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Horakova Z, Starek I, Salzman R. Current status and future perspectives of oral HPV testing in the diagnosis and monitoring of oropharyngeal cancer. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:319-327. [PMID: 37901925 DOI: 10.5507/bp.2023.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023] Open
Abstract
HPV16 status in oropharyngeal cancer (OPC) is an important prognostic factor. Its determination, based on immunistochemical analysis of p16 oncoprotein requires an invasive biopsy. Thus, alternative methods are being sought. Determining oral HPV16 status appears to be a promising alternative. However, it is not used routinely. This prompted us to perform a systematic literature review enabling us to evaluate the diagnostic and predictive ability of this approach. Thirty-four relevant studies were finally selected. For determination of HPV status in OPC, the calculated average sensitivity and specificity for oral sampling was 74% and 91%, respectively, with p16 tumour tissue marker being the gold standard. The method appears to be valuable in monitoring treatment response as well as the biological activity of the tumour, enabling early detection of persistent or relapsing carcinoma sufficiently long before its clinical and/or radiological manifestation. It can also contribute to identification of the primary tumour in cases of metastases of unknown origin. Last but not least, the screening HPV oral testing would help to identify individuals with persistent HPV oral infection who are at increased risk of development of OPC.
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Affiliation(s)
- Zuzana Horakova
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
| | - Ivo Starek
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
| | - Richard Salzman
- Clinic of ENT and Head and Neck Surgery, University Hospital Olomouc, Palacky University Olomouc, Zdravotniku 248/7, 779 00, Olomouc, Czech Republic
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Zhu Y, He H, Zhu X, Hu Y, Yu S, Diao W, Li S, Shan G, Chen X. Epidemiology of Oral Human Papillomavirus Infection among Diverse Chinese Adults in Typical Areas of China: Findings from the DLCC Study. Cancer Epidemiol Biomarkers Prev 2023; 32:1635-1643. [PMID: 37676643 PMCID: PMC10618732 DOI: 10.1158/1055-9965.epi-23-0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/02/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is a predominant cause of oropharyngeal squamous cell carcinoma. However, there is limited knowledge about the epidemiology of oral HPV infections among adults in China. METHODS We collected data from a prospective cohort that enrolled participants in Mainland China. A total of 9,867 participants ages at least 20 years provided oral swab specimens in typical areas of China (Hebei and Guangdong provinces) in 2021. HPV DNA in oral exfoliated cells was tested using nested PCR and sequencing. Prevalence among subpopulations was compared. Multivariable logistic regression models were employed to assess possible factors influencing oral HPV infection. RESULTS The overall prevalence of oral HPV infection was 3.0% [95% confidence interval (CI): 2.68-3.36]. Among those infected, 1.3% (1.08-1.53) were infected with high-risk HPV types. Men had a higher age-standardized HPV infection prevalence (3.6%, 2.96-4.29) compared with their female counterparts (2.7%, 2.35-3.12). People in Hebei had a higher age- and sex-standardized prevalence (4.1%, 3.50-4.70) than those in Guangdong (2.2%, 1.80-2.56). Generally, men (OR and 95% CI: 1.42, 1.09-1.85) and people in Hebei (2.01, 1.53-2.65) had higher odds of any type of HPV infection. In addition, people living in urban areas had a 2.15-fold (1.43-3.26) higher odds of high-risk HPV infection. CONCLUSIONS This study reveals a low prevalence of oral HPV infection with significant geographic and sex differences among Chinese population. IMPACT This is the first study to report the epidemiologic characteristics of oral HPV infection among Chinese adults in diverse geographic areas with large sample size.
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Affiliation(s)
- Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, State Key Laboratory of Common Mechanism Research for Major Disease, Peking Union Medical College, Beijing, P.R. China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Yaoda Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, State Key Laboratory of Common Mechanism Research for Major Disease, Peking Union Medical College, Beijing, P.R. China
| | - Shuting Yu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Shuguang Li
- Department of Music Artificial Intelligence and Music Information Technology, Central Conservatory of Music, Beijing, P.R. China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, State Key Laboratory of Common Mechanism Research for Major Disease, Peking Union Medical College, Beijing, P.R. China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China
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Poljak M, Cuschieri K, Alemany L, Vorsters A. Testing for Human Papillomaviruses in Urine, Blood, and Oral Specimens: an Update for the Laboratory. J Clin Microbiol 2023; 61:e0140322. [PMID: 37439692 PMCID: PMC10446865 DOI: 10.1128/jcm.01403-22] [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] [Indexed: 07/14/2023] Open
Abstract
Twelve high-risk alpha human papillomavirus (HPV) genotypes cause approximately 690,000 cancer cases annually, with cervical and oropharyngeal cancer being the two most prominent types. HPV testing is performed in laboratory settings for various applications of a clinical, epidemiological, and research nature using a range of clinical specimens collected by clinicians or by individuals (self-collected specimens). Here, we reflect on the importance and justification of using the right test for the right application and provide practical updates for laboratories either participating in or anticipating involvement in HPV testing in three specimen types, namely, urine, blood, and oral specimens, which are considered "alternative" specimens by many. In addition to clinician-collected cervical samples and self-collected cervicovaginal samples, first-void urine is emerging as a credible specimen for HPV-based cervical cancer screening, triage of HPV screen-positive women, monitoring HPV vaccine impact, and HPV testing in groups for which a less invasive sample is preferred. Detection of cell-free DNA (including HPV DNA) in blood has great promise for the early detection of HPV-attributable oropharyngeal cancer (HPV-AOC) and potentially other HPV-driven cancers and as an adjunct prognostic marker in long-term tumor surveillance, including treatment response. The moderate sensitivity of HPV testing in oral rinses or swabs at HPV-AOC diagnosis prevents its use in HPV-AOC secondary prevention but represents a promising prognostic tool in HPV-AOC tertiary prevention, where the HPV persistence in oral rinses throughout treatment may predict early HPV-AOC recurrences and/or the development of secondary HPV-AOC. The increasing sophistication of specific collection devices designed for alternative samples and the enhanced precision of novel molecular technologies are likely to support the evolution of this field and catalyze potential translation into routine practice.
