impact of HPV status on overall survival (OS) for patients with Stage IVC non-OPSCC. Materials and methods Patients diagnosed with Stage IVC non-OPSCC and known HPV status between 2010-2013 were identified in the National Cancer Database. Univariate and multivariate analyses were performed to determine factors associated with OS. Propensity score-weighted Kaplan-Meier estimation was used to adjust for confounders in OS analyses. Multiple imputation method was used for sensitivity analysis. Results We identified 708 patients with Stage IVC non-OPSCC with 30% being HPV-positive. Unadjusted median survival was 10.3 months for HPV-negative patients and 21.4 months for HPV-positive patients (p<0.0001). Age ≥ 65 and tumor diameter were associated with worse OS (p<0.05) while treatment versus no treatment and HPV-positive status were associated with improved OS on multivariate analysis (p<0.001). Adjusted median survival for patients with HPV-negative and HPV-positive disease was 11.1 months and 23.8 months, respectively (p<0.001). On unadjusted subgroup analysis, patients with HPV-positive oral cavity disease exhibited improved outcomes (p<0.0001) while HPV-positive hypopharynx (p<0.06) and larynx (p<0.12) patients exhibited a trend for improved OS compared to HPV-negative patients. The survival advantage associated with HPV positivity was maintained on sensitivity analysis (p<0.01). Conclusion These data demonstrate a clinically meaningful association between HPV status and OS in patients with non-OSPCC presenting with Stage IVC disease. In the absence of randomized data, these findings support active consideration of HPV status in clinical decision making, clinical trial design, and patient counseling regarding prognosis.
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Affiliation(s)
- Adam R Burr
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Paul M Harari
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Huaising C Ko
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Shuai Chen
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Andrew M Baschnagel
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Randall J Kimple
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
| | - Matthew E Witek
- Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Carbone Cancer Center, Madison, WI, USA
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27
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dos Santos Costa SF, Brennan PA, Gomez RS, Fregnani ER, Santos-Silva AR, Martins MD, de Castro-Junior G, Rahimi S, Fonseca FP. Molecular basis of oral squamous cell carcinoma in young patients: Is it any different from older patients? J Oral Pathol Med 2018; 47:541-546. [DOI: 10.1111/jop.12642] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Sara Ferreira dos Santos Costa
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Peter A. Brennan
- Department of Oral and Maxillofacial Surgery; Queen Alexandra Hospital; Portsmouth UK
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | | | - Alan Roger Santos-Silva
- Department of Oral Diagnosis; Piracicaba Dental School; University of Campinas; Piracicaba Brazil
| | - Manoela Domingues Martins
- Department of Pathology; School of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Gilberto de Castro-Junior
- Faculdade de Medicina; Clinical Oncology; Instituto do Câncer do Estado de São Paulo; Universidade de São Paulo; São Paulo Brazil
| | - Siavash Rahimi
- Department of Histopathology; Queen Alexandra Hospital; Portsmouth UK
- School of Pharmacy and Biomedical Sciences; University of Portsmouth; Portsmouth UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
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28
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Nasri E, Wiesen LB, Knapik JA, Fredenburg KM. Eps8 expression is significantly lower in p16 + head and neck squamous cell carcinomas (HNSCCs) compared with p16 - HNSCCs. Hum Pathol 2017; 72:45-51. [PMID: 29107665 DOI: 10.1016/j.humpath.2017.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
In vitro head and neck cancer studies have demonstrated that epidermal growth factor receptor kinase substrate 8 (Eps8) overexpression contributes to squamous carcinogenesis. Oral squamous cell carcinoma studies have correlated Eps8 expression with metastatic disease and poor prognosis. Head and neck squamous cell carcinoma (HNSCC) studies comparing its expression by anatomic site or in in vivo regional metastases have not been performed. In this study, we compared Eps8 expression in HNSCCs arising in the oral cavity (OCSCC) and oropharynx (OPSCC) along with their corresponding regional lymph node (LN) metastases. We then correlated our findings with clinicopathologic data including tumor-node-metastasis stage, p16 status, age, sex, and smoking and alcohol history. Eps8 immunohistochemistry was performed on 69 archived OCSCCs and OPSCCs, and 24 paired and 4 unpaired LNs. Expression was scored from 0 to 3. Eps8 expression was detected in 49% of combined OCSCC and OPSCC cases. We found that expression correlated with advanced tumor stage (P = .022) and p16 status (P = .032) but not with anatomic site. Notably, p16+ HNSCCs had significantly lower Eps8 expression than p16- HNSCCs. No significant difference was observed between primary HNSCCs and their corresponding metastatic LNs. Neither p16 status nor anatomic site influenced Eps8 expression in regional LN metastases. In conclusion, our data offer in vivo support that, in HNSCCs, Eps8 is involved in tumor invasion but not necessarily the development of regional LN metastasis. The association between low Eps8 expression and p16+ HNSCCs suggests that alternative signaling pathways may be used for their tumorigenesis.
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Affiliation(s)
- Elham Nasri
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Lisa B Wiesen
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Jacquelyn A Knapik
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Kristianna M Fredenburg
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610.
