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Lee SM, Park JS, Norwitz ER, Koo JN, Oh IH, Park JW, Kim SM, Kim YH, Park CW, Song YS. Risk of vertical transmission of human papillomavirus throughout pregnancy: a prospective study. PLoS One 2013; 8:e66368. [PMID: 23785495 PMCID: PMC3681772 DOI: 10.1371/journal.pone.0066368] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 05/05/2013] [Indexed: 11/19/2022] Open
Abstract
Objective Much controversy still exists about maternal-to-infant transmission of human papillomavirus (HPV) infection, specifically about the magnitude of the risk and the route and timing of such vertical transmission. This prospective cohort study examines the risk of vertical transmission of maternal HPV in each trimester of pregnancy. Study design One hundred fifty three healthy pregnant women were followed longitudinally throughout pregnancy and cervical swabs obtained in each trimester and postpartum for HPV detection. Cord blood, neonatal nasopharyngeal aspirates, and placental biopsies were collected at delivery. DNA isolation, polymerase chain reaction, and hybridization were performed using the GG HPV Genotyping Chip Kit (Goodgene Inc., Seoul, Korea). Detection of HPV in neonates was defined as the presence of HPV DNA in either cord blood or neonatal nasopharyngeal aspirate. Results HPV DNA was detected in 14%(22/153) of healthy women in the first trimester, 18%(22/124) in the second trimester, and 10%(15/153) in the third trimester; 24%(37/153) were positive for HPV DNA on at least one occasion in pregnancy. At birth, 5.2%(8/153) of neonates were HPV DNA positive. Seven of these eight infants were born to HPV-positive mothers. Placental HPV DNA was positive in 3.3%(5/152) of cases, and all five cases were from mothers with at least one HPV-positive test. Detection of HPV DNA in neonates was associated with detection of HPV in mothers during any of the three trimesters of pregnancy. Conclusion HPV DNA was detected at birth in 5.2%(8/153) of neonates born to healthy women, and was associated with the detection of HPV in mothers during any of the three trimesters of pregnancy.
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Affiliation(s)
- Seung Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
| | - Errol R. Norwitz
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | | | | | - Jeong Woo Park
- Department of Obstetrics and Gynecology, Inje University College of Medicine, Ilsan-Paik Hospital, Gyeonggi, Korea
| | - Sun Min Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Hwan Kim
- Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Chan-Wook Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Sang Song
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Major in Biomodulation, World Class University, Seoul National University, Seoul, Korea
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Gillison ML, Alemany L, Snijders PJF, Chaturvedi A, Steinberg BM, Schwartz S, Castellsagué X. Human papillomavirus and diseases of the upper airway: head and neck cancer and respiratory papillomatosis. Vaccine 2013. [PMID: 23199965 DOI: 10.1016/j.vaccine.2012.05.070] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Human papillomavirus (HPV) infection is causally associated with benign and malignant diseases of the upper airway, including respiratory papillomatosis and oropharyngeal cancer. Low-risk HPV types 6 and 11 are the predominant cause of papillomatosis, whereas only HPV16 definitively satisfies both molecular and epidemiological causal criteria as a carcinogenic or high-risk type in the upper airway. HPV16 E6/E7 mRNA expression and integration are observed predominantly among oropharyngeal cancers, and experimental models have shown E6/E7 expression to be necessary for the initiation and maintenance of the malignant phenotype of these cancers. From an epidemiological perspective, a strong and consistent association between markers of HPV16 exposure and oropharyngeal cancer has been demonstrated in numerous case-control studies. HPV-positive oropharyngeal cancers have also been shown to be distinct from HPV-negative head and neck squamous cell cancers with regard to risk-factor profiles, molecular genetic alterations, population-level incidence trends over time, and prognosis. Tumor HPV status (as determined by certain HPV16 in situ hybridization assays or certain p16 immunohistochemistry assays) is the strongest determinant of survival for patients with local-regionally advanced oropharyngeal cancer: patients with HPV-positive cancer have at least a 50% improvement in overall survival at 5 years, which is equivalent to an approximate 30% difference in absolute survival. Thus, HPV status determination is now part of the routine diagnostic evaluation for prognostication. Preliminary evidence indicates that a small proportion of head and neck cancers may be caused by additional HPV types (e.g., 18, 31, 33, 35) and that HPV-caused cancers may rarely arise from non-oropharyngeal sites (e.g., the oral cavity, nasopharynx, and larynx). Whether or not HPV vaccination has the potential to prevent oral HPV infections that lead to cancer or papillomatosis in the upper airway is currently unknown, as is the potential for secondary prevention with HPV detection. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Maura L Gillison
- Viral Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
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Khangura RK, Sengupta S, Sircar K, Sharma B, Singh S, Rastogi V. HPV involvement in OSCC: Correlation of PCR results with light microscopic features. J Oral Maxillofac Pathol 2013; 17:195-200. [PMID: 24250078 PMCID: PMC3830226 DOI: 10.4103/0973-029x.119756] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The study evaluated pathognomic histopathological features with the help of light microscopy for detecting the integration of human papillomavirus (HPV) (type 16 and 18) in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS Forty-five histopathologically diagnosed cases of OSCC were evaluated for the presence of E6/E7 protein of HPV (16 + 18) with the help of nested multiplex polymerase chain reaction. Both HPV-positive and -negative cases were evaluated for four histological features: Koilocytes, dyskeratosis, invasion, and alteration of collagen. RESULTS Fischer's exact test showed significant difference (P < 0.01%) for the presence of koilocytes and dyskeratosis, whereas no difference was observed for invasion and alteration in collagen between HPV-positive and -negative OSCC. CONCLUSION The presence of koilocytes and dyskeratosis at light microscopic level can be used as a marker for the presence of HPV (type 16 and 18) in OSCC.
