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Cui M, Cheng J, Cheng H, Zhao M, Zhou D, Zhang M, Jia J, Luo L. Characteristics of human papillomavirus infection among oropharyngeal cancer patients: A systematic review and meta-analysis. Arch Oral Biol 2024; 157:105830. [PMID: 37924712 DOI: 10.1016/j.archoralbio.2023.105830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study aimed to explore the characteristics of human papillomavirus (HPV) in oropharyngeal carcinoma (OPC), in order to provide a new theoretical basis for the prevention, treatment, and management of OPC. METHODS The electronic databases were searched available publications relevant to HPV infection and OPC. Studies were collected until July, 2023. The effect sizes were combined using R 4.2.2 software. Subgroup and sensitivity analyses were performed to explore the sources of heterogeneity. Funnel plot and Egger's test were used to assess the publication bias. RESULTS Seventy-one studies were included with 10,908 OPC patients. The pooled prevalence of HPV and HR-HPV infection was 44.22% and 43.94%, respectively. The genotypes of HR-HPV were HPV16 (37.24%), HPV33 (2.44%), HPV18 (1.64%), HPV35 (1.53%), and HPV58 (0.89%). The highest HPV infection was in North America (66.87%), Oceania (43.09%), and Europe (41.49%), lowest in Africa (4.89%). Females exhibited higher HPV infection (43.18% vs 34.59% in males). Top subsites of HPV infection was tonsil (45.78%), followed by base of tongue (36.66%). Infection was higher in OPC patients aged > 60 (38.15%) than < 60 (34.73%). The prevalence of HPV infection in stage I-II of OPC patients is higher than that in stage III-IV. CONCLUSIONS HPV genotyping (16, 18, 33, 35, 58) is a key factor in the prevention and treatment of OPC. Identifying tonsils, base of tongue, and soft palate as common subsites to improve early detection. Elderly women with high HPV infection require attention to risk management and health education for prevention.
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Affiliation(s)
- Meimei Cui
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; Department of Pathology, Weifang Medical University, Weifang, China
| | - Jinling Cheng
- Digestive Department, Shandong Second Provincial General Hospital, Jinan, China
| | - Huijuan Cheng
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China
| | - Ming Zhao
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Dan Zhou
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Min Zhang
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; School of Public Health, Jiamusi University, Jiamusi, China
| | - Jingjing Jia
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China; Department of Basic medicine, Jiamusi University, China
| | - Limei Luo
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, China.
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Wang J, Li X, Niu D, Huang J, Ye E, Zhao Y, Yue S, Hou X, Wu J. Mortality patterns of patients with tonsillar squamous cell carcinoma: a population-based study. Front Endocrinol (Lausanne) 2023; 14:1158593. [PMID: 38130394 PMCID: PMC10733501 DOI: 10.3389/fendo.2023.1158593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
Objective Tonsillar squamous cell carcinoma (TSCC) and second primary malignancies (SPMs) are the most common causes of mortality in patients with primary TSCC. However, the competing data on TSCC-specific death (TSD) or SPM-related death in patients with TSCC have not been evaluated. This study aimed to analyze the mortality patterns and formulate prediction models of mortality risk caused by TSCC and SPMs. Methods Data on patients with a first diagnosis of TSCC were extracted as the training cohort from the 18 registries comprising the Surveillance, Epidemiology, and End Results (SEER) database. A competing risk approach of cumulation incidence function was used to estimate cumulative incidence curves. Fine and gray proportional sub-distributed hazard model analyses were performed to investigate the risk factors of TSD and SPMs. A nomogram was developed to predict the 5- and 10-year risk probabilities of death caused by TSCC and SPMs. Moreover, data from the 22 registries of the SEER database were also extracted to validate the nomograms. Results In the training cohort, we identified 14,530 patients with primary TSCC, with TSCC (46.84%) as the leading cause of death, followed by SPMs (26.86%) among all causes of death. In the proportion of SPMs, the lungs and bronchus (22.64%) were the most common sites for SPM-related deaths, followed by the larynx (9.99%), esophagus (8.46%), and Non-Melanoma skin (6.82%). Multivariate competing risk model showed that age, ethnicity, marital status, primary site, summary stage, radiotherapy, and surgery were independently associated with mortality caused by TSCC and SPMs. Such risk factors were selected to formulate prognostic nomograms. The nomograms showed preferable discrimination and calibration in both the training and validation cohorts. Conclusion Patients with primary TSCC have a high mortality risk of SPMs, and the competing risk nomogram has an ideal performance for predicting TSD and SPMs-related mortality. Routine follow-up care for TSCC survivors should be expanded to monitor SPMs.