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29
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Wang CC, Palefsky JM. Human papillomavirus-related oropharyngeal cancer in the HIV-infected population. Oral Dis 2017; 22 Suppl 1:98-106. [PMID: 27109278 DOI: 10.1111/odi.12365] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023]
Abstract
Human papillomavirus (HPV) is a common sexually transmitted virus and an important etiologic factor in head and neck cancers. HIV-infected individuals are at increased risk of developing oropharyngeal cancers (OPC) compared with the general population. HPV-positive OPC are also increasingly a significant cause of morbidity and mortality for HIV-infected individuals in the era of effective combination antiretroviral therapy. The epidemiology and natural history of oral HPV infection have not been well established, but it appears that oral HPV infection is less common than anal infection, and more common among HIV-infected persons than the general population. Prevention of OPC is therefore increasingly important in HIV-infected individuals. Although not demonstrated in randomized controlled trials, HPV vaccination may prevent oral HPV infection as well. The focus of organized HPV cancer prevention programs should include prophylactic HPV vaccination to reduce the burden of high-risk HPV and low-risk HPV types who have not yet been exposed.
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Affiliation(s)
- C C Wang
- Division of Hematology/Oncology, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA
| | - J M Palefsky
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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30
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Almangush A, Heikkinen I, Mäkitie AA, Coletta RD, Läärä E, Leivo I, Salo T. Prognostic biomarkers for oral tongue squamous cell carcinoma: a systematic review and meta-analysis. Br J Cancer 2017; 117:856-866. [PMID: 28751758 PMCID: PMC5589992 DOI: 10.1038/bjc.2017.244] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 05/02/2017] [Accepted: 07/03/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Identifying informative prognostic biomarkers for oral tongue squamous cell carcinoma (OTSCC) is of great importance in order to better predict tumour behaviour and to guide treatment planning. Here, we summarise existing evidence regarding immunohistochemical prognostic biomarkers for OTSCC. METHODS A systematic search of the literature was performed using the databases of Scopus, Ovid Medline, Web of Science and Cochrane Library. All studies which had investigated the prognostic significance of immunohistochemical biomarkers in OTSCC during the period from 1985 to 2015 were retrieved. For the five most often evaluated biomarkers a random-effects meta-analysis on overall survival was performed, including those studies that provided the necessary statistical results. RESULTS A total of 174 studies conducted during the last three decades were found, and in these 184 biomarkers were evaluated for the prognostication of OTSCC. The five biomarkers most frequently assessed were p53, Ki-67, p16, VEGFs and cyclin D1. In the meta-analyses, the most promising results of the prognostic power for OTSCC were obtained for cyclin D1. For studies of VEGF A and C the results were equivocal, but the pooled analysis of VEGF A separately showed it to be a useful prognosticator for OTSCC. There was no sufficient evidence to support p53, Ki-67 and p16 as prognostic biomarkers for OTSCC. Limitations in the quality of the published studies (e.g., small cohorts, lack of compliance with REMARK guidelines) are widespread. CONCLUSIONS Numerous biomarkers have been presented as useful prognosticators for OTSCC, but the quality of the conduct and reporting of original studies is overall unsatisfactory which does not allow reliable conclusions. The value of two biomarkers (VEGF-A and cyclin D1) should be validated in a multicentre study setting following REMARK guidelines.
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Affiliation(s)
- Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Institute of Dentistry, University of Misurata, Misurata, Libya
| | - Ilkka Heikkinen
- Department of Pathology, University of Helsinki, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Antti A Mäkitie
- Department of Otorhinolaryngology- Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ricardo D Coletta
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Esa Läärä
- Department of Mathematical Sciences and Statistics, University of Oulu, Oulu, Finland
| | - Ilmo Leivo
- Department of Pathology, University of Turku, Turku, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Department of Pathology, HUSLAB, Helsinki University Hospital, Helsinki, Finland
- Department of Diagnostics and Oral Medicine, Research Group of Cancer Research and Translational Medicine, Medical Faculty, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
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31
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Ko HC, Harari PM, Sacotte RM, Chen S, Wieland AM, Yu M, Baschnagel AM, Bruce JY, Kimple RJ, Witek ME. Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas. J Cancer Res Clin Oncol 2017; 143:2341-2350. [PMID: 28752235 DOI: 10.1007/s00432-017-2481-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 07/17/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE We examined overall survival in a large cohort of patients with human papillomavirus (HPV)-positive and HPV-negative non-oropharyngeal squamous cell carcinoma of the head and neck (non-OPSCC). METHODS Patients diagnosed with non-OPSCC and known HPV status were identified in the National Cancer Database (NCDB). Multivariate logistic regression was applied to examine factors associated with HPV status. Multivariate analysis was utilized to determine factors correlated with overall survival. Propensity score-weighted Kaplan-Meier estimation was used to adjust for confounders in survival analyses. Multiple imputation method was used for sensitivity analysis. RESULTS We identified 19,993 non-OPSCC patients with 5070 being positive for HPV in the NCDB. Median follow-up was 23.5 months. HPV-positive patients were more commonly male, white, with a lower comorbidity index score, presenting with T-stage <2, and N-stage ≥1. Unadjusted 3-year overall survival was 62% and 80% for HPV-negative and HPV-positive patients, respectively (p < 0.0001). On multivariate analysis, mortality was reduced for HPV-positive patients with early stage (HR = 0.68) and locally advanced disease (HR = 0.46). Adjusted 3-year overall survival was 65% for HPV-negative and 76% for HPV-positive patients (p < 0.0001). The survival advantage of HPV was maintained in all subsites and robust on sensitivity analysis. CONCLUSIONS Patients with HPV-positive non-OPSCC exhibit similar characteristics as HPV-positive OPSCC. Overall survival was significantly higher for patients with HPV-positive versus HPV-negative non-OPSCC. These data reveal that HPV-positive non-OPSCC represent a favorable cohort that warrants recognition in the design of future clinical trial investigation.
