1
|
Woodley N, Slim MAM, Ton T, Montgomery J, Douglas C. Does recreational drug use influence survival and morbidity associated with laryngeal cancer. ADDICTION & HEALTH 2022; 14:115-126. [PMID: 36544516 PMCID: PMC9743818 DOI: 10.22122/ahj.2022.196452.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022]
Abstract
Background The use of opioids is considered a risk factor for laryngeal cancer. A retrospective study was performed to explore the relationship between recreational drug exposure and laryngeal cancer. Methods Patients diagnosed between the 1st of January 2013 and the 31st of December 2017 using ICD-10 CD-32 coding were identified from the Head and Neck Multidisciplinary Team database. We divided the study population into two cohorts (RD and non-RD) and compared the demographics, morbidity, and outcomes of these two populations. In addition, we performed case-matched analysis to control for potential confounding factors including gender, alcohol use and cigarette smoking. Findings 329 patients in Glasgow, Scotland were included with a mean age of 64.96 ± 10.94 and a follow-up of 24 ± 13.91 months. Of these, 39 reported recreational drug use (RD). RD was associated with younger age (53.0 vs. 66.6, p<0.001) at diagnosis with laryngeal cancer. A greater proportion of tumours occurred in the supraglottic subsite (p=0.041). Furthermore, these patients were more likely to undergo tracheostomy (RR=2.50, 95% CI: 1.41-4.44, p=0.008) and laryngectomy (RR=2.25, 95% CI: 1.57-3.21, p<0.001). Recreational drug users were more likely to require enteral feeding support (RR= 1.44, 95% CI: 1.13-1.84, p=0.02) during oncological treatment. No survival differences were noted at 1, 2, or 3-years (plog-rank=0.83). Case matched analysis correcting for smoking, alcohol and gender confirmed that recreational drug users were younger at diagnosis with a predilection for the supraglottic subsite. Conclusion Recreational drug use is associated with an increased burden of disease and morbidity in laryngeal cancer. We suggest that clinicians view recreational drug exposure as a red flag in those with suspected laryngeal cancer regardless of patient age.
Collapse
Affiliation(s)
- Niall Woodley
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF,Correspondence to: Niall Woodley; ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | | | - Trung Ton
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - Jenny Montgomery
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| | - Catriona Douglas
- ENT Department, Queen Elizabeth University Hospital, Glasgow, G51 4TF
| |
Collapse
|
2
|
Weinreb SF, Piersiala K, Dhar SI, Hillel AT, Akst L, Best SRA. Impact of human immunodeficiency virus status on laryngeal cancer survival and locoregional control. Laryngoscope Investig Otolaryngol 2022; 7:153-160. [PMID: 35155793 PMCID: PMC8823145 DOI: 10.1002/lio2.736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To compare long-term outcomes of laryngeal cancer (LC) in people living with HIV (PLWH) versus uninfected individuals and determine how clinical and viral factors-such as demographics, cancer stage, HIV viral load, and CD4 nadir-contribute to these outcomes. METHODS This was a retrospective case-control study of 749 patients seen for LC at a single tertiary care center between 2003 and 2017. Of these, 22 had HIV at the time of LC diagnosis, and they were matched in a 1:4 ratio to uninfected controls based on sex, presence of smoking history, and age at cancer diagnosis. Kaplan-Meier survival curves and Cox proportional hazards models were constructed to identify overall and disease-free survival differences based on HIV status, as well as other clinical and viral factors. RESULTS Compared to all uninfected individuals, PLWH were diagnosed with LC approximately 6 years younger (p = .013). 1-, 2-, and 5-year overall survival for PLWH were 86.4% (63.4%-95.4%), 77.3% (53.7%-89.9%), and 65.8% (40.8%-82.2%), respectively following LC diagnosis, and HIV was not significantly associated with overall (HR = 3.34 [0.59-18.79]) or disease-free survival (HR = 2.12 [0.71-6.36]). The incidence rate of locoregional recurrence among PLWH was 541 compared to 371 per 10,000 person-years in controls, which were not significantly different (p = .420). Furthermore, among PLWH, peak viral load and CD4 nadir were not associated with overall or disease-free survival. CONCLUSION While previous work has shown that HIV is associated with elevated risk of LC, survival did not differ significantly between PLWH and uninfected individuals in this study. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Samuel Franklin Weinreb