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Affiliation(s)
- Jia Wang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xiaolin Li
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Dongdong Niu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jiasheng Huang
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Enlin Ye
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Yumei Zhao
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Suru Yue
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Xuefei Hou
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jiayuan Wu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- Guangdong Engineering Research Center of Collaborative Innovation of Clinical Medical Big Data Cloud Service in Western Guangdong Medical Union, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
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Schindele A, Holm A, Nylander K, Allard A, Olofsson K. Mapping human papillomavirus, Epstein-Barr virus, cytomegalovirus, adenovirus, and p16 in laryngeal cancer. Discov Oncol 2022; 13:18. [PMID: 35312853 PMCID: PMC8938541 DOI: 10.1007/s12672-022-00475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/02/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Apart from tobacco and alcohol, viral infections are proposed as risk factors for laryngeal cancer. The occurrence of oncogenic viruses including human papilloma virus (HPV) and Epstein-Barr virus (EBV), in laryngeal squamous cell carcinoma (LSCC) varies in the world. Carcinogenesis is a multi-step process, and the role of viruses in LSCC progression has not been clarified. We aimed to analyze the presence and co-expression of HPV, EBV, human cytomegalovirus (HCMV) and human adenovirus (HAdV) in LSCC. We also investigated if p16 can act as surrogate marker for HPV in LSCC. METHODS Combined PCR/microarrays (PapilloCheck®) were used for detection and genotyping of HPV DNA, real-time PCR for EBV, HCMV and HAdV DNA detection, and EBER in situ hybridization (EBER-ISH) for EBV detection in tissue from 78 LSCC patients. Additionally, we analyzed p16 expression with immunohistochemistry. RESULTS Thirty-three percent (26/78) of LSCC tumor samples were EBV positive, 9% (7/78) HCMV positive and 4% (3/78) HAdV positive. Due to DNA fragmentation, 45 samples could not be analyzed with PapilloCheck®; 9% of the remaining (3/33) were high-risk HPV16 positive and also over-expressed p16. A total of 14% (11/78) of the samples over-expressed p16. CONCLUSION These findings present a mapping of HPV, EBV, HCMV and HAdV, including the HPV surrogate marker p16, in LSCC in this cohort. Except for EBV, which was detected in a third of the samples, data show viral infection to be uncommon, and that p16 does not appear to be a specific surrogate marker for high-risk HPV infection in LSCC.
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Affiliation(s)
- Alexandra Schindele
- Department of Clinical Sciences, Otorhinolaryngology, ÖNH-Kliniken Östersunds Sjukhus, Umeå University, 831 83, Östersund, Sweden.