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Affiliation(s)
- Huaising C Ko
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Paul M Harari
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Ryan M Sacotte
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shuai Chen
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Aaron M Wieland
- Division of Otolaryngology and Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Andrew M Baschnagel
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Justine Y Bruce
- Section of Hematology Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Randall J Kimple
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Matthew E Witek
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA.
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32
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Awan MS, Irfan B, Zahid I, Mirza Y, Ali SA. Comparison of Polymerase Chain Reaction and Immunohistochemistry Assays for Analysing Human Papillomavirus Infection in Oral Squamous Cell Carcinoma. J Clin Diagn Res 2017; 11:XC10-XC13. [PMID: 28764278 DOI: 10.7860/jcdr/2017/24742.10119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/30/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) are two well-known techniques used for the diagnoses of genetic diseases, tumours and different pathogens. PCR basically amplify regions of DNA within a single molecule which may have etiologic significance, it is a method for in vitro amplification of specific DNA or RNA sequences, whereas IHC is used to verify tissue constituents (the antigens) with the utilization of specific antibodies that can be visualized through staining. AIM To compare and analyse PCR and IHC for their sensitivity to detect Human Papillomavirus (HPV) in Oral Squamous Cell Carcinoma (OSCC). MATERIALS AND METHODS This study was based on samples retrospectively collected from 47 patients with primary OSCC who were diagnosed and treated at The Aga Khan University Hospital, Karachi, Pakistan, during the period of January 2010 to December 2013. Inclusion criteria were complete clinicopathologic data, adequate clinical follow up and availability of sufficient paraffin- embedded tumour material. HPV general and type specific 16 and 18 were investigated by means of PCR. HPV immunoreactivity was further investigated by means of IHC. RESULTS Among the 47 evaluated patients, 32 (68.1%) were male and 15 (31.9%) were female, PCR detected the presence of HPV in 32 (68.1%) patients while IHC showed no positive test results. p53 was positive in 32 (68.1%) patients and negative in 15 (31.9%). HPV type 16 being most prevalent showing positivity in 27 (57.4%) patients whereas, type 18 was positive in only 1 (2.1%) patient. CONCLUSION We concluded that PCR is more sensitive and reliable when diagnosing and detecting HPV for OSCC rather than IHC as results from IHC were all negative and insignificant, hence PCR should be the first initial diagnostic test for detecting HPV due to its better sensitivity and successful detection of HPV.
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Affiliation(s)
- Muhammad Sohail Awan
- Associate Professor, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Babar Irfan
- Student, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ibrahim Zahid
- Student, Dow University of Health Sciences, Karachi, Pakistan
| | - Yumna Mirza
- Research Associate, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Adnan Ali
- Assistant Professor, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Brennan K, Koenig JL, Gentles AJ, Sunwoo JB, Gevaert O. Identification of an atypical etiological head and neck squamous carcinoma subtype featuring the CpG island methylator phenotype. EBioMedicine 2017; 17:223-236. [PMID: 28314692 PMCID: PMC5360591 DOI: 10.1016/j.ebiom.2017.02.025] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/23/2017] [Accepted: 02/24/2017] [Indexed: 02/06/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is broadly classified into HNSCC associated with human papilloma virus (HPV) infection, and HPV negative HNSCC, which is typically smoking-related. A subset of HPV negative HNSCCs occur in patients without smoking history, however, and these etiologically 'atypical' HNSCCs disproportionately occur in the oral cavity, and in female patients, suggesting a distinct etiology. To investigate the determinants of clinical and molecular heterogeneity, we performed unsupervised clustering to classify 528 HNSCC patients from The Cancer Genome Atlas (TCGA) into putative intrinsic subtypes based on their profiles of epigenetically (DNA methylation) deregulated genes. HNSCCs clustered into five subtypes, including one HPV positive subtype, two smoking-related subtypes, and two atypical subtypes. One atypical subtype was particularly genomically stable, but featured widespread gene silencing associated with the 'CpG island methylator phenotype' (CIMP). Further distinguishing features of this 'CIMP-Atypical' subtype include an antiviral gene expression profile associated with pro-inflammatory M1 macrophages and CD8+ T cell infiltration, CASP8 mutations, and a well-differentiated state corresponding to normal SOX2 copy number and SOX2OT hypermethylation. We developed a gene expression classifier for the CIMP-Atypical subtype that could classify atypical disease features in two independent patient cohorts, demonstrating the reproducibility of this subtype. Taken together, these findings provide unprecedented evidence that atypical HNSCC is molecularly distinct, and postulates the CIMP-Atypical subtype as a distinct clinical entity that may be caused by chronic inflammation.
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Affiliation(s)
- K Brennan
- Department of Medicine, Stanford University, United States
| | - J L Koenig
- Department of Medicine, Stanford University, United States
| | - A J Gentles
- Department of Medicine, Stanford University, United States
| | - J B Sunwoo
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, United States
| | - O Gevaert
- Department of Medicine, Stanford University, United States.