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Affiliation(s)
- Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kate Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Alex Vorsters
- Centre for Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Bruno MT, Boemi S, Caruso G, Sgalambro F, Ferlito S, Cavallaro A, Sudano MC, Palumbo M. Oral HPV Infection in Women with HPV-Positive Cervix Is Closely Related to Oral Sex. Diagnostics (Basel) 2023; 13:2096. [PMID: 37370992 DOI: 10.3390/diagnostics13122096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The oral transmission of HPV and, consequently, the risk of oral cancer has increased in the last years. Oral sex has often been implicated among the risk factors for oral HPV infections, however, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. The present study aimed to evaluate the coexistence of papilloma virus, at the levels of the oral and genital mucosa, in women with a histologically confirmed HPV lesions (and a positive HPV test) at the genital level and a negative HPV control group. We also evaluated how some risk factors, such as smoking, the number of partners, age, and sexual habits can influence the possible presence of the virus itself in the oropharynx of the same women. In total, 117 unvaccinated women aged between 18 and 52 were enrolled. We found that the prevalence of oral HPV infection was high among the women with concomitant genital HPV infection (22%) compared to the HPV-negative women (0%), and the estimated odds ratio was 17.36 (95% CI: 1.02, 297.04). In none of the women with oral HPV did we find any relevant clinical lesions. The potential risk factors for HPV infections in the oropharynx and genitals were analyzed based on questionnaire responses. A multivariate analysis showed that genital HPV infections were significantly associated with a number of sexual partners > 10 (OR 138.60, 95% CI: 6.04-3181.30, p < 0.001), but the data also referred to having between 3-5 or 6-10 partners as being significant, as were a high level of education (OR 6.24, 95% CI: 1.67-4.23.26 p = 0.003), a frequency of sexual intercourse >10 (OR 91.67 95% CI: 3.20-2623.52, p = 0.004), oral sex (OR 6.16, 95% CI: 1.22-31.19, p = 0.014), and >20 cigarettes/day (OR 6.09 95% CI: 1.21-30.61, p = 0.014). Furthermore, being "separate" and having multiple sexually transmitted diseases were also significantly associated with genital HPV infection. In contrast, oral HPV infections were significantly associated with women aged 36 to 50 years (OR 27.38, 95% CI: 4.37-171.37; p = 0.000202) and oral sex (OR 95.5, 95% CI: 5.13-1782.75, p = 0.001126).Additionally, being separate, being cohabitant, lifetime sexual partners of >10, 3-5 lifetime sexual partners, <20 years of age, >10 sexual intercourse per month, occasional and regular anal sex, >20 cigarettes per day, a history of sexually transmitted disease (herpes and multiple), and having a history of genital warts were significant. Screening and early diagnosis are considered to be practically unfeasible for this category of cancer, given the lack of visible lesions; the 9-valent HPV vaccine remains the only means that could help to successfully counter the growing incidence of oral squamous cell carcinoma.
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Affiliation(s)
- Maria Teresa Bruno
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, Italy
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Sara Boemi
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Giuseppe Caruso
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, Italy
| | - Francesco Sgalambro
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Salvatore Ferlito
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy
| | - Antonio Cavallaro
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Maria Chiara Sudano
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgery Specialties, Gynecological Clinic, University of Catania, Via S.Sofia 78, 95123 Catania, Italy
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Roman C, Andrade D, Hernández Y, Salazar ZK, Espinosa L, Campoverde E, Guallaizaca L, Merchán M, Sarmiento M, Brenner J. Biological, demographic, and health factors associated with HPV infection in Ecuadorian women. Front Public Health 2023; 11:1158270. [PMID: 37397749 PMCID: PMC10311495 DOI: 10.3389/fpubh.2023.1158270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives The study aims to identify the correlation between human papillomavirus (HPV) infection and sociodemographic and sexual reproductive health factors in Ecuadorian women from March to August 2019. Methods 120 women were randomly selected from two gynecological clinics to complete a questionnaire and provide a biospecimen. PCR-Hybridization was used to genotype 37 HPV serotypes in samples obtained by endo-cervical brushing for liquid-based cytology. Sociodemographic and sexual health data were collected through a validated questionnaire during a medical consultation. Mathematical modeling of HPV infection was done using bivariate logistic regression. Results 65.0% of the women sampled had an HPV infection; 74.3% of these women had co-infections with other HPV genotypes. Out of the women who were HPV positive, 75.6% were diagnosed with high-risk genotypes from HPV strains 18, 35, 52, and 66. Parity, immunosuppression, and use of oral contraception/intrauterine devices (IUDs) were identified as associated variables. The explanatory model had a sensitivity of 89.5% and a specificity of 73.8%. Conclusion The predominant strains of HPV among Ecuadorian women are diverse. The risk of HPV infection is a complex phenomenon where biological and psychosocial variables are integrated into a model. In populations with limited access to health services, low socioeconomic status, and negative sociocultural beliefs about sexually transmitted infections (STIs), surveys can be used as a pre-screening step for HPV infections. The diagnostic value of the model should be tested in multicenter studies that include women from all over the country.
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Affiliation(s)
- Carlos Roman
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
| | - Diego Andrade
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Yenima Hernández
- Department of Mental Health, The Angels Mental Health Community, Tampa, FL, United States
| | - Zoila K. Salazar
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
- Medical Center Association for the Well-being of the Ecuadorian Family (APROFE), Cuenca, Ecuador
| | - Lizette Espinosa
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Erika Campoverde
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Lourdes Guallaizaca
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - María Merchán
- Investigation Center for Health, Academic Unit of Health and Wellness, Catholic University of Cuenca (UCACUE), Cuenca, Ecuador
| | - Miriam Sarmiento
- Obstetrics Department, San Juan de Dios Hospital, Cuenca, Ecuador
| | - Jonathan Brenner
- Diagnostic Department, MEDsan, Inc., Saint Petersburg, FL, United States
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Hidalgo-Tenorio C, Calle-Gómez I, Moya-Megías R, Rodríguez-Granges J, Omar M, López Hidalgo J, García-Martínez C. HPV Infection of the Oropharyngeal, Genital and Anal Mucosa and Associated Dysplasia in People Living with HIV. Viruses 2023; 15:v15051170. [PMID: 37243256 DOI: 10.3390/v15051170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The main objectives were to describe the prevalence of HPV, its genotypes and HPV-associated dysplastic lesions in the oropharyngeal mucosa of PLHIV and related factors. MATERIAL AND METHODS This cross-sectional prospective study consecutively enrolled PLHIV attending our specialist outpatient units. At visit, HIV-related clinical and analytical variables were gathered, and oropharyngeal mucosa exudates were taken to detect HPV and other STIs by polymerase chain reaction. Samples were also taken from the anal canal of all participants and from the genital mucosa of the women for HPV detection/genotyping and cytological study. RESULTS The 300 participants had a mean age of 45.1 years; 78.7% were MSM and 21.3% women; 25.3% had a history of AIDS; 99.7% were taking ART; and 27.3% had received an HPV vaccine. HPV infection prevalence in the oropharynx was 13%, with genotype 16 being the most frequent (2.3%), and none had dysplasia. Simultaneous infection with Treponema pallidum (HR: 4.02 (95% CI: 1.06-15.24)) and a history of anal HSIL or SCCA (HR: 21.52 (95% CI: 1.59-291.6)) were risk factors for oropharyngeal HPV infection, whereas ART duration (8.8 vs. 7.4 years) was a protective factor (HR: 0.989 (95% CI: 0.98-0.99)). CONCLUSIONS The prevalence of HPV infection and dysplasia was low in the oropharyngeal mucosae. A higher exposure to ART was protective against oral HPV infection.