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Affiliation(s)
- Rajbir Kaur Khangura
- Department of Oral Pathology and Microbiology, M N D.A.V. Dental College, Tatul, Solan, Himachal Pradesh, India
| | - Shamindra Sengupta
- Department of Oral Pathology and Microbiology, D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Keya Sircar
- Department of Oral Pathology and Microbiology, Faculty of Dentistry Jamia Mallia Islamia, Delhi, India
| | - Bhudev Sharma
- Department of Oral Pathology and Microbiology, D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Sanjeet Singh
- Department of Oral Pathology and Microbiology, D.J. College of Dental Sciences and Research, Modinagar, Ghaziabad, Uttar Pradesh, India
| | - Varun Rastogi
- Department of Oral Pathology and Microbiology, Kalka Dental College, Meerut, India
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Abstract
An increasing subset of patients with head and neck squamous cell carcinoma (HNSCCA) is positive for high-risk human papillomavirus (HR-HPV). Patients tend to be younger, have a minimal or absent tobacco and ethanol abuse history, increased number of lifetime sexual partners (particularly oral-genital sex), and squamous cell carcinomas (SCCAs) arising in the oropharynx. The most common HR-HPV associated with HNSCCA is HPV-16. HR-HPV positivity is associated with decreased expression of the p53 and Rb genes, overexpression of p16, decreased expression of EGFR, and a different genetic expression pattern compared with patients with HR-HPV-negative SCCAs, leading to the conclusion that this is a distinct clinical entity. Patients who have HR-HPV-positive HNSCCAs have an improved prognosis, particularly those with oropharyngeal SCCAs, leading some to speculate that the intensity of treatment might be decreased. At present, whether this can be done safely remains unclear.
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Hernández-Guerrero JC, Jacinto-Alemán LF, Jiménez-Farfán MD, Macario-Hernández A, Hernández-Flores F, Alcántara-Vázquez A. Prevalence trends of oral squamous cell carcinoma. Mexico City's General Hospital experience. Med Oral Patol Oral Cir Bucal 2013; 18:e306-11. [PMID: 23385493 PMCID: PMC3613885 DOI: 10.4317/medoral.18043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 08/31/2012] [Indexed: 11/23/2022] Open
Abstract
Objective: Recent reports suggest an increase in oral squamous cell carcinoma (OSCC) frequency. To improve programs in public health, it is necessary to understand the epidemiological conditions. The aim of this study was to analyze the trend in gender, age, anatomic zone and OSCC stage from Mexico City’s General Hospital patients from 1990 to 2008.
Study design: A retrospective review of all OSCC cases diagnosed by the Pathology Department of the Mexico City General Hospital was performed. Demographic data, in addition to anatomic zone and histological degree of differentiation were obtained. Central tendency, dispersion and prevalence rate per 100,000 individuals were determined.
Results: A total of 531 patients were diagnosed with OSCC; 58.4% were men, giving a male:female ratio of 1.4:1, and the mean age was 62.5 ± 14.9 years. The predominant anatomic zone was the tongue (44.7%), followed by the lips (21.2%) and gums (20.5%). The most frequent histological degree was moderately differentiated in 325 cases (61.2%). The rates of OSCC prevalence showed similar patterns in terms across time. A significant correlation (P = 0.007) between anatomic zone and age was observed.
Conclusion: According to our results, the prevalence of OSCC does not show important variations; however, a relationship between age and anatomic zone was observed. These data could be used as parameters for the diagnosis of OSCC as well as for the development and dissemination of preventive programs for the early detection of oral cancer.
Key words:Oral squamous cell carcinoma, prevalence, histology degree and anatomic zone.