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Khanal S, Trainor PJ, Zahin M, Ghim SJ, Joh J, Rai SN, Jenson AB, Shumway BS. Histologic variation in high grade oral epithelial dysplasia when associated with high-risk human papillomavirus. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:566-585. [PMID: 28407985 DOI: 10.1016/j.oooo.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 01/05/2017] [Accepted: 01/10/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Reported cytologic alterations associated with high-risk human papillomavirus (HR-HPV) in oral epithelial dysplasia (HPV-OED) need further characterization. STUDY DESIGN Archival cases of high-grade oral epithelial dysplasia (hgOED) (N = 38) were assigned a cytologic score (CS) based on the average number of mitotic, karyorrhectic, and apoptotic cells per high-power field. Three groups were then generated on the basis of increasing CS: Focal (group 1, N = 14), Intermediate (group 2, N = 12), and Diffuse (group 3, N = 12). Polymerase chain reaction-based HPV genotyping and p16 immunohistochemistry were performed. RESULTS HR-HPV was found significantly more in group 3 (83.3%) compared with groups 1 and 2 (group 1&2; 42.9% and 41.7%, respectively; P = .047). HPV16 predominated in HR-HPV-positive cases (90.5%). By location, the tongue or the floor of mouth was associated with all groups (P = .04). Increasing CS was associated with a slightly younger age (P = .04) and increased expression of p16 (P = .005). CS and p16 expression were not sensitive but were highly specific predictors for HR-HPV presence. Based on limited follow-up information, HPV-OED does not differ in clinical aggressiveness compared with conventional OED. CONCLUSIONS Increased CS in hgOED is strongly associated with HR-HPV (mostly HPV16) and p16 expression. CS and p16 expression are specific predictors of HR-HPV presence. Further molecular study and long-term follow-up of HPV-OED are needed.
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Affiliation(s)
- Sujita Khanal
- James Graham Brown Cancer Center, Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, KY, USA
| | - Patrick J Trainor
- Research Associate, Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Maryam Zahin
- Postdoctoral Associate, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shin-Je Ghim
- Assistant Professor, Department of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Joongho Joh
- Assistant Professor, Department of Medicine, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Shesh N Rai
- Professor, Wendell Cherry Chair in Clinical Trial Research; Director, Biostatistics Shared Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Alfred Bennett Jenson
- Senior scientist, Professor of Vaccinology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Brian S Shumway
- Associate Professor, Oral and Maxillofacial Pathology, Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA.
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Abstract
Oral squamous cell carcinoma is the most common neoplasia of the mouth. Downregulation of p16(INK4a) (a cyclin-dependent kinase inhibitor) has been reported for mouth cancer and it is believed that its inactivation is an early event in oral carcinogenesis. The goal of this article is to quantitatively report expression of p16(INK4a) and the state of methylation in oral squamous cell carcinoma, and evaluate its relationship with the clinical and prognostic factors, in addition to setting out a multivariate model that predicts survival. The mean expression of p16(INK4a) was 7.70 (SD=14.07) (F=0.894; P=0.449). According to the semiquantitative analysis, there were statistically significant differences, where 19 cases were negative (<2 %), 11 at initial stages, and 8 at advanced stages (χ(2)=6.016; P<0.05). The methylation of p16(INK4a) was not associated with any of the clinical or pathologic variables. Kaplan-Meier curve showed a better survival for patients in initial stages (40.72 mo) compared to those in advanced stages (28.6 mo) (P<0.01). Survival was also reduced in a statistically significant manner in patients with any degree of dysplasia in the adjacent margin (P<0.05). During univariate Cox regression analysis, it was observed that individuals with relapse had a higher risk (almost 9 times higher) [P<0.001; hazard ratio=8.91; 95% confidence interval (CI), 4.18-19.02]. During the Cox multivariate analysis for each unit of decrease in p16(INK4a), the risk increased by 1.06) (P<0.05; hazard ratio=0.94; 95% CI, 0.89-1.00). p16(INK4a) expression is reduced with advancing tumor stage and its gene silencing is associated with an increased risk of death.
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Rodríguez-Santamarta T, Rodrigo JP, García-Pedrero JM, Álvarez-Teijeiro S, Ángeles Villaronga M, Suárez-Fernández L, Alvarez-Argüelles ME, Astudillo A, de Vicente JC. Prevalence of human papillomavirus in oral squamous cell carcinomas in northern Spain. Eur Arch Otorhinolaryngol 2016; 273:4549-4559. [PMID: 27342404 DOI: 10.1007/s00405-016-4152-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/14/2016] [Indexed: 01/19/2023]
Abstract
The aim of this study was to analyze the prevalence of high-risk HPV in oral squamous cell carcinoma (OSCC) in a northern Spanish population, as well as to ascertain the prognostic role of p16INK4a expression. The examination samples were collected from paraffin tissue blocks, from 125 patients surgically treated between 1996 and 2007. All cases were histologically evaluated, and the presence of HPV was assessed by p16 and p53immunohistochemistry followed by DNA detection by in situ hybridization (ISH) and polymerase chain reaction (PCR) amplification using the combination of consensus primers MY11/GP6 + . Fourteen cases (11 %) were p16-immunopositive, and p53 was scored positive in 73 cases (58 %). Five cases (4 %) showed a simultaneous p16-positive and p53-negative immunostaining. ISH was negative in all the cases. Among the p16INK4a-immunopositive cases, PCR amplification failed to reveal HPV DNA in any tumor samples. There were no statistically significant differences in any clinical or pathological characteristics of the patients regarding p16INK4a expression. T classification, neck-node metastasis, and clinical stage showed outcome relevance. However, no significant differences in cause-specific survival based on p16INK4a were observed. We did not find any high-risk HPV types in our patients, thus, are unlikely that HPV has an important role in the etiology of OSCC. p16INK4a protein was neither an accurate marker of HPV infection nor a prognosis marker in OSCC.