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Affiliation(s)
- Carmen Hidalgo-Tenorio
- Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
| | - Inmaculada Calle-Gómez
- Internal Medicine Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
| | - Raquel Moya-Megías
- Internal Medicine Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
| | - Javier Rodríguez-Granges
- Microbiology Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
| | - Mohamed Omar
- Unit of Infectious Diseases, Complejo Hospitalario de Jaen, 23007 Jaen, Spain
| | - Javier López Hidalgo
- Pathology Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
| | - Carmen García-Martínez
- Internal Medicine Service, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18014 Granada, Spain
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Vani NV, Madhanagopal R, Swaminathan R, Ganesan TS. Dynamics of oral human papillomavirus infection in healthy population and head and neck cancer. Cancer Med 2023. [PMID: 36846921 DOI: 10.1002/cam4.5686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
The recent increase in high-risk human papillomavirus (HR-HPV)-associated oral and oropharyngeal cancers has gained considerable importance due to their distinct clinical and molecular characteristics. However, the natural history of oral HPV from acquisition to persistence and malignant transformation is still unclear. The global prevalence of oral HPV infection in healthy individuals ranges from 0.67% to 35%, while 31%-38.5% in head and neck cancer (HNC). The persistence rate of oral HR-HPV infection is 5.5% -12.8% globally. India has the highest HNC burden due to apparent differences in predisposing factors compared with the West. The prevalence of oral HPV in healthy individuals and its contribution to HNC is less evident in Indian studies. HR-HPV-associated HNC in this region accounts for 26%, with an active infection in 8%-15% of these tumors. There is a lack of concordance in the expression of p16 as a surrogate marker for HPV detection in HNC because of differences in behavioral risk factors. Due to a lack of evidence, treatment de-escalation cannot be implemented despite the improved outcome of HPV-associated oropharyngeal cancers. This review critically analyzes the existing literature on the dynamics of oral HPV infection and HPV-associated HNC, identifying potential avenues for future research. A better understanding of the oncogenic role of HR-HPV in HNC will help to formulate novel therapeutic approaches and is expected to have a significant public health impact as preventive strategies can be implemented.
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Affiliation(s)
- N V Vani
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - R Madhanagopal
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - R Swaminathan
- Epidemiology, Biostatistics, and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - T S Ganesan
- Medical Oncology, Cancer Institute (WIA), Chennai, India
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Wang W, Kothari-Talwar S, Roberts C, Lu Q, Lara N, Panchal R, Morais E, Chen YT, Qiao Y, Cui F. Estimating the prevalence of non-cervical human papillomavirus infection in mainland China (PROGRESS-Plus): protocol of a national cross-sectional study. BMJ Open 2023; 13:e065749. [PMID: 36731925 PMCID: PMC9896211 DOI: 10.1136/bmjopen-2022-065749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) infection is the most common sexually transmissible infection worldwide. Although the prevalence of cervical HPV infection has been extensively reported in women worldwide, few epidemiological studies have examined the prevalence of non-cervical HPV infection among both women and men, especially in China. METHODS AND ANALYSIS PROGRESS-Plus is a national, multisite, cross-sectional study that aims to estimate the prevalence of non-cervical HPV infection in women and men aged 18-60 years residing in mainland China. More specifically, PROGRESS-Plus will estimate the prevalence rate of HPV DNA in oral samples from both women and men, and that of anogenital samples from men. The secondary study objectives are to (1) report the aforementioned prevalence rates by HPV genotype, age and geographical region, (2) examine the concordance (ie, prevalence of the same HPV genotype) between the oral and anogenital samples among men, (3) explore risk factors associated with oral (in both women and men) and anogenital (in men only) HPV infection and (4) describe study participants' health-related quality of life, health behaviour, sexual behaviour and health status. ETHICS AND DISSEMINATION The study protocol and all required documents have been submitted for review and approval to the Independent Ethics Committees of all the participating sites. All participants will provide their written informed consent on study entry, and all the recorded data will be treated as confidential.
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Affiliation(s)
- Wei Wang
- Merck & Co Inc, Rahway, New Jersey, USA
| | | | | | - Qingbin Lu
- School of Public Health, Peking University, Beijing, China
| | | | | | | | | | - Youlin Qiao
- Cancer Epidemiology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fuqiang Cui
- Peking University Health Science Centre, Beijing, China
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Gheit T, Muwonge R, Lucas E, Galati L, Anantharaman D, McKay-Chopin S, Malvi SG, Jayant K, Joshi S, Esmy PO, Pillai MR, Basu P, Sankaranarayanan R, Tommasino M. Impact of HPV vaccination on HPV-related oral infections. Oral Oncol 2023; 136:106244. [PMID: 36402055 PMCID: PMC9833124 DOI: 10.1016/j.oraloncology.2022.106244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Although the efficacy of the HPV vaccine in preventing the development of cervical pre-malignant lesions has been well demonstrated, the efficacy of the HPV vaccine in preventing HPV infection in the upper respiratory tract has been poorly studied. METHODS In the context of the IARC cohort study of two versus three doses of HPV vaccine in India, we compared the HPV type prevalence in the oral cavity of women vaccinated with three doses, two doses, or a single dose of quadrivalent HPV vaccine with that of unvaccinated women. A total of 997 oral samples, from 818 vaccinated women and 179 unvaccinated women, were collected at three study sites. All the participants were sexually active at the time of sample collection. RESULTS The age-standardized proportion (ASP) of HPV16/18 infections was 2.0 % (95 % CI, 1.0-3.0 %) in vaccinated women and 4.2 % (95 % CI, 1.2-7.2 %) in unvaccinated women. HPV16 was detected in 3.5 % of single-dose recipients, 1.2 % of two-dose recipients (days 1 and 180), and 1.5 % of three-dose recipients (days 1, 60, and 180), whereas 3.3 % of the unvaccinated women tested positive for HPV16. The same trend was observed for HPV18. DISCUSSION Our findings agree with those of previous studies on the efficacy of HPV vaccination in reducing oral HPV infections and provide indications that a single vaccine dose may be less efficient than two or three doses in preventing oral HPV infection.