| | - Anna Holm
- Department of Clinical Sciences, Otorhinolaryngology, ÖNH-Kliniken Östersunds Sjukhus, Umeå University, 831 83, Östersund, Sweden
| | - Karin Nylander
- Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
| | - Annika Allard
- Department of Clinical Microbiology, Clinical Virology, Umeå University, Umeå, Sweden
| | - Katarina Olofsson
- Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden
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Derhy S, Gaillot J, Rousseau S, Piel C, Thorrington D, Zanetti L, Gall B, Venot C, Chyderiotis S, Mueller J. Extension de la vaccination contre les HPV aux garçons : enquête auprès de familles et de médecins généralistes. Bull Cancer 2022. [DOI: 10.1016/j.bulcan.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/15/2022]
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Tsai CJ, Galloway TJ, Margalit DN, Bakst RL, Beadle BM, Beitler JJ, Chang S, Chen A, Cooper J, Koyfman SA, Ridge JA, Robbins J, Truong MT, Yom SS, Siddiqui F. Ipsilateral radiation for squamous cell carcinoma of the tonsil: American Radium Society appropriate use criteria executive summary. Head Neck 2021; 43:392-406. [PMID: 33068064 PMCID: PMC9128573 DOI: 10.1002/hed.26492] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND We conducted the current systemic review to provide up-to-date literature summary and optimal evidence-based recommendations for ipsilateral radiation for squamous cell carcinoma of the tonsil. METHODS We performed literature search of peer-reviewed journals through PubMed. The search strategy and subject-specific keywords were developed based on the expert panel's consensus. Articles published from January 2000 to May 2020 with full text available on PubMed and restricted to the English language and human subjects were included. Several prespecified search terms were used to identify relevant publications and additional evidence published since the initial American College of Radiology Appropriateness Criteria Ipsilateral Tonsil Radiation recommendation was finalized in 2012. The full bibliographies of identified articles were reviewed and irrelevant studies were removed. RESULTS The initial search and review returned 46 citations. The authors added three citations from bibliographies, websites, or books not found in the literature search. Of the 49 citations, 30 citations were retained for further detailed review, and 14 of them were added to the evidence table. Articles were removed from the bibliography if they were not relevant or generalizable to the topic, or focused on unknown primary disease. Several commonly encountered clinical case variants were created and panelists anonymously rated each treatment recommendation. The results were reviewed and disagreements discussed. CONCLUSIONS The panel provided updated evidence and recommendations for ipsilateral radiation for squamous cell carcinoma of the tonsil in the setting of primary radiation-based therapy and postoperative adjuvant radiotherapy. This committee did not reach agreements for some case variants due to a lack of strong evidence supporting specific treatment decisions, indicating a further need for research in these topics.
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Affiliation(s)
- C Jillian Tsai
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Danielle N Margalit
- Dana Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard L Bakst
- Mount Sinai Icahn School of Medicine, New York, New York, USA
| | - Beth M Beadle
- Stanford University School of Medicine, Stanford, California, USA
| | | | - Steven Chang
- Henry Ford Cancer Institute, Detroit, Michigan, USA
| | - Allen Chen
- University of California, Irvine, California, USA
| | - Jay Cooper
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - John A Ridge
- Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Jared Robbins
- University of Arizona Cancer Center, Phoenix, Arizona, USA
| | - Minh Tam Truong
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sue S Yom
- University of California San Francisco, San Francisco, California, USA
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Holm A, Allard A, Eriksson I, Laurell G, Nylander K, Olofsson K. Absence of high-risk human papilloma virus in p16 positive inverted sinonasal papilloma. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:201-206. [DOI: 10.1016/j.anorl.2017.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/19/2017] [Accepted: 10/01/2017] [Indexed: 10/25/2022]
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Talani C, Mäkitie A, Beran M, Holmberg E, Laurell G, Farnebo L. Early mortality after diagnosis of cancer of the head and neck - A population-based nationwide study. PLoS One 2019; 14:e0223154. [PMID: 31577831 PMCID: PMC6774523 DOI: 10.1371/journal.pone.0223154] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Cancers of the head and neck have a high mortality rate, and roughly 10% of the patients die within six months of diagnosis. To our knowledge little has been written about this group. We wished to identify risk factors for early death, to predict and monitor patients at risk better and, if possible, avoid unjustified major treatment. Methods and findings This population-based nationwide study from the Swedish Head and Neck Cancer Register (SweHNCR) included data from 2008–2015 and 9733 patients at potential risk of early death. A total of 925 (9.5%) patients died within six months. For every year older the patients became, the risk of early death increased by 2.3% (p<0.001). The relative risk of death was 3.37 times higher (237%) for patients with WHO score 1 compared with WHO score 0. A primary tumour in the hypopharynx correlated with a 24% increased risk over the oral cavity (p<0.024). Patients with stage IV disease had a 3.7 times greater risk of early death than those with stage I (p<0.001). As expected, a 12 times increased risk of early death was noted in the palliative treatment group, compared to the curative group. Limitations to this study were that the actual cause of death was not recorded in the SweHNCR, and that socioeconomic factors, alcohol consumption, smoking habits, and HPV status, were not reported in SweHNCR until 2015. However, the fact that this is a population-based nationwide study including 9733 patients compensates for some of these limitations. Conclusions Identification of patients at increased risk of early death shows that older patients with advanced disease, increased WHO score, primary tumour in the hypopharynx, and those given palliative treatment, are more likely than the others to die from head and neck cancer within six months of diagnosis.