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Affiliation(s)
- Tania Rodríguez-Santamarta
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011, Oviedo, Asturias, Spain
| | - Juan Pablo Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011, Oviedo, Asturias, Spain.,Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain
| | - Juana M García-Pedrero
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain
| | - Saúl Álvarez-Teijeiro
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain
| | - M Ángeles Villaronga
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain
| | - Laura Suárez-Fernández
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain
| | - Marta E Alvarez-Argüelles
- Department of Microbiology, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011, Oviedo, Asturias, Spain
| | - Aurora Astudillo
- Department of Pathology, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011, Oviedo, Asturias, Spain
| | - Juan Carlos de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011, Oviedo, Asturias, Spain. .,Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Hospital Universitario Central de Asturias, Edificio Consultas Externas, Planta Baja Lab 2 ORL-IUOPA, C/Celestino Villamil, s/n, 33006, Oviedo, Asturias, Spain. .,Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias, School of Medicine, c/Catedrático José Serrano s/n, 33006, Oviedo, Spain.
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Dediol E, Sabol I, Virag M, Grce M, Muller D, Manojlović S. HPV prevalence and p16INKa overexpression in non-smoking non-drinking oral cavity cancer patients. Oral Dis 2016; 22:517-22. [PMID: 26993152 DOI: 10.1111/odi.12476] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/29/2016] [Accepted: 03/08/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Our aim was to compare HPV and p16INK4a (p16) expression and their influence on survival and prognosis in oral cavity squamous cell cancer (OCSCC), between non-smokers and non-drinkers (NSND) and smokers and drinkers (SD). SUBJECTS AND METHODS Patients with OCSCC treated with surgery from 2000 to 2010 were included in the study. Patients who did not smoke at all or smoked less than 10 pack per years and did not drink alcohol on a daily basis were considered the NSND group. An equal number of SD were the control group. HPV presence was determined from paraffin-embedded blocks investigated by PCR analysis. p16 expression was evaluated with immunohistochemistry. RESULTS The NSND group were mostly younger or older female patients with tongue or gingival cancers. p16 expression was significantly more frequent in NSND patients (27% vs 10%). Patients with stronger p16 expression had significantly worse survival, especially for tongue cancers (P = 0.026). In Cox multivariate analysis, both HPV and p16 expression carried a negative prognosis for NSND patients (P = 0.0351 and P = 0.0260). CONCLUSIONS NSND are a specific population of OCSCC patients. In contrast to oropharyngeal cancer, HPV and p16 expression in OCSCC are negative predictive factors, especially in NSND patients.
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Affiliation(s)
- E Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - I Sabol
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - M Virag
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - M Grce
- Department of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - D Muller
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
| | - S Manojlović
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Pathology, University Hospital Dubrava, Zagreb, Croatia
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Eckert AW, Wickenhauser C, Salins PC, Kappler M, Bukur J, Seliger B. Clinical relevance of the tumor microenvironment and immune escape of oral squamous cell carcinoma. J Transl Med 2016; 14:85. [PMID: 27044404 PMCID: PMC4820994 DOI: 10.1186/s12967-016-0828-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 03/02/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Changes in the tumor microenvironment and immune surveillance represent crucial hallmarks of various kinds of cancer, including oral squamous cell carcinoma (OSCC), and a close crosstalk of hypoxia regulating genes, an activation of chemokines and immune cells has been described. METHODS A review about the pivotal role of HIF-1, its crosstalk to various cornerstones in OSCC tumorigenesis is presented. RESULTS Hypoxia is a frequent event in OSCC and leads to a reprogramming of the cellular metabolism in order to prevent cell death. Hypoxic OSCC cells induce different adaptive changes such as anaerobic glycolysis, pH stabilisation and alterations of the gene and protein expression profile. This complex metabolic program is orchestrated by the hypoxia inducible factor (HIF)-1, the master regulator of early tumor progression. Hypoxia-dependent and -independent alterations in immune surveillance lead to different immune evasion strategies, which are partially mediated by alterations of the tumor cells, changes in the frequency, activity and repertoire of immune cell infiltrates and of soluble and environmental factors of the tumor micromilieu with consecutive generation of an immune escape phenotype, progression of disease and poor clinical outcome of OSCC patients. CONCLUSIONS This review focusses on the importance of HIF-1 in the adaption and reprogramming of the metabolic system to reduced oxygen values as well as on the role of the tumor microenvironment for evasion of OSCC from immune recognition and destruction.
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Affiliation(s)
- Alexander W Eckert
- Department of Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany.
| | - Claudia Wickenhauser
- Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06110, Halle (Saale), Germany
| | - Paul C Salins
- Mazumdar Shaw Cancer Center and Narayana Hrudayalaya Multi Specialty Hospital, 258/A, Bommasandra Industrial Area, Bangalore, 560099, India
| | - Matthias Kappler
- Department of Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
| | - Juergen Bukur
- Institute of Medical Immunology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 2, 06110, Halle (Saale), Germany
| | - Barbara Seliger
- Institute of Medical Immunology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 2, 06110, Halle (Saale), Germany.