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Affiliation(s)
- Tarik Gheit
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Richard Muwonge
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eric Lucas
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Luisa Galati
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, India
| | - Sandrine McKay-Chopin
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sylla G Malvi
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Kasturi Jayant
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Smita Joshi
- Jehangir Clinical Development Centre, Jehangir Hospital Premises, Pune, India
| | - Pulikkottil O Esmy
- Christian Fellowship Community Health Centre, Ambillikai, Dindigul District, Tamil Nadu, India
| | | | - Partha Basu
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Monti E, Barbara G, Libutti G, Boero V, Parazzini F, Ciavattini A, Bogani G, Pignataro L, Magni B, Merli CEM, Vercellini P. A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission? BMC Womens Health 2022; 22:379. [PMID: 36115987 PMCID: PMC9482202 DOI: 10.1186/s12905-022-01965-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Abstract
Head and neck cancer, the sixth most common cancer worldwide, account for about 1 out of 20 malignant tumors. In recent years a reduction in the incidence of cervical cancer, but a concomitant major increase in the incidence of HPV-mediated oropharyngeal cancer caused by orogenital HPV transmission has been observed. Consequently, in wealthy countries oropharyngeal squamous-cell carcinomas (OPSCC) is now the most frequent HPV-related cancer, having overtaken cervical cancer. Without effective medical interventions, this incidence trend could continue for decades. As no specific precursor lesion has been consistently identified in the oral cavity and oropharynx, HPV vaccination is the logical intervention to successfully counteract also the rising incidence of OPSCCs. However, HPV vaccine uptake remains suboptimal, particularly in males, the population at higher risk of OPSCC. Alternative primary prevention measures, such as modifications in sexual behaviors, could be implemented based on knowledge of individual genital HPV status. Until recently, this information was not available at a population level, but the current gradual shift from cytology (Pap test) to primary HPV testing for cervical cancer screening is revealing the presence of oncogenic viral genotypes in millions of women. In the past, health authorities and professional organizations have not consistently recommended modifications in sexual behaviors to be adopted when a persistent high-risk HPV cervicovaginal infection was identified. However, given the above changing epidemiologic scenario and the recent availability of an immense amount of novel information on genital HPV infection, it is unclear whether patient counseling should change. The right of future partners to be informed of the risk could also be considered. However, any modification of the provided counseling should be based also on the actual likelihood of a beneficial effect on the incidence of HPV-associated oropharyngeal cancers. The risk is on one side to induce unjustified anxiety and provide ineffective instructions, on the other side to miss the opportunity to limit the spread of oral HPV infections. Thus, major health authorities and international gynecologic scientific societies should issue or update specific recommendations, also with the aim of preventing inconsistent health care professionals’ behaviors.
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11
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Salivary HPV infection in healthy people. POSTEP HIG MED DOSW 2022. [DOI: 10.2478/ahem-2022-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction
In recent years, interest in human papillomavirus infections as a causative factor in epithelial cancer development has grown. Literature indicates that HPV involvement in malignant transformations in oral mucosa can vary significantly, from 0 up to 87%. The aim of our study was to detect the prevalence of salivary HPV infection among generally healthy adults.
Materials and Methods
The examination involved 139 patients, from whom 139 whole, 1.5ml saliva samples were obtained. HPV DNA was detected by the nested PCR technique. To visualize the PCR products electrophoresis reactions were carried out.
Results
Sample analysis showed that DNA for HPV was detected in 14 patients: 11 positive results were obtained from men, and 3 from women. This yields a high infection rate: 10.07%.
Conclusions
The HPV prevalence in the male group was more than twice as high as in the female group. Also, subclinical oral HPV infection was detected more frequently in young (19–39 years old) and older (=>60 years old) adults.
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12
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Guarda V, Schroeder L, Pawlita M, Ikenberg K, Rupp NJ, Jochum W, Stoeckli SJ, Holzinger D, Broglie MA. Prevalence of Transcriptionally Active HPV Infection in Tumor-Free Oropharyngeal Tissue of OPSCC-Patients. Front Oncol 2022; 12:835814. [PMID: 35530340 PMCID: PMC9074725 DOI: 10.3389/fonc.2022.835814] [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: 12/14/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe natural history of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is still largely unknown. Since reports of second primary tumors (SPTs) in patients with HPV-related OPSCCs are increasing, a multifocal HPV infection, hinting a «virus-induced field effect», has been hypothesized. This study aimed to investigate the HPV-prevalence in normal appearing oropharyngeal tissue in patients with OPSCCs.Materials and Methods49 OPSCC patients undergoing panendoscopy were prospectively enrolled. Tumor specimens and biopsies of normal appearing oropharyngeal tissue adjacent to and distant from the index OPSCC underwent histopathological examination, p16INK4A immunohistochemical staining, HPV DNA and mRNA-detection. Patient characteristics and follow-up data on SPTs were obtained.Results26 of 49 (53%) OPSCC were positive for HPV DNA and p16INK4A. HPV mRNA was detected in 23 of 26 (88%) of these tumor samples. HPV DNA was detected in 36% adjacent mucosa and in 17% distant mucosa samples and only in patients with an HPV-related index OPSCC. HPV mRNA could not be detected in tumor-free distant and adjacent mucosa samples. No evidence of association between HPV detection in normal appearing mucosa and development of second primary tumors was found.ConclusionsHPV was detectable but not transcriptionally active in adjacent/distant tumor-free oropharyngeal tissue. This suggests that a multifocal HPV infection, hinting a «virus-induced fielcd cancerization», may not be pertaining to HPV-related OPSCC.
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Affiliation(s)
- Vittoria Guarda
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- *Correspondence: Vittoria Guarda,
| | - Lea Schroeder
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Niels J. Rupp
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dana Holzinger
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
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13
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Epidemiology and Prevention of HPV-Associated Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-021-00385-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Morais E, Kothari S, Roberts C, Yen G, Chen YT, Lynam M, Pedrós M, Mirghani H, Alemany L, Pavon MA, Waterboer T, Mehanna H, Giuliano AR. Oral human papillomavirus (HPV) and associated factors among healthy populations: The design of the PROGRESS (PRevalence of Oral hpv infection, a Global aSSessment) study. Contemp Clin Trials 2021; 115:106630. [PMID: 34838717 DOI: 10.1016/j.cct.2021.106630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/22/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Head and neck cancers are increasingly associated with human papillomavirus (HPV) infection. Previous studies of oral HPV indicate considerable heterogeneity across geographic regions and by sex, but studies differ in methodologies used and risk groups included. Understanding the natural history of oral HPV in the general population is important to assess HPV-related disease burden and plan effective prevention programs. In this study, we aim to assess the prevalence, incidence, and persistence of oral HPV among adult men and women. Factors independently associated with oral HPV will also be evaluated. METHODS The PROGRESS (PRevalence of Oral hpv infection, a Global aSSessment) study is a non-interventional study of 7877 healthy men and women aged 18-60 years, from France, Germany, Spain, the United Kingdom (UK) and the United States (US). Oral HPV prevalence will be measured using a commercially available PCR DNA test. In the US, participants will be followed prospectively every 6 months for 24 months to assess incidence, clearance, and persistence of oral HPV infection. Eligible individuals presenting for regular dental check-ups will be recruited from participating dental offices via systematic consecutive sampling. Participant dentists will collect clinical characteristics, and participants will complete self-reported study questionnaires and provide an oral rinse and gargle (ORG) specimen for HPV-DNA detection and genotyping at each study visit. HPV-DNA detection and genotyping will be performed in two reference laboratories, using the SPF10/DEIA/LiPA25 system. DISCUSSION PROGRESS study aims to fill knowledge gaps concerning the natural history of oral HPV using a standardized methodology. PROGRESS will also assess factors associated with oral HPV prevalence and natural history in the general population.