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Affiliation(s)
- Charbél Talani
- Division of Speech language pathology, Audiology and Otorhinolaryngology, Department of Clinical and Experimental medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
| | - Antti Mäkitie
- Department of Otorhinolaryngology–Head and Neck Surgery, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
- Research Programme in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Martin Beran
- Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhattan, Sweden
| | - Erik Holmberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Göran Laurell
- Department of Clinical Sciences, ENT, Uppsala University, Uppsala, Sweden
| | - Lovisa Farnebo
- Division of Speech language pathology, Audiology and Otorhinolaryngology, Department of Clinical and Experimental medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden
- * E-mail:
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Holm A, Schindele A, Allard A, Eriksson I, Sandström K, Laurell G, Nylander K, Olofsson K. Mapping of human papilloma virus, p16, and epstein-barr virus in non-malignant tonsillar disease. Laryngoscope Investig Otolaryngol 2019; 4:285-291. [PMID: 31236460 PMCID: PMC6580074 DOI: 10.1002/lio2.260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives Due to their location in the entrance of the aero-digestive tract, tonsils are steadily exposed to viruses. Human papilloma virus (HPV) and Epstein-Barr virus (EBV) are two potentially oncogenic viruses that tonsils encounter. The incidence of HPV positive tonsillar cancer is on the rise and it is unknown when infection with HPV occurs. Aim To investigate if tonsils are infected with HPV and EBV, to study the co-expression of HPV and its surrogate marker p16, and to evaluate the number of EBV positive cells in benign tonsillar disease. Materials and Methods Tonsils from 40 patients in a university hospital were removed due to hypertrophy, chronic or recurrent infection. These were analyzed for presence of HPV, its surrogate marker p16, and EBV. HPV was studied using PapilloCheck (a PCR method), while p16 was identified in epithelial and lymphoid tissue with immunohistochemistry and EBV using EBER-ISH (Epstein-Barr encoding region-in situ hybridization). Results HPV was not detected, and p16 was present at low numbers in all epithelial samples as well as in 92.5% of the lymphoid tonsillar samples. At least one EBER-positive cell was seen in 65% of cases. Larger numbers of EBER-expressing cells were only seen in two cases. Conclusion These findings demonstrate that EBV and HPV infect tonsils independently, but further studies are warranted to confirm their infectious relationship. Level of Evidence Cross-sectional study.