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Krzysztof Piersiala
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and TechnologyKarolinska InstituteStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Shumon Ian Dhar
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Alexander T. Hillel
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Lee Akst
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Simon R. A. Best
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| |
Collapse
|
3
|
Piersiala K, Weinreb SF, Akst LM, Hillel AT, Best SR. Laryngeal disorders in people living with HIV. Am J Otolaryngol 2022; 43:103234. [PMID: 34560598 DOI: 10.1016/j.amjoto.2021.103234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/23/2021] [Accepted: 09/09/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Several studies have shown that HIV infected individuals are at higher risk compared to the general population of developing non-AIDS defining conditions such as some types of cancer, kidney disease, liver disease and others. In this case-control study, we compared the incidence of laryngeal disorders between a treatment-seeking HIV-positive population and uninfected controls. We aimed to investigate whether there are any laryngeal disorders that are overrepresented in HIV-positive individuals. METHODS This was a case-control study based on retrospective chart review, comparing the incidence of laryngeal, airway, and swallowing disorders in sixty-nine HIV positive individuals and 4178 HIV negative controls treated between January 1, 2016 and December 31, 2017, at the Johns Hopkins Voice Center. RESULTS A majority of HIV-infected patients (59.4%) had at least one diagnosis belonging to the Vocal cord pathology category compared to 48.2% of controls (OR 1.57, p = 0.065). Compared to the entire treatment-seeking population, HIV patients were more likely to present with laryngeal cancer (15.9% vs. 3.4% in controls, OR 5.43, p < 0.001) and chronic laryngitis (17.4% vs. 4.2%, OR 4.79, p < 0.001). Fungal and ulcerative laryngitis were also overrepresented in HIV-positive individuals (OR 9.45, p < 0.001 and 6.29, p < 0.001, respectively). None of the diagnoses categorized as functional voice disorders, swallowing, or airway problems showed a significant difference between groups. Laryngeal papillomatosis, which is an HPV-dependent disease, had similar prevalence in both groups. CONCLUSIONS Treatment-seeking HIV-positive patients presenting to a laryngology clinic suffer significantly more often from laryngeal squamous cell carcinoma as well as chronic, fungal, and ulcerative laryngitis compared to HIV-negative individuals. LEVEL OF EVIDENCE 4.
Collapse
|
4
|
de Lima MAP, Silva ÁDL, do Nascimento Filho ACS, Cordeiro TL, Bezerra JPDS, Rocha MAB, Pinheiro SDFL, Pinheiro Junior RFF, Gadelha MDSV, da Silva CGL. Epstein-Barr Virus-Associated Carcinoma of the Larynx: A Systematic Review with Meta-Analysis. Pathogens 2021; 10:pathogens10111429. [PMID: 34832585 PMCID: PMC8618428 DOI: 10.3390/pathogens10111429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Over the past few decades, several publications have investigated the role of Epstein-Barr virus (EBV) in head and neck squamous cell carcinomas, and an increasing number of them have shown its presence in laryngeal tumors. The purpose of this meta-analysis was to evaluate the association of EBV with laryngeal carcinoma. The search was carried out in two databases, Scopus and PubMed, using the following terms: “Epstein-Barr virus” and “laryngeal carcinoma”. A total of 187 records were found, of which 31 were selected for meeting the inclusion and exclusion criteria. The meta-analysis yielded an overall pooled prevalence of 43.72% (95% confidence interval (CI): 34.35–53.08). Studies carried out in Europe and Eurasia had slightly higher pooled prevalence than other subgroups, while the prevalence of studies performed in developed countries was higher than in developing countries (46.37% vs. 34.02%). Furthermore, laryngeal carcinoma occurred almost three times as often among EBV-infected individuals compared to those without EBV infection (odds ratio = 2.86 (95% CI: 1.18–6.90); Begg’s test, p = 0.843 and Egger’s test, p = 0.866). Our findings support the idea that EBV is related to laryngeal carcinoma. However, further studies are needed before recognizing a definitive etiological role of EBV in the development and/or progression of laryngeal carcinomas.