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Affiliation(s)
| | - Smita Kothari
- Merck & Co., Inc., 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Craig Roberts
- Merck & Co., Inc., 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Glorian Yen
- Merck & Co., Inc., 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Ya-Ting Chen
- Merck & Co., Inc., 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Mark Lynam
- IQVIA, Provença, 392, 3rd Floor, 08025 Barcelona, Spain
| | - Montse Pedrós
- IQVIA, Provença, 392, 3rd Floor, 08025 Barcelona, Spain.
| | - Haitham Mirghani
- Hôpital Européen Georges-Pompidou, 20 Rue Leblanc, 75015, Paris, France
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology - IDIBELL, Hospitalet de Llobregat; and CIBERESP, Granvia de l'Hospitalet, 199-203, 08908, Barcelona, Spain
| | - Miquel Angel Pavon
- Cancer Epidemiology Research Program, Catalan Institute of Oncology - IDIBELL, Hospitalet de Llobregat; and CIBERESP, Granvia de l'Hospitalet, 199-203, 08908, Barcelona, Spain
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Im Neuenheimer Feld, 280, 69120, Heidelberg, Germany
| | - Hisham Mehanna
- Institute of Head & Neck Studies and Education (InHANSE), University of Birmingham, Robert Aitken Building, Vincent Drive, B15 2TT Birmingham, United Kingdom
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, 33612, Tampa, Florida, USA
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15
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Morhason-Bello IO, Baisley K, Pavon MA, Adewole IF, Bakare R, de Sanjosé S, Francis SC, Watson-Jones D. Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women. Infect Agent Cancer 2021; 16:59. [PMID: 34496909 PMCID: PMC8424803 DOI: 10.1186/s13027-021-00398-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/24/2021] [Indexed: 12/24/2022] Open
Abstract
Background Human papillomavirus (HPV) associated cancers are increasingly reported globally, including in sub-Saharan Africa (SSA). However, with the exception of cervical HPV infection, data from SSA on the epidemiology of oral and genital HPV infections are limited. This study assessed the prevalence and concordance of oro-genital and anal HPV genotype specific infections among women in the general population.
Methods We conducted a cross-sectional study in sexually active women aged 18–45 years in Ibadan, Nigeria. After a face-to-face interview and clinical examination, oral, cervical, vulvar, and anal samples were collected from participants and tested by the Anyplex II 28 HPV assay. Descriptive and multivariable analyses were used to report prevalence and risk factors associated with HPV infections. Results The prevalence of any vulva, cervical, anal, and oral HPV infections was 68.0% (210/309), 59.7% (182/305), 56.8% (172/303), and 16.1% (14/286), respectively. There was an inverse relationship between age-group and HPV prevalence of HPV in all anatomic sites except for the oral HPV infections. HPV 35 was the most prevalent high-risk HPV genotype in the vulva, cervix and oral cavity. Associated risk factors for HPV infection in each of the anatomic sites were reported. Overall, 10.0% (31/310) women had concordance of any HPV type in the four anatomic sites. Conclusion There was a high prevalence of oro-genital and anal HPV infections among sexually active Nigerian women, with concordance of HPV types in the cervix, vulva, anus and oral cavity. We advocate large longitudinal studies that will involve sampling of multiple anatomic sites and inclusion of other women in the community for better understanding of HPV epidemiology in this region. Supplementary Information The online version contains supplementary material available at 10.1186/s13027-021-00398-9.
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Affiliation(s)
- Imran O Morhason-Bello
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria. .,Institute of Advance Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Miquel Angel Pavon
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain
| | - Isaac F Adewole
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Rasheed Bakare
- Department of Microbiology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Silvia de Sanjosé
- Infection and Cancer Laboratory, Cancer Epidemiology Research Program, ICO, Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), L'Hospitalet de Llobregat, Gran Via de l'Hospitalet, 199-203, 08908, Barcelona, Spain.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, USA
| | - Suzanna C Francis
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Deborah Watson-Jones
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
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16
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Abstract
Human papillomavirus is the most common sexually transmitted infection in the world and had been linked to both anogenital and oropharyngeal cancers. It causes nearly 100% of cervical cancers and an increasing portion of oropharyngeal cancers. The geographical burden of cervical HPV infection and associated cancers is not uniform and is mainly found in low middle income countries in South America, Africa, and Asia. However, HPV-positive oropharyngeal cancer is rapidly becoming more prevalent in high middle income countries. With the development of vaccines which prevent HPV infection, the World Health Organization has designated the extirpation of HPV and its associated cancers a priority. Countries that have implemented adequate vaccine programs have shown a decrease in HPV prevalence. Understanding the epidemiology of HPV and its associated cancers is fundamental in improving vaccine programs and other health programs.
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Affiliation(s)
- Nicholas Scott-Wittenborn
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
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17
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Bettampadi D, Dickey B, Abrahamsen M, Sirak B, Baggio ML, Galan L, Silva RC, Villa L, Ponce EL, Giuliano AR. Differences in Factors Associated With High- and Low-Risk Oral Human Papillomavirus Genotypes in Men. J Infect Dis 2021; 223:2099-2107. [PMID: 33151300 DOI: 10.1093/infdis/jiaa693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) causes oral warts and oropharyngeal cancer (OPC). Human papillomavirus-attributable OPC incidence among men is significantly increasing worldwide, yet few studies have reported oral HPV across multiple countries or examined factors associated with low- and high-risk HPV separately. METHODS Oral gargles from 3095 men in the multinational HPV Infection in Men (HIM) Study were HPV genotyped. Multivariable models assessed factors independently associated with high-risk and low-risk HPV prevalence. RESULTS The prevalence of high-risk and low-risk HPV was 6.0% and 2.8%, respectively. Greater number of sexual partners was only associated with high-risk HPV (1.88; 95% confidence interval [CI], 1.22-2.90) prevalence. In multivariable models, residing in Mexico (1.66; 95% CI, 1.15-2.40) and smoking (1.66; 95% CI, 1.13-2.44) were significantly associated with high-risk HPV, and history of consistent gum bleeding (2.16; 95% CI, 1.35-3.45) was significantly associated with low-risk HPV. Gender of the sexual partner did not alter the results for either high- or low-risk HPV endpoints. CONCLUSIONS Different factors were independently associated with high- and low-risk oral HPV. Oral sexual behaviors were associated with high-risk HPV, and oral health was associated with low-risk HPV. High-risk HPV prevalence differed by country of residence, highlighting the need for additional studies in multiple countries.