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Affiliation(s)
- Anna Holm
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden
| | - Alexandra Schindele
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden.,Department of Ear, Nose and Throat Östersunds hospital, Jämtland/Härjedalen County Council, Uppsala University Uppsala Sweden
| | - Annika Allard
- Division of Clinical Virology, Department of Clinical Microbiology Uppsala University Uppsala Sweden
| | - Irene Eriksson
- Division of Clinical Virology, Department of Clinical Microbiology Uppsala University Uppsala Sweden
| | - Karl Sandström
- Division of Otorhinolaryngology, Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Göran Laurell
- Division of Otorhinolaryngology, Department of Surgical Sciences Uppsala University Uppsala Sweden
| | | | - Katarina Olofsson
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden
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Gu X, Wang L, Boldrup L, Coates PJ, Fahraeus R, Sgaramella N, Wilms T, Nylander K. AP001056.1, A Prognosis-Related Enhancer RNA in Squamous Cell Carcinoma of the Head and Neck. Cancers (Basel) 2019; 11:cancers11030347. [PMID: 30862109 PMCID: PMC6468641 DOI: 10.3390/cancers11030347] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/01/2019] [Accepted: 03/07/2019] [Indexed: 12/24/2022] Open
Abstract
A growing number of long non-coding RNAs (lncRNAs) have been linked to squamous cell carcinoma of the head and neck (SCCHN). A subclass of lncRNAs, termed enhancer RNAs (eRNAs), are derived from enhancer regions and could contribute to enhancer function. In this study, we developed an integrated data analysis approach to identify key eRNAs in SCCHN. Tissue-specific enhancer-derived RNAs and their regulated genes previously predicted using the computational pipeline PreSTIGE, were considered as putative eRNA-target pairs. The interactive web servers, TANRIC (the Atlas of Noncoding RNAs in Cancer) and cBioPortal, were used to explore the RNA levels and clinical data from the Cancer Genome Atlas (TCGA) project. Requiring that key eRNAs should show significant associations with overall survival (Kaplan⁻Meier log-rank test, p < 0.05) and the predicted target (correlation coefficient r > 0.4, p < 0.001), we identified five key eRNA candidates. The most significant survival-associated eRNA was AP001056.1 with ICOSLG encoding an immune checkpoint protein as its regulated target. Another 1640 genes also showed significant correlation with AP001056.1 (r > 0.4, p < 0.001), with the "immune system process" being the most significantly enriched biological process (adjusted p < 0.001). Our results suggest that AP001056.1 is a key immune-related eRNA in SCCHN with a positive impact on clinical outcome.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
| | - Lixiao Wang
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
| | - Linda Boldrup
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
| | - Philip J Coates
- RECAMO, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic.
| | - Robin Fahraeus
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
- RECAMO, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic.
- Équipe Labellisée Ligue Contre le Cancer, INSERM UMRS1162, Institut de Génétique Moléculaire, Université Paris 7, IUH Hôpital St. Louis, 75010 Paris, France.
| | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
| | - Torben Wilms
- Department of Clinical Sciences/ENT, Umeå University, 90185 Umeå, Sweden.
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, 90185 Umeå, Sweden.
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Danielsson K, Olah J, Zohori-Zangeneh R, Nylander E, Ebrahimi M. Increased expression of p16 in both oral and genital lichen planus. Med Oral Patol Oral Cir Bucal 2018; 23:e449-e453. [PMID: 29924765 PMCID: PMC6051687 DOI: 10.4317/medoral.22432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/22/2018] [Indexed: 12/29/2022] Open
Abstract
Background Lichen Planus, LP, is an inflammatory disease of possible autoimmune origin affecting mainly oral and genital mucosa and skin. According to the WHO oral LP is considered a potentially malignant disorders. The p16 tumour suppressor protein can act as an inhibitor of cyclin dependent kinases 4 and 6 and thus down regulate cell cycle progression. Since the discovery of p16 several studies have evaluated its expression in various forms of human cancers. The aim of this study was to evaluate and compare the expression of p16 in oral and genital LP and corresponding healthy mucosa. Material and Methods A total of 76 cases of oral LP (OLP), 34 cases of genital LP (GLP), 12 cases of healthy oral and 9 cases of healthy genital mucosa were analysed by the use of immunohistochemistry. Results Data showed p16 to be highly expressed in both oral and genital LP, higher than in oral (p=0.000), and genital controls (p=0.002). Conclusions Results suggest that the over-expression of p16 seen in LP play a part in the histopathology of the disease. Key words:p16, inflammation, oral, genital, lichen planus, malignant risk.