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Increased Risk of Oral Cancer in Patients With Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol 2016; 14:413-20. [PMID: 26499929 DOI: 10.1016/j.cgh.2015.09.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/29/2015] [Accepted: 09/30/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Epidemiology studies have consistently found an increased risk of oral malignancies in organ transplant recipients, patients with graft-versus-host disease, and people with human immunodeficiency virus infection. We assessed the risk of oral cancer in patients with inflammatory bowel diseases (IBD). METHODS We collected data on 7294 patients with IBD (3785 women) seen at Mount Sinai Medical Center, New York, from 2000 through 2011. The expected incidence of oral cancer was calculated for each sex-specific and 5-year age-specific stratum by specific incidence rates using the Surveillance, Epidemiology and End Results 18 registry data (2000-2011), adjusted for age to the 2000 United States population (census P25-1130). RESULTS Eleven patients (7 men) were found to have biopsy-proven oral cancer. Six patients had cancer of the tongue; 2 patients had cancer of the hard palate; and the remaining 3 had tonsillar, buccal, or mandibular sarcoma. Before the cancer diagnosis, IBD had been treated in 4 patients with azathioprine or mercaptopurine, in 1 patient with infliximab, and 3 in patients with combination of biologic agents and azathioprine; 4 of the patients had not been treated for IBD. The age- and sex-adjusted standardized incidence ratio (SIR) for oral cancer in patients with IBD was 9.77 (95% confidence interval [CI], 5.14-16.98). In women, the SIR was 12.07 (95% CI, 3.84-29.11), and in men the SIR was 8.49 (95% CI, 3.71-16.78). The age-adjusted SIR for tongue cancer was 18.91 (95% CI, 7.66-39.33): 17.06 for men (95% CI, 5.42-41.15) and 22.10 for women (95% CI, 3.70-73.01). CONCLUSIONS We found patients with IBD to be at increased risk for oral cancers, especially tongue cancer. Women are at higher risk than men.
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Santos HBDP, dos Santos TKG, Paz AR, Cavalcanti YW, Nonaka CFW, Godoy GP, Alves PM. Clinical findings and risk factors to oral squamous cell carcinoma in young patients: A 12-year retrospective analysis. Med Oral Patol Oral Cir Bucal 2016; 21:e151-6. [PMID: 26827057 PMCID: PMC4788792 DOI: 10.4317/medoral.20770] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 11/13/2015] [Indexed: 11/06/2022] Open
Abstract
Background In recent years have been observed an increased incidence of OSCC in young individuals. Based on this, the aim this study was to describe the clinical characteristics of all cases of OSCC in younger patients, diagnosed in two oncology referral hospitals, at the northeast region of Brazil within a 12-year period. Material and Methods Data regarding general characteristics of patients (age, gender and tobacco and/or alcohol habits) and information about the lesions (tumor location, size, regional lymph node metastasis, distant metastasis and clinical stage) were submitted to descriptive and inferential analysis. Statistical analysis included Chi-square and Fisher’s exact tests (P<0.05). Results Out of 2311 registered cases of OSCC, 76 (3.3%) corresponded to OSCC in patients under 45 years old. Most of them were male (n=62, 81.6%) and tobacco and/or alcohol users (n=40, 52.8%). The most frequent site was the tongue (n=31, 40.8%), with predominance of cases classified at advanced clinical stage (III and IV, n = 46, 60.5%). The advanced stage of OSCC (III and IV) was statistically associated with male gender (P=0.035), lower education level (P=0.007), intraoral site(P<0.001), presence of pain symptomatology (P=0.006), and consumption of tobacco and/or alcohol (P=0.001). Conclusions The profile of OSCC in young patients resembles to the commonly characteristics reported for overall population. The late diagnosis in young patients usually results in poor prognosis, associated with gender, harmful habits and tumor location. Although prevalence is low, stimulus to prevention and to early diagnosis should be addressed to young individuals exposed to risk factors. Key words:Squamous cell carcinoma, head and neck neoplasms, risk factors, young patients, prognosis.
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Affiliation(s)
- Hellen-Bandeira-de-Pontes Santos
- State University of Paraiba, Dentistry Department, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brazil. CEP: 58429-500,
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Sedghizadeh PP, Billington WD, Paxton D, Ebeed R, Mahabady S, Clark GT, Enciso R. Is p16-positive oropharyngeal squamous cell carcinoma associated with favorable prognosis? A systematic review and meta-analysis. Oral Oncol 2016; 54:15-27. [PMID: 26794879 DOI: 10.1016/j.oraloncology.2016.01.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/30/2015] [Accepted: 01/01/2016] [Indexed: 12/29/2022]
Abstract
The purpose of this systematic review and meta-analysis was to compare the prognosis of patients with p16 expressing oropharyngeal squamous cell cancers to patients with p16 non-expressing cancers. Clinical outcomes that were evaluated included overall survival, local recurrence, disease-free survival, disease-specific survival, and event-free survival. The following electronic databases were searched: Cochrane Library, MEDLINE (via Pubmed), and Web of Science. Publications were restricted to English language. Studies were limited to controlled clinical trials on the survival rates of patients with oropharyngeal tumors that were p16 expressing, compared to patients with p16 non-expressing tumors, and at least one clinical endpoint reported by trial authors (hazard ratios). Specific ascertainment criteria were applied for inclusion and exclusion of eligible studies. Data was independently extracted in duplicate. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis PRISMA checklist. Risk of bias was assessed for all included studies, and disagreements between review authors were discussed until an agreement was reached. Eighteen studies were included for final review and meta-analysis. The subgroup meta-analyses, which included survival and recurrence data, showed significantly favorable outcomes for patients with p16 expressing tumors. There is strong evidence to support that patients with p16 expressing oropharyngeal squamous cell cancers have favorable clinical outcomes and prognosis.