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Affiliation(s)
- Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Brittney Dickey
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Lenice Galan
- Centro de Referencia e Treinamento em DST/AIDS, São Paulo, Brazil
| | | | - Luisa Villa
- Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil.,Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano Ponce
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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18
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Tewari P, Banka P, Kernan N, Reynolds S, White C, Pilkington L, O'Toole S, Sharp L, D'Arcy T, Murphy C, Comiskey C, Martin CM, O'Leary JJ. Prevalence and concordance of oral HPV infections with cervical HPV infections in women referred to colposcopy with abnormal cytology. J Oral Pathol Med 2021; 50:692-699. [PMID: 33733523 DOI: 10.1111/jop.13172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Considering the shared aetiology of Human Papillomavirus infections in oropharyngeal and cervical cancers and the possible role for sexual transmission, several key aspects of the relationship between cervical and oral infections merit investigation, including prevalence of concomitant oral HPV infection and type-specific concordance with concurrent cervical infections. METHODS A cross-section study was performed on women referred to colposcopy clinics with cytological abnormalities and a cervical HPV infection. An oral rinse sample was taken from the participants at their baseline visit for HPV testing, and a demographic and risk factor questionnaire was also administered. HPV DNA testing was carried out on the Cobas 4800 platform and extended genotyping was carried out with the INNO-LiPA HPV Genotyping Extra II assay. HPV genotyping was also carried out on the concurrent cervical tissue samples on all women who had a positive oral HPV infection. RESULTS The prevalence of oral HPV infections was 10.0% (95%CI:5.9-13.7) in the study population. HPV18 was the most frequent genotype (7.0%). Concordant oral and cervical HPV infections were detected in 28.6% of women. Age (p = 0.005) and level of education (p = 0.02) were significantly associated with a prevalent oral HPV infection. CONCLUSION Concomitant oral HPV infections were present in 10.0% of women referred to colposcopy with a pre-existing cervical HPV infections and cytological abnormalities. Although mild type-specific concordance was observed between oral and cervical HPV infections, findings suggest that infections at these sites may not be independent of each other.
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Affiliation(s)
- Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Prakashini Banka
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niamh Kernan
- Department of Histopathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Stephen Reynolds
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Christine White
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Loretto Pilkington
- Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Science Institute, Newcastle University, Newcastle, UK
| | - Tom D'Arcy
- Department of Obstetrics & Gynaecology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Cliona Murphy
- Department of Obstetrics & Gynaecology, Tallaght University Hospital, Dublin, Ireland
| | - Catherine Comiskey
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Cara M Martin
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
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19
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Ju X, Canfell K, Smith M, Sethi S, Garvey G, Hedges J, Logan RM, Antonsson A, Jamieson LM. High-Risk Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma Among Non-Indigenous and Indigenous Populations: A Systematic Review. Otolaryngol Head Neck Surg 2020; 165:23-32. [PMID: 33228443 DOI: 10.1177/0194599820975042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To estimate the prevalence of oral high-risk human papillomavirus (hr-HPV) infection and the proportion of hr-HPV-related oropharyngeal squamous cell carcinoma (OPSCC) among Indigenous and non-Indigenous populations. DATA SOURCE Electronic database searches of PubMed, PubMed Central, Embase, MEDLINE, Scope, and Google Scholar were conducted for articles published from January 2000 until November 2019. REVIEW METHODS Studies were included with a minimum of 100 cases assessing hr-HPV infection in either population samples or oropharyngeal cancer tumor series. The objective was to conduct meta-analyses to calculate the pooled prevalence of oral hr-HPV infection by adjusting for age group or sex in primary studies, the incidence of OPSCC, and the proportion of hr-HPV-related OPSCC in Indigenous people and non-Indigenous/general populations. RESULTS We identified 47 eligible studies from 157 articles for meta-analyses. The pooled prevalence of oral hr-HPV infection was 7.494% (95% CI, 5.699%-9.289%) in a general population, with a higher prevalence among men (10.651%) than women (5.176%). The pooled incidence rate was 13.395 (95% CI, 9.315-17.475) and 7.206 (95% CI, 4.961-9.450) per 100,000 person-years in Indigenous and non-Indigenous populations, respectively. The overall pooled proportion of hr-HPV-related OPSCC was 50.812% (95 CI, 41.656%-59.969%). The highest proportion was in North America (60.221%), while the lowest proportion was in the Asia-Pacific (34.246%). CONCLUSION Our findings suggest that in the general population, the prevalence of oral hr-HPV infection is lower among females and those in younger age groups. The incidence of OPSCC was higher among Indigenous than non-Indigenous populations, with the proportion being highest in North America.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Karen Canfell
- Cancer Council NSW, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Megan Smith
- Cancer Council NSW, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Gail Garvey
- Menzies School of Health Research, Spring Hill, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Richard M Logan
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Annika Antonsson
- QIMR Berghofer Medical Research Institute, Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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20
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Dwedar RA, Omar NM, Eissa SAL, Badawy AYA, El-Kareem DA, Ahmed Madkour LAEF. Diagnostic and prognostic impact of E6/E7 mRNA compared to HPV DNA and p16 expression in head and neck cancers: an Egyptian study. ALEXANDRIA JOURNAL OF MEDICINE 2020. [DOI: 10.1080/20905068.2020.1827944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Reham Ali Dwedar
- Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Mohamed Omar
- Department of Microbiology and Immunology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Dalia Abd El-Kareem
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
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21
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Pinatti LM, Walline HM, Carey TE, Klussmann JP, Huebbers CU. Viral Integration Analysis Reveals Likely Common Clonal Origin of Bilateral HPV16-Positive, p16-Positive Tonsil Tumors. ACTA ACUST UNITED AC 2020; 4:680-696. [PMID: 32954225 PMCID: PMC7497862 DOI: 10.26502/acmcr.96550248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Infections with high-risk human papilloma viruses (HPV) are responsible for a significant number of oropharyngeal squamous cell carcinoma (OPSCC), with infection rates currently rising at epidemic rates in the western world. Synchronous bilateral HPV+ tumors of both tonsils are a very rare event whose understanding, however, could provide important insights into virus-driven tumor development and progression and whether such integration events are of clonal origin. In this study we analyzed a single case of a bilateral tonsillar p16+ HPV+OPSCC. The viral integration status of the various tumor samples was determined by integration-specific PCR methods and sequencing, which identified viral insertion sites and affected host genes. Integration events were further confirmed by transcript analysis. Analysis of the tumors revealed common viral integration events involving the CD36 gene, as well as a unique event in the LAMA3 gene which resulted in loss of LAMA3 exon one in both tissues that had lost the complex viral LAMA3 integration event. In addition, there were several integration events into intergenic regions. This suggests a common origin but individual evolution of the tumors, supporting the single-clone hypothesis of bilateral tumor development. This hypothesis is further supported by the fact that the two cellular genes LAMA3 and CD36 as targets of viral integration are involved in cell migration and ECM-receptor interactions, which provides a possible mechanism for clonal migration from one tonsil to another.