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Affiliation(s)
- K Danielsson
- Department of Odontology, Umeå University, SE - 901 85 Umeå, Sweden,
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Hettmann A, Demcsák A, Bach Á, Decsi G, Dencs Á, Pálinkó D, Rovó L, Terhes G, Urbán E, Buzás K, Nagy K, Takács M, Minarovits J. Prevalence and genotypes of human papillomavirus in saliva and tumor samples of head and neck cancer patients in Hungary. Infect Genet Evol 2018; 59:99-106. [PMID: 29408738 DOI: 10.1016/j.meegid.2018.01.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 01/08/2023]
Abstract
In addition to traditional risk factors such as smoking, alcohol consumption and betel nut use, human papillomavirus (HPV) infection also plays a role in the development of head and neck squamous cell carcinomas (HNSCCs). Although among European countries the highest incidence and mortality rates of head and neck cancer types were recorded in Hungary, data regarding HPV prevalence in HNSCCs is scarce. We collected biopsy and saliva samples from patients diagnosed with HNSCC or oral potentially malignant disorders (OPMDs) and tested them for the presence of HPV using the PCR consensus primer set MY09/11 and the GP5+/6+ primer pair. HPV genotypes were assessed by sequencing of the amplified PCR fragments. Oral mucosa and saliva samples from tumor- and OPMD-free individuals were also analysed. HPV was detected in 11 out of 60 HNSCC samples (18%). All of the HPV positive tumors carried HPV type 16. 5 out of the 57 saliva samples collected from HNSCC patients was HPV positive (8.8%); among them, in addition to HPV16, HPV13 was also detected. Tumors located to the oropharynx had the highest HPV positivity rate with 50% (7 out of 14), which was significantly higher than the HPV prevalence in oral mucosa samples collected from controls (0 out of 20; p > 0.001) or in OPMD biopsies (0 out of 21, p > 0.001). 2 out of 57 control saliva samples (3.5%, subtype HPV13 and 11) and 3 out of 39 saliva samples from OPMD patients (7.7%, subtype HPV18, 81 and 10) were HPV positive. Our data suggested that HPV16 infection may contribute, in concert with cigarette smoking, to the development of a subset of head and neck cancers in Hungary. HPV16 infection per se does not account, however, for the high HNSCC incidence rate recorded in this country.
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Affiliation(s)
- Andrea Hettmann
- Division of Virology, National Public Health Institute, Budapest, Hungary
| | - Anett Demcsák
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Ádám Bach
- Department of Otorhinolaryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Gábor Decsi
- Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Ágnes Dencs
- Division of Virology, National Public Health Institute, Budapest, Hungary
| | - Dóra Pálinkó
- Department of Otorhinolaryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - László Rovó
- Department of Otorhinolaryngology and Head-Neck Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Gabriella Terhes
- Institute of Clinical Microbiology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Edit Urbán
- Institute of Clinical Microbiology, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Krisztina Buzás
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Szeged, Hungary; Hungarian Academy of Sciences, Biological Research Centre, Szeged, Hungary
| | - Katalin Nagy
- Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Mária Takács
- Division of Virology, National Public Health Institute, Budapest, Hungary
| | - Janos Minarovits
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
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Wilms T, Khan G, Coates PJ, Sgaramella N, Fåhraeus R, Hassani A, Philip PS, Norberg Spaak L, Califano L, Colella G, Olofsson K, Loizou C, Franco R, Nylander K. No evidence for the presence of Epstein-Barr virus in squamous cell carcinoma of the mobile tongue. PLoS One 2017; 12:e0184201. [PMID: 28926591 PMCID: PMC5604943 DOI: 10.1371/journal.pone.0184201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/15/2017] [Indexed: 12/27/2022] Open
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) comprises a large group of cancers in the oral cavity and nasopharyngeal area that typically arise in older males in association with alcohol/tobacco usage. Within the oral cavity, the mobile tongue is the most common site for tumour development. The incidence of tongue squamous cell carcinoma (TSCC) is increasing in younger people, which has been suggested to associate with a viral aetiology. Two common human oncogenic viruses, human papilloma virus (HPV) and Epstein-Barr virus (EBV) are known causes of certain types of SCCHN, namely the oropharynx and nasopharynx, respectively. EBV infects most adults worldwide through oral transmission and establishes a latent infection, with sporadic productive viral replication and release of virus in the oral cavity throughout life. In view of the prevalence of EBV in the oral cavity and recent data indicating that it infects tongue epithelial cells and establishes latency, we examined 98 cases of primary squamous cell carcinoma of the mobile tongue and 15 cases of tonsillar squamous cell carcinoma for the presence of EBV-encoded RNAs (EBERs), EBV DNA and an EBV-encoded protein, EBNA-1. A commercially available in situ hybridisation kit targeting EBER transcripts (EBER-ISH) showed a positive signal in the cytoplasm and/or nuclei of tumour cells in 43% of TSCCs. However, application of control probes and RNase A digestion using in-house developed EBER-ISH showed identical EBER staining patterns, indicating non-specific signals. PCR analysis of the BamH1 W repeat sequences did not identify EBV genomes in tumour samples. Immunohistochemistry for EBNA-1 was also negative. These data exclude EBV as a potential player in TSCC in both old and young patients and highlight the importance of appropriate controls for EBER-ISH in investigating EBV in human diseases.