Collapse
Affiliation(s)
- Marcos Antonio Pereira de Lima
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
- Ceará Cancer Institute, ICC, Fortaleza 60430-230, Ceará, Brazil
- Correspondence: ; Tel.: +55-88-3221-9600
| | - Álife Diêgo Lima Silva
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Antônio Carlos Silva do Nascimento Filho
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Thiago Lima Cordeiro
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - João Pedro de Souza Bezerra
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Maria Aline Barroso Rocha
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Sally de França Lacerda Pinheiro
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Roberto Flávio Fontenelle Pinheiro Junior
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Maria do Socorro Vieira Gadelha
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| | - Cláudio Gleidiston Lima da Silva
- School of Medicine, Federal University of Cariri, UFCA, Barbalha 63180-000, Ceará, Brazil; (Á.D.L.S.); (A.C.S.d.N.F.); (T.L.C.); (J.P.d.S.B.); (M.A.B.R.); (S.d.F.L.P.); (R.F.F.P.J.); (M.d.S.V.G.); (C.G.L.d.S.)
| |
Collapse
|
5
|
Ceccarelli M, Rullo EV, Facciolà A, Madeddu G, Cacopardo B, Taibi R, D'Aleo F, Pinzone MR, Picerno I, di Rosa M, Visalli G, Condorelli F, Nunnari G, Pellicanò GF. Head and neck squamous cell carcinoma and its correlation with human papillomavirus in people living with HIV: a systematic review. Oncotarget 2018; 9:17171-17180. [PMID: 29682214 PMCID: PMC5908315 DOI: 10.18632/oncotarget.24660] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/27/2018] [Indexed: 12/19/2022] Open
Abstract
Over the last 20 years we assisted to an increase in the mean age of People Living with HIV and their comorbidities. Especially, there was an increase in Human Papillomavirus-related head and neck squamous cell carcinomas. Despite their increasing incidence in HIV-positive people, mechanisms that lead to their development and progression are only partially understood. The aim of this review is to identify key data and factors about HPV-related head and neck squamous cell carcinoma in HIV-seropositive patients. Systematic search and review of the relevant literature-peer-reviewed and grey-was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. We included in our review only the 35 full-text articles we considered the most substantial. It is mandatory to improve our knowledge about the interactions existing between HPV and HIV, and about their actions on oral mucosa immune system.
Collapse
Affiliation(s)
- Manuela Ceccarelli
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Emmanuele Venanzi Rullo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Alessio Facciolà
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Giordano Madeddu
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Bruno Cacopardo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Catania, Catania, Italy
| | - Rosaria Taibi
- Department of Medical Oncology A, National Cancer Institute of Aviano, Aviano, Italy
| | - Francesco D'Aleo
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Marilia Rita Pinzone
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Isa Picerno
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
| | - Michele di Rosa
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, University of Catania, Catania, Italy
| | - Giuseppa Visalli
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
| | - Fabrizio Condorelli
- Department of Pharmacological Sciences, Università del Piemonte Orientale “A. Avogadro”, Novara, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, University of Messina, Messina, Italy
| | - Giovanni Francesco Pellicanò
- Department of Human Pathology of The Adult and The Developmental Age “G. Barresi”, Unit of Infectious Diseases, University of Messina, Messina, Italy
| |
Collapse
|
6
|
Vianna LMDS, Carneiro FP, Amorim R, Guerra ENDS, Cavalcanti Neto FF, Tiziani V, Motoyama AB, Bocca AL. Oropharynx HPV status and its relation to HIV infection. PeerJ 2018; 6:e4407. [PMID: 29593938 PMCID: PMC5866915 DOI: 10.7717/peerj.4407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 02/02/2018] [Indexed: 01/28/2023] Open
Abstract