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Affiliation(s)
- Lisa M. Pinatti
- Cancer Biology Program, Program in the Biomedical Sciences, Rackham Graduate School, University of Michigan, Ann Arbor, MI, USA
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Heather M. Walline
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Thomas E. Carey
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Jens Peter Klussmann
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Christian U. Huebbers
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany
- Corresponding Author: Dr. Christian U. Huebbers, Jean-Uhrmacher-Institute for Otorhinolaryngological Research, University of Cologne, Cologne, Germany, Tel: +49221478-97017; Fax +4922147897010;
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22
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Kerry-Barnard S, Beddows S, Reid F, Beckley-Hoelscher N, Soldan K, Panwar K, Seran C, Fleming C, Lesniewska A, Planche T, Williamson J, Hay P, Oakeshott P. Human papillomavirus (HPV) vaccination and oropharyngeal HPV in ethnically diverse, sexually active adolescents: community-based cross-sectional study. Sex Transm Infect 2020; 97:458-460. [PMID: 32883750 PMCID: PMC8380902 DOI: 10.1136/sextrans-2020-054428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/07/2020] [Accepted: 07/26/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives Oropharyngeal squamous cell carcinoma is the most common human papillomavirus (HPV)-associated cancer in the UK, but little is known about the prevalence of oropharyngeal HPV in sexually active teenagers. We investigated reported HPV vaccination coverage (in females) and prevalence of oropharyngeal HPV in sexually active students attending six technical colleges in London, UK. Methods In 2017, we obtained mouthwash samples and questionnaires from male and female students taking part in the ‘Test n Treat’ chlamydia screening trial. Samples were subjected to HPV genotyping. Results Of 232 participants approached, 202 (87%) provided a mouthwash sample and questionnaire. Participants’ median age was 17 years and 47% were male. Most (73%) were from black and minority ethnic groups, 64% gave a history of oral sex, 52% reported having a new sexual partner in the past 6 months, 33% smoked cigarettes, 5.9% had concurrent genitourinary Chlamydia trachomatis infection and 1.5% Neisseria gonorrhoeae and 5.0% were gay or bisexual. Only 47% (50/107) of females reported being vaccinated against HPV 16/18, of whom 74% had received ≥2 injections. HPV genotyping showed three mouthwash samples (1.5%, 95% CI 0.3% to 4.3%) were positive for possible high-risk human papillomavirus (HR-HPV), one (0.5%, 0.0% to 2.7%) for low-risk HPV 6/11, but none (0.0%, 0.0% to 1.8%) for HR-HPV. Four samples (2.0%, 0.5% to 5.0%) were positive for HPV16 using a HPV16 type-specific quantitative PCR, but these were at a very low copy number and considered essentially negative. Conclusions Despite the high prevalence of oral sex and genitourinary chlamydia and low prevalence of HPV vaccination, the prevalence of oropharyngeal HR-HPV in these adolescents was negligible.
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Affiliation(s)
- Sarah Kerry-Barnard
- Population Health Research Institute, St George's University of London, London, UK
| | - Simon Beddows
- National Infection Service, Public Health England, London, UK
| | - Fiona Reid
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | | | - Kate Soldan
- National Infection Service, Public Health England, London, UK
| | - Kavita Panwar
- National Infection Service, Public Health England, London, UK
| | - Cangul Seran
- National Infection Service, Public Health England, London, UK
| | - Charlotte Fleming
- Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Public Health, London, UK
| | - Agata Lesniewska
- Population Health Research Institute, St George's University of London, London, UK
| | - Tim Planche
- Infection and Immunity, St George's University of London, London, UK
| | - Jonathan Williamson
- Population Health Research Institute, St George's University of London, London, UK
| | - Phillip Hay
- Burrell Street Sexual Health Clinic, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Pippa Oakeshott
- Population Health Research Institute, St George's University of London, London, UK
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23
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Bettampadi D, Villa LL, Ponce EL, Salmeron J, Sirak BA, Abrahamsen M, Rathwell JA, Reich RR, Giuliano AR. Oral human papillomavirus prevalence and type distribution by country (Brazil, Mexico and the United States) and age among HPV infection in men study participants. Int J Cancer 2020; 146:3026-3033. [PMID: 31583681 PMCID: PMC7117984 DOI: 10.1002/ijc.32713] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/03/2019] [Accepted: 09/13/2019] [Indexed: 01/20/2023]
Abstract
Incidence of human papillomavirus (HPV) attributable oropharyngeal cancers (OPCs) has been increasing globally, especially among men in high-income countries. There is a lack of studies comparing oral HPV prevalence by age and country among healthy men. The purpose of our study was to assess oral HPV prevalence by country and age. Participants of the HPV Infection in Men Study (HIM), a cohort of 3,098 healthy men from São Paulo, Brazil, Cuernavaca, Mexico and Tampa, USA, were studied. Oral HPV prevalence and type distribution were assessed using the SPF10 PCR-DEIA-LiPA25 system. The prevalence of any HPV in Brazil, Mexico and the US was 8.7% (95% CI: 7.1%, 10.4%), 10.0% (95% CI: 8.3%, 12.1%) and 7.6% (95% CI: 5.9%, 9.5%), respectively, while the prevalence of high-risk HPV was 5.3% (95% CI: 4.1%, 6.7%), 7.3% (95% CI: 5.7%, 9.0%) and 5.4% (95% CI: 4.0%, 7.0%), respectively. No significant differences in prevalence of grouped HPV types were observed by country despite significant differences in sexual behaviors. However, the age-specific prevalence of oral HPV differed by country. Brazilian (6.0% [95% CI: 3.4%, 9.7%]) and Mexican (9.2% [95% CI: 5.6%, 14.0%]) participants had peak high-risk HPV prevalence among men aged 41-50 years whereas the US participants had peak prevalence at ages 31-40 years (11.0% [95% CI: 6.4%, 17.3%]). In conclusion, oral HPV prevalence was low with no difference in overall prevalence observed by country. Factors associated with the differences in oral HPV age-patterning by country and sexual orientation require further study.