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Affiliation(s)
- Parish P Sedghizadeh
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States.
| | - William D Billington
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Dain Paxton
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Rabeh Ebeed
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Susan Mahabady
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Glenn T Clark
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
| | - Reyes Enciso
- University of Southern California, Ostrow School of Dentistry, 925 West 34th Street, Los Angeles, CA 90089, United States
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Giagkou E, Christodoulou DK, Katsanos KH. Mouth cancer in inflammatory bowel diseases. Oral Dis 2016; 22:260-4. [DOI: 10.1111/odi.12420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/06/2015] [Accepted: 12/07/2015] [Indexed: 12/26/2022]
Affiliation(s)
- E Giagkou
- Division of Gastroenterology; School of Health Sciences; University of Ioannina; Ioannina Greece
| | - DK Christodoulou
- Division of Gastroenterology; School of Health Sciences; University of Ioannina; Ioannina Greece
| | - KH Katsanos
- Division of Gastroenterology; School of Health Sciences; University of Ioannina; Ioannina Greece
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Rischin D, Spigel DR, Adkins D, Wein R, Arnold S, Singhal N, Lee O, Murugappan S. PRISM: Phase 2 trial with panitumumab monotherapy as second-line treatment in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. Head Neck 2015; 38 Suppl 1:E1756-61. [DOI: 10.1002/hed.24311] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 09/05/2015] [Accepted: 09/20/2015] [Indexed: 01/09/2023] Open
Affiliation(s)
- Danny Rischin
- Division of Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | | | - Douglas Adkins
- Washington University School of Medicine; St. Louis Missouri
| | - Richard Wein
- Department of Otolaryngology - Head and Neck Surgery; Tufts Medical Center; Boston Massachusetts
| | - Susanne Arnold
- University of Kentucky, Markey Cancer Center; Lexington Kentucky
| | - Nimit Singhal
- Royal Adelaide Hospital and University of Adelaide; Adelaide SA Australia
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Chinn SB, Myers JN. Oral Cavity Carcinoma: Current Management, Controversies, and Future Directions. J Clin Oncol 2015; 33:3269-76. [PMID: 26351335 PMCID: PMC5320919 DOI: 10.1200/jco.2015.61.2929] [Citation(s) in RCA: 255] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Oral cavity carcinoma (OCC) remains a major cause of morbidity and mortality in patients with head and neck cancer. Although the incidence has decreased over the last decade, outcomes remain stagnant with only a 5% improvement in overall survival in the last 20 years. Although surgical resection remains the primary treatment modality, several areas of controversy exist with regard to work-up, management of the primary and neck tumors, and adjuvant therapy. As surgical techniques evolve, so has the delivery of radiotherapy and systemic treatment, which have helped to improve the outcomes for patients with advanced disease. Recently, the addition of cetuximab has shown promise as a way to improve outcomes while minimizing toxicity, and this remains an active area of study in the adjuvant setting. Advances in microvascular free-flap reconstruction have extended the limits of resection and enabled enhanced restoration of function and cosmesis. While these advances have led to limited survival benefit, evaluation of alternative modalities has gained interest on the basis of success in other head and neck subsites. Organ preservation with definitive chemoradiotherapy, though proven in the larynx and pharynx, remains controversial in OCC. Likewise, although the association of human papillomavirus is well established in oropharyngeal carcinoma, it has not been proven in the pathogenesis or survival of OCC. Future study of the molecular biology and pathogenesis of OCC should offer additional insight into screening, treatment selection, and novel therapeutic approaches.
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Affiliation(s)
- Steven B Chinn
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeffrey N Myers
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX.
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Abstract
Oral cavity squamous cell carcinoma (OC-SCC) is the most common malignancy of the head and neck (excluding nonmelanoma skin cancer). Recent trends have shown a dramatic rise in the incidence of oropharyngeal squamous cell carcinoma (OP-SCC), with a marked increase in lesions related to human papillomavirus infection. This update presents the latest evidence regarding OC-SCC and OP-SCC. In particular, the authors compare and contrast tumors at these two sites with respect to epidemiology, etiopathogenesis, clinicopathologic presentation, clinical assessment, imaging, management, and prognosis. It is important for clinicians to be aware of differences between OC-SCC and OP-SCC so that appropriate patient education and multidisciplinary care can be provided to optimize outcomes.