Background The number of oropharyngeal lesions caused by HPV (Human papillomavirus) has been increasing worldwide in the past years. In spite of the clinical relevance of HPV infection in the anogenital tract of HIV-positive patients, the relevance of oropharynx HPV infection in these patients is not clear. The aim of the present study was to detect HPV infection, and clinical and cytological changes in the oropharynx of HIV-positive patients. Methods Samples collected from the oropharynx of 100 HIV-positive patients were subjected to hybrid capture (HC), conventional and liquid-based cytology. Clinical data were also collected to investigate the relation with HPV status. Results High and low-risk types of HPV were present in 8% and 16.7% of the total sample. The mean ± sd (maximum-minimum) of the relative ratio light unit (RLU)/cutoff (CO) was 2.94 ± 2.58 (1.09–7.87) and 1.61 ± 0.65 (1.07–2.8) for high- and low-risk-HPV, respectively. By cytology, dysplasia was not detected, but atypical squamous cells of undetermined significance (ASC-US) were diagnosed in two samples. No clinical change, suggestive of dysplasia/cancer, was detected. Conclusion Our study was able to detect and characterize HPV infection by hybrid capture, which may represent a good tool for screening and follow-up of HPV in the studied population. The frequency and viral load of HPV were low. Neither clinical nor cytological changes suggestive of dysplasia/neoplasia were observed in oropharynx of HIV-positive patients.
Collapse
Affiliation(s)
| | - Fabiana Pirani Carneiro
- Department of Pathology, School of Medicine, University of Brasilia (UnB), Brasíla, DF, Brazil
| | - Rivadavio Amorim
- Department of Pathology, School of Medicine, University of Brasilia (UnB), Brasíla, DF, Brazil
| | | | | | - Valdenize Tiziani
- Center for Learning and Research, Brasilia Children Hospital, Brasilia-DF, DF, Brasil
| | | | | |
Collapse
|
7
|
Gama RR, Carvalho AL, Filho AL, Scorsato AP, López RVM, Rautava J, Syrjänen S, Syrjänen K. Detection of human papillomavirus in laryngeal squamous cell carcinoma: Systematic review and meta-analysis. Laryngoscope 2015; 126:885-93. [DOI: 10.1002/lary.25738] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Ricardo Ribeiro Gama
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - André Lopes Carvalho
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - Adhemar Longatto Filho
- Laboratory of Medical Investigation (LIM) 14; Department of Pathology; University of São Paulo School of Medicine; São Paulo Brazil
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital; Barretos Brazil
| | | | | | - Jaana Rautava
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Kari Syrjänen
- Department of Clinical Research; Biohit HealthCare Plc; Helsinki Finland
| |
Collapse
|
8
|
Grulich AE, Vajdic CM. The epidemiology of cancers in human immunodeficiency virus infection and after organ transplantation. Semin Oncol 2014; 42:247-57. [PMID: 25843729 DOI: 10.1053/j.seminoncol.2014.12.029] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The authors provide an update on the association between immune deficiency and cancer risk in people with human immunodeficiency virus (HIV) and in solid organ transplant recipients. Over the past decade, it has become clear that a wider range of about 20 mostly infection-related cancers occur at increased rates in people with immune deficiency. The human herpes virus 8 (HHV8) and Epstein Barr Virus (EBV)-related cancers of Kaposi sarcoma (KS) and non-Hodgkin lymphoma (NHL) are most closely related to level of immune deficiency. Transplant recipients also have a greatly increased risk of squamous cell carcinoma (SCC) of the skin, related to direct carcinogenic effects of the pharmaceuticals used for immune suppression. For those three cancer types, the increased cancer risk is largely reversed when immune deficiency is decreased by treatment of HIV or by reduction of iatrogenic immune suppression. Other infection-related cancers also occur at increased rates, but it is not clear whether reduction of immune deficiency reduces cancer risk. Prostate and breast cancer do not occur at increased rates, providing strong evidence that these cancers are unlikely to be related to infection. Epidemiological and clinical trends in these two populations have led to substantial recent changes in cancer occurrence.