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Affiliation(s)
- Torben Wilms
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
- * E-mail: (TW); (KN)
| | - Gulfaraz Khan
- United Arab Emirates University, College of Medicine & Health Sciences, Dept. of Medical Microbiology and Immunology, Tawam Hospital Campus, Al Ain, UAE
| | - Philip J. Coates
- RECAMO, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic
| | | | - Robin Fåhraeus
- RECAMO, Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
- University Paris Diderot, INSERM UMRS1162, 27 rue Juliette Dodu, Paris, France
| | - Asma Hassani
- United Arab Emirates University, College of Medicine & Health Sciences, Dept. of Medical Microbiology and Immunology, Tawam Hospital Campus, Al Ain, UAE
| | - Pretty S. Philip
- United Arab Emirates University, College of Medicine & Health Sciences, Dept. of Medical Microbiology and Immunology, Tawam Hospital Campus, Al Ain, UAE
| | | | - Luigi Califano
- Department of Neuroscience Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Colella
- Second University of Naples, Multidisciplinary Department of Medical, Surgical and Dental Specialties, Naples, Italy
| | | | - Christos Loizou
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | - Renato Franco
- Dipartimento Universitario di Anatomia Patologica, Seconda Universita' Degli Studi di Napoli, Piazza Miraglia, Naples, Italy
| | - Karin Nylander
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
- * E-mail: (TW); (KN)
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Yoshida H, Murono S, Ueno T, Nakanishi Y, Tsuji A, Hatano M, Endo K, Kondo S, Sugimoto H, Wakisaka N, Yoshizaki T. Usefulness of human papillomavirus detection in oral rinse as a biomarker of oropharyngeal cancer. Acta Otolaryngol 2017; 137:773-777. [PMID: 28093931 DOI: 10.1080/00016489.2016.1274426] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION The detection of human papillomavirus (HPV)-DNA in oral rinse with auto-nested GP5+/GP6 + PCR is useful as a biomarker of oropharyngeal cancer. BACKGROUND This study aimed to determine the usefulness of oral rinse to detect HPV-DNA as a biomarker of HPV-positive oropharyngeal cancer (OPC). PATIENTS AND METHODS One hundred and ten patients with various head and neck diseases, including 19 patients with OPC, were enrolled. Oral rinse and tonsillar swab were collected, and auto-nested GP5+/GP6 + PCR for HPV-DNA was performed. For oropharyngeal cancer, p16 immunostaining was also conducted. RESULTS The rate of HPV-DNA detection in both oral rinse and tonsillar swab was significantly higher in OPC compared with non-OPC upper respiratory tract cancer and non-cancer diseases. HPV-DNA was detected in oral rinse in nine out of 12 p16-positive OPC cases, while none of the p16-negative OPC cases demonstrated detectable HPV-DNA. All p16-positive cases were also positive for HPV-DNA in tumor tissue. Based on p16 immunostaining, the sensitivity and specificity of HPV-DNA detection in oral rinse were 75% and 100%, respectively. Among eight of nine evaluable OPC cases positive for HPV-DNA in oral rinse at diagnosis, HPV-DNA was undetectable in oral rinse in seven cases after treatment.