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Affiliation(s)
- Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Luisa L. Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eduardo L. Ponce
- Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico
| | - Jorge Salmeron
- Mexican Institute of Social Security, Mexico City, Mexico
| | - Bradley A. Sirak
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Julie A. Rathwell
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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24
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Giuliani M, Rollo F, Vescio MF, Pichi B, Latini A, Benevolo M, Pellini R, Cristaudo A, Dona' MG. Oral human papillomavirus infection in HIV-infected and HIV-uninfected MSM: the OHMAR prospective cohort study. Sex Transm Infect 2020; 96:528-536. [PMID: 32001661 DOI: 10.1136/sextrans-2019-054301] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/30/2019] [Accepted: 01/12/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE We aimed to assess incidence and clearance of oral human papillomavirus (HPV) infection and the respective risk factors in HIV-infected and uninfected men who have sex with men (MSM). METHODS Oral rinse and gargles were collected semiannually from 244 MSM (103, 42.2% HIV-infected). HPV-DNA testing was performed with the Linear Array HPV Genotyping test. A Markov model was used for estimation of incidence, clearance and risk factor analysis. RESULTS Incidence rates for any HPV were 21.2 and 15.0×1000 person-months in HIV-infected and uninfected MSM, respectively. The respective figures for high-risk HPVs were 10.7 and 6.5×1000 person-months. The clearance rate was 4-12 times higher than the respective incidence rate. HIV-infected MSM with >95 lifetime oral sex partners showed increased incidence of any HPV (adjusted HR, aHR: 8.46, 95% CI 1.89 to 37.92). Condomless oral sex appeared the strongest predictor for incident infection by high-risk HPVs in this group (aHR: 13.40, 95% CI 2.55 to 70.53). Those aged >46 years (aHR: 0.30, 95% CI 0.12 to 0.74) and those with nadir CD4+ T count of <200 cells/mm3 (aHR: 0.14, 95% CI 0.03 to 0.75) displayed a significantly reduced clearance of any and high-risk HPVs, respectively. HIV-uninfected MSM aged >46 years had increased risk of acquiring any HPV (aHR: 3.70, 95% CI 1.30 to 10.52) and high-risk HPV (aHR: 5.33, 95% CI 1.06 to 26.68). Any HPV clearance declined in those with more than six recent oral sex partners (aHR: 0.18, 95% CI 0.05 to 0.65). CONCLUSIONS Acquisition of oral HPV infection in MSM seems to occur rarely, whereas clearance seems to be a frequent event. Oral HPV natural history in these at-risk subjects is differently influenced by age and sex behaviour, depending on HIV status.
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Affiliation(s)
- Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Francesca Rollo
- Pathology Department, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Maria Fenicia Vescio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Pichi
- Otolaryngology Head and Neck Surgery Department, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Maria Benevolo
- Pathology Department, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Raul Pellini
- Otolaryngology Head and Neck Surgery Department, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
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25
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Fulla M, Szafarowski T, Frias-Gomez J, Quiros B, Clavero O, Gomà M, Pavon MA, Jurek-Matusiak O, Lares HR, Mañós M, Alemany L, Mena M, Gonzalez X. Human Papillomavirus and Factors Associated with Recurrence in Sinonasal Inverted Papillomas from Poland and Spain. Head Neck Pathol 2020; 14:758-767. [PMID: 31916205 PMCID: PMC7413944 DOI: 10.1007/s12105-019-01125-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 12/30/2019] [Indexed: 12/11/2022]
Abstract
Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has a tendency for recurrence and malignant transformation. The role of human papillomavirus (HPV) in SNIP is controversial. To determine the HPV-DNA prevalence and type distribution in SNIP in two different geographic areas and assess the association between SNIP recurrence and HPV infection, as well as additional potential etiologic factors. Two retrospective cohorts of SNIP patients from Poland and Spain were evaluated. Demographic, tobacco/alcohol use, clinical, and follow-up data were collected. All samples were subject to histopathologic evaluation, DNA quality control, and HPV-DNA detection by PCR. HPV-DNA positive samples and a random sample of HPV-DNA negative cases were further subject to p16INK4a analysis. Proportional-hazards models were used to evaluate the risk of recurrence by selected variables. Seventy-nine SNIP patients (46 from Spain diagnosed between 1995 and 2014, and 33 from Poland diagnosed between 2012 and 2017) were included in the study. HPV-DNA was detected in four patients (5.1%), two from each region, and all four were positive for the HPV11 subtype. Seventeen patients (21.5%) experienced recurrence, with a median time to recurrence of 14 months. No association was identified between lesional HPV-DNA positivity, toxic habits, Krouse stage, or malignant transformation and a higher risk of recurrence. The low prevalence of HPV-DNA in SNIPs suggests that HPV is not a main etiology for development of these lesions. With a lack of association between the evaluated factors and recurrence, further research with larger number of patients and additional biomarkers is warranted to further understand predisposing risk factors.
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Affiliation(s)
- M. Fulla
- grid.417656.7Department of Otorhinolaryngology, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Program of Molecular Mechanisms and Experimental Therapy in Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - T. Szafarowski
- grid.13339.3b0000000113287408Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - J. Frias-Gomez
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - B. Quiros
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - O. Clavero
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - M. Gomà
- grid.417656.7Program of Molecular Mechanisms and Experimental Therapy in Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Department of Pathology, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - M. A. Pavon
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - O. Jurek-Matusiak
- grid.13339.3b0000000113287408Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
| | - H. R. Lares
- grid.417656.7Department of Otorhinolaryngology, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Program of Molecular Mechanisms and Experimental Therapy in Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - M. Mañós
- grid.417656.7Department of Otorhinolaryngology, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Program of Molecular Mechanisms and Experimental Therapy in Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.5841.80000 0004 1937 0247University of Barcelona, Barcelona, Spain
| | - L. Alemany
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - M. Mena
- grid.418701.b0000 0001 2097 8389Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO) – L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - X. Gonzalez
- grid.417656.7Department of Otorhinolaryngology, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.417656.7Program of Molecular Mechanisms and Experimental Therapy in Oncology, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
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