Collapse
Affiliation(s)
- Andrew E Grulich
- HIV Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales, Sydney, Australia.
| | - Claire M Vajdic
- Adult Cancer Program, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| |
Collapse
|
9
|
Relationship of cell bearing EBER and p24 antigens in biopsy-proven lymphocytic interstitial pneumonia in HIV-1 subtype E infected children. Appl Immunohistochem Mol Morphol 2012; 19:547-51. [PMID: 21623184 DOI: 10.1097/pai.0b013e31821bfc34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Lymphocytic interstitial pneumonia (LIP) is an uncommon histopathologic entity characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes and other lymphoid elements. An increased incidence of LIP has been seen in the pediatric population, especially in children with acquired immune deficiency syndrome. Our previous study supports the notion that Langerhans cells (LCs) are reservoirs for Epstein-Barr virus (EBV) in lungs of human immunodeficiency virus (HIV) subtype E-infected pediatric LIP. To further understand the pathogenesis of LIP, we studied the relationship between EBV, the suggested causative agent of LIP and HIV-1 capsid protein p24, which play an important role in the interaction with host proteins during HIV-1 adsorption, membrane fusion, and entry in surgical lung biopsy-proven LIP from 9 vertically HIV subtype E-infected pediatric patients. The dominant microscopic feature of LIP demonstrated widespread widening of alveolar septum by mononuclear inflammatory cell infiltrate, mainly composed of mature lymphocytes and plasma cells surrounding airways and expanding to the lung interstitium. EBV-encoded RNA (EBER) in situ hybridization (ISH) and p24 immunohistochemistry, performed on formalin-fixed, paraffin-embedded tissue from open lung biopsy specimens, revealed positive intranuclear EBER signals and intracytoplasmic immunostains for p24 core protein in all 9 LIP cases. By combining ISH and immunohistochemistry, these results suggest that (i) EBV/p24-carrying cells are likely involved in the development of LIP, either directly or indirectly; (ii) LCs and related dendritic cells are the main reservoir of both EBV and HIV subtype E in pediatric LIP and possibly LCs may play an important role in the recruitment of inflammatory cell infiltrates, especially T cells into these tissues; (iii) coexpression of EBV/p24 in bronchioalveolar epithelium supports the hypothesis that these cells serve as a reactivation source for both viruses to achieve greater quantities in alveolar septum and interstitium around bronchioles. These results indicate a strong association between the presence of HIV core protein p24 and expression of EBV RNA transcripts (EBER). Interactions between LCs and related dendritic cells together with T cells are important for effective HIV and EBV replications. The coexpression of both viruses could be related to the evolution of pediatric LIP in HIV subtype E infection.
Collapse
|
10
|
McLemore MS, Haigentz M, Smith RV, Nuovo GJ, Alos L, Cardesa A, Brandwein-Gensler M. Head and neck squamous cell carcinomas in HIV-positive patients: a preliminary investigation of viral associations. Head Neck Pathol 2010; 4:97-105. [PMID: 20333562 PMCID: PMC2878620 DOI: 10.1007/s12105-010-0171-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 03/04/2010] [Indexed: 10/19/2022]
Abstract
Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60%) men and 16 (40%) women. The larynx was most commonly involved (65%, n = 26); followed by the oropharynx (22.5%, n = 9). Four carcinomas arose from the oral cavity (10%) and one from the nasal cavity (2.5%). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5%) than the control group (27/102, 26%, p 0.001, chi-square). HPV was detected in 6 of 25 (24%) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83%) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3%) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24% of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.
Collapse
Affiliation(s)
| | - Missak Haigentz
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Richard V. Smith
- Department of Otorhinolaryngology, Head & Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY USA
| | - Gerard J. Nuovo
- Department of Pathology, Ohio State University College of Medicine, Columbus, OH USA
| | - Llucia Alos
- Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | - Margaret Brandwein-Gensler
- Department of Pathology, NP 3545, University of Alabama at Birmingham, 1802 6th Avenue South, Birmingham, AL 35249 USA
| |
Collapse
|