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Affiliation(s)
- Hiroshi Yoshida
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Shigeyuki Murono
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
- Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - Takayoshi Ueno
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Yosuke Nakanishi
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Akira Tsuji
- Department of Otolaryngology, Toyama City Hospital, Toyama, Japan
| | - Miyako Hatano
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Kazuhira Endo
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Satoru Kondo
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Hisashi Sugimoto
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Naohiro Wakisaka
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
| | - Tomokazu Yoshizaki
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, Japan
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14
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Gu X, Boldrup L, Coates PJ, Fahraeus R, Nylander E, Loizou C, Olofsson K, Norberg-Spaak L, Gärskog O, Nylander K. Epigenetic regulation of OAS2 shows disease-specific DNA methylation profiles at individual CpG sites. Sci Rep 2016; 6:32579. [PMID: 27572959 PMCID: PMC5004144 DOI: 10.1038/srep32579] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 08/10/2016] [Indexed: 12/27/2022] Open
Abstract
Epigenetic modifications are essential regulators of biological processes. Decreased DNA methylation of OAS2 (2′-5′-Oligoadenylate Synthetase 2), encoding an antiviral protein, has been seen in psoriasis. To provide further insight into the epigenetic regulation of OAS2, we performed pyrosequencing to detect OAS2 DNA methylation status at 11 promoter and first exon located CpG sites in psoriasis (n = 12) and two common subtypes of squamous cell carcinoma (SCC) of the head and neck: tongue (n = 12) and tonsillar (n = 11). Compared to corresponding controls, a general hypomethylation was seen in psoriasis. In tongue and tonsillar SCC, hypomethylation was found at only two CpG sites, the same two sites that were least demethylated in psoriasis. Despite differences in the specific residues targeted for methylation/demethylation, OAS2 expression was upregulated in all conditions and correlations between methylation and expression were seen in psoriasis and tongue SCC. Distinctive methylation status at four successively located CpG sites within a genomic area of 63 bp reveals a delicately integrated epigenetic program and indicates that detailed analysis of individual CpGs provides additional information into the mechanisms of epigenetic regulation in specific disease states. Methylation analyses as clinical biomarkers need to be tailored according to disease-specific sites.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Linda Boldrup
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Philip J Coates
- RECAMO, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Robin Fahraeus
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden.,RECAMO, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Institut de Génétique Moléculaire, Université Paris 7, Hôpital St. Louis, Paris, France
| | - Elisabet Nylander
- Department of Public Health and Clinical Medicine/Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Christos Loizou
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | | | | | - Ola Gärskog
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
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15
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Sgaramella N, Coates PJ, Strindlund K, Loljung L, Colella G, Laurell G, Rossiello R, Muzio LL, Loizou C, Tartaro G, Olofsson K, Danielsson K, Fåhraeus R, Nylander K. Expression of p16 in squamous cell carcinoma of the mobile tongue is independent of HPV infection despite presence of the HPV-receptor syndecan-1. Br J Cancer 2015; 113:321-6. [PMID: 26057450 DOI: 10.1038/bjc.2015.207] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/07/2015] [Accepted: 05/13/2015] [Indexed: 02/03/2023] Open
Abstract
Background: Tongue squamous cell carcinoma (TSCC) is increasing in incidence, especially among young patients and preferably females. Infection with human papilloma virus (HPV) has been suggested as a cause of SCC in the head and neck, and the proportion of oropharyngeal cancers caused by HPV has steadily increased. Methods: Samples from 109 patients with primary TSCC were analysed for the presence of HPV16 by in situ hybridisation and for expression of its surrogate marker p16 and the HPV receptor syndecan-1 by immunhistochemistry. Results: No evidence of HPV16 DNA was observed in the tumours, although one-third showed p16 staining. There was no difference in the expression of the primary HPV receptor, syndecan-1, between TSCC and a group of tonsil SCC. Conclusion: Whereas p16 is expressed in some TSCCs, HPV16 is undetectable, therefore, p16 cannot be used as a surrogate marker for high-risk HPV-infection in this tumour. Despite presence of the HPV-receptor syndecan-1 in TSCC, HPV prefers the tonsillar environment. Lack of p16 associates with worse prognosis primarily in patients aged ⩽40 years with tongue SCC. The improved prognosis seen in p16-positive TSCC can be due to induction of a senescent phenotype or an inherent radiosensitivity due to the ability of p16 to inhibit homologous recombination repair.
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