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Affiliation(s)
- Angela C Chi
- Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| | - Terry A Day
- Professor, Wendy and Keith Wellin Endowed Chair for Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Brad W Neville
- Distinguished University Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
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Reyes M, Rojas-Alcayaga G, Pennacchiotti G, Carrillo D, Muñoz JP, Peña N, Montes R, Lobos N, Aguayo F. Human papillomavirus infection in oral squamous cell carcinomas from Chilean patients. Exp Mol Pathol 2015; 99:95-9. [DOI: 10.1016/j.yexmp.2015.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/22/2015] [Accepted: 06/04/2015] [Indexed: 12/11/2022]
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Baruah P, Lee M, Wilson POG, Odutoye T, Williamson P, Hyde N, Kaski JC, Dumitriu IE. Impact of p16 status on pro- and anti-angiogenesis factors in head and neck cancers. Br J Cancer 2015; 113:653-9. [PMID: 26171937 PMCID: PMC4647678 DOI: 10.1038/bjc.2015.251] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/17/2015] [Accepted: 06/09/2015] [Indexed: 12/19/2022] Open
Abstract
Background: Head and neck cancers (HNC) are aggressive tumours. Overexpression of p16 in HNC correlates with human papilloma virus (HPV)-associated HNC that carry a better prognosis than HPV-negative tumours. Angiogenesis is an important factor in tumour progression. Our aim was to dissect the impact of p16 expression on angiogenesis factors in HNC. Methods: Eighteen newly diagnosed HNC patients and controls were analysed. Eleven pro- and anti-angiogenesis factors were quantified using multiplex ELISA in HNC patients and controls. Angiogenesis factors were analysed in tumour tissue using immunohistochemistry. Results: Circulating levels of endostatin (anti-angiogenesis factor) were higher in the HNC group compared with healthy donors. Interestingly, the pro-angiogenesis factors angiopoietin-1 and vascular endothelial growth factor (VEGF) were significantly higher in patients with p16-negative compared with p16-positive HNC. Moreover, the major source of VEGF in p16-positive HNC tissue was tumour stromal cells. In contrast, both tumour cells and stromal cells expressed VEGF in p16-negative tissue. Conclusions: We show that p16-negative tumours associate with increased circulating levels of pro-angiogenic VEGF and angiopoietin-1. Tissue expression of VEGF differs between p16-positive and p16-negative tumours. These findings may explain differences in the biological behaviour of p16-positive and p16-negative HNC. Better understanding of mechanisms by which the p16 status influences tumour angiogenesis may guide the development of targeted therapies.
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Affiliation(s)
- P Baruah
- 1] Department of ENT, St George's Hospital NHS Trust London, London, UK [2] Department of Oral and Maxillo-Facial Surgery, St George's Hospital NHS Trust London, London, UK [3] Cardiovascular and Cell Sciences Research Institute, St George's University of London, London, UK
| | - M Lee
- Department of ENT, St George's Hospital NHS Trust London, London, UK
| | - P O G Wilson
- Department of Pathology, St George's Hospital NHS Trust London, London, UK
| | - T Odutoye
- Department of ENT, St George's Hospital NHS Trust London, London, UK
| | - P Williamson
- Department of ENT, St George's Hospital NHS Trust London, London, UK
| | - N Hyde
- Department of Oral and Maxillo-Facial Surgery, St George's Hospital NHS Trust London, London, UK
| | - J C Kaski
- Cardiovascular and Cell Sciences Research Institute, St George's University of London, London, UK
| | - I E Dumitriu
- Cardiovascular and Cell Sciences Research Institute, St George's University of London, London, UK
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Expression of p16 in squamous cell carcinoma of the mobile tongue is independent of HPV infection despite presence of the HPV-receptor syndecan-1. Br J Cancer 2015; 113:321-6. [PMID: 26057450 PMCID: PMC4506391 DOI: 10.1038/bjc.2015.207] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/07/2015] [Accepted: 05/13/2015] [Indexed: 02/03/2023] Open
Abstract
Background: Tongue squamous cell carcinoma (TSCC) is increasing in incidence, especially among young patients and preferably females. Infection with human papilloma virus (HPV) has been suggested as a cause of SCC in the head and neck, and the proportion of oropharyngeal cancers caused by HPV has steadily increased. Methods: Samples from 109 patients with primary TSCC were analysed for the presence of HPV16 by in situ hybridisation and for expression of its surrogate marker p16 and the HPV receptor syndecan-1 by immunhistochemistry. Results: No evidence of HPV16 DNA was observed in the tumours, although one-third showed p16 staining. There was no difference in the expression of the primary HPV receptor, syndecan-1, between TSCC and a group of tonsil SCC. Conclusion: Whereas p16 is expressed in some TSCCs, HPV16 is undetectable, therefore, p16 cannot be used as a surrogate marker for high-risk HPV-infection in this tumour. Despite presence of the HPV-receptor syndecan-1 in TSCC, HPV prefers the tonsillar environment. Lack of p16 associates with worse prognosis primarily in patients aged ⩽40 years with tongue SCC. The improved prognosis seen in p16-positive TSCC can be due to induction of a senescent phenotype or an inherent radiosensitivity due to the ability of p16 to inhibit homologous recombination repair.
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Ludmir EB, Stephens SJ, Palta M, Willett CG, Czito BG. Human papillomavirus tumor infection in esophageal squamous cell carcinoma. J Gastrointest Oncol 2015; 6:287-95. [PMID: 26029456 DOI: 10.3978/j.issn.2078-6891.2015.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 11/30/2014] [Indexed: 02/06/2023] Open
Abstract
The association between human papillomavirus (HPV) and esophageal squamous cell carcinoma (ESCC) has been recognized for over three decades. Recently, multiple meta-analyses have drawn upon existing literature to assess the strength of the HPV-ESCC linkage. Here, we review these analyses and attempt to provide a clinically-relevant overview of HPV infection in ESCC. HPV-ESCC detection rates are highly variable across studies. Geographic location likely accounts for a majority of the variation in HPV prevalence, with high-incidence regions including Asia reporting significantly higher HPV-ESCC infection rates compared with low-incidence regions such as Europe, North America, and Oceania. Based on our examination of existing data, the current literature does not support the notion that HPV is a prominent carcinogen in ESCC. We conclude that there is no basis to change the current clinical approach to ESCC patients with respect to tumor HPV status.
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Affiliation(s)
- Ethan B Ludmir
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
| | - Sarah J Stephens
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
| | - Manisha Palta
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
| | - Christopher G Willett
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
| | - Brian G Czito
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
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