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Affiliation(s)
- Juan-Carlos Hernández-Guerrero
- Immunology Laboratory, Postgraduate and Research Division, Dental School, National Autonomous University of Mexico, Mexico, DF, Mexico
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Kouvousi M, Xesfyngi D, Tsimplaki E, Argyri E, Ioannidou G, Ploxorou M, Lazaris AC, Patsouris E, Panotopoulou E. Prevalence of human papillomavirus in 45 greek patients with oral cancer. JOURNAL OF ONCOLOGY 2013; 2013:756510. [PMID: 23533409 PMCID: PMC3600178 DOI: 10.1155/2013/756510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/15/2013] [Accepted: 02/01/2013] [Indexed: 12/01/2022]
Abstract
The relation between HPV and head and neck cancer has recently and extensively been investigated. The purpose of this study was to indentify HPV genotypes, as well as E6/E7 mRNA expression of high-risk HPVs (16, 18, 31, 33 and 45) in oral squamous cell carcinomas (OSCCs) from 45 Greek patients. The overall prevalence of HPV DNA positive OSCCs was 11.1% (5/45), while high-risk HPV DNA was found in 6.7% (3/45) of OSCCs. E6/E7 mRNA expression was detected in 8.9% (4/45) of the oral cavity samples. Our data indicated that HPV 16 was the commonest genotype identified in HPV-positive OSCCs by both DNA and RNA tests. This study confirms the prevalence of HPV infections among patients with OSCCs. Future analysis and followup of more OSCCs will enable us to correlate HPV detection and clinical outcome.
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Affiliation(s)
- Maria Kouvousi
- Department of Virology, “G. Papanikolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Dimitra Xesfyngi
- Radiotherapy Department, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Elpida Tsimplaki
- Department of Virology, “G. Papanikolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Elena Argyri
- Department of Virology, “G. Papanikolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Georgia Ioannidou
- Radiotherapy Department, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Maria Ploxorou
- Radiotherapy Department, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Andreas C. Lazaris
- 1st Department of Pathology, Medical School, University of Athens, Goudi, 11527 Athens, Greece
| | - Efstratios Patsouris
- 1st Department of Pathology, Medical School, University of Athens, Goudi, 11527 Athens, Greece
| | - Efstathia Panotopoulou
- Department of Virology, “G. Papanikolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
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González-Ramírez I, Irigoyen-Camacho ME, Ramírez-Amador V, Lizano-Soberón M, Carrillo-García A, García-Carrancá A, Sánchez-Pérez Y, Méndez-Martínez R, Granados-García M, Ruíz-Godoy LM, García-Cuellar CM. Association between age and high-risk human papilloma virus in Mexican oral cancer patients. Oral Dis 2013; 19:796-804. [DOI: 10.1111/odi.12071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/01/2013] [Indexed: 12/21/2022]
Affiliation(s)
- I González-Ramírez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - ME Irigoyen-Camacho
- Departamento de Atención a la Salud; Universidad Autónoma Metropolitana Xochimilco; Mexico City; Mexico
| | - V Ramírez-Amador
- Departamento de Atención a la Salud; Universidad Autónoma Metropolitana Xochimilco; Mexico City; Mexico
| | - M Lizano-Soberón
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México; Mexico City; Mexico
| | - A Carrillo-García
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - A García-Carrancá
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México; Mexico City; Mexico
| | - Y Sánchez-Pérez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - R Méndez-Martínez
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - M Granados-García
- Departamento de Tumores de Cabeza y Cuello; Instituto Nacional de Cancerología; Mexico City; Mexico
| | - LM Ruíz-Godoy
- Instituto Nacional de Cancerología, Banco de Tumores; Mexico City; Mexico
| | - CM García-Cuellar
- Subdirección de Investigación Básica; Instituto Nacional de Cancerología; Mexico City; Mexico
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Onicescu G, Hill EG, Lawson AB, Korte JE, Gillespie MB. Joint disease mapping of cervical and male oropharyngeal cancer incidence in blacks and whites in South Carolina. Spat Spatiotemporal Epidemiol 2013; 1:133-41. [PMID: 20563237 DOI: 10.1016/j.sste.2010.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human papillomavirus (HPV) infection is an established causal agent for cervical cancer and a subset of oropharyngeal cancers. It is hypothesized that orogenital transmission results in oral cavity infection. In this paper we explore the geographical association between cervical and male oropharyngeal cancer incidence in blacks and whites in South Carolina using Bayesian joint disease mapping models fit to publicly available data. Our results suggest weak evidence for county-level association between the diseases, and different patterns of joint disease behavior for blacks and whites.
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Affiliation(s)
- Georgiana Onicescu
- Division of Biostatistics and Epidemiology, Department of Medicine, Medical University of South Carolina, USA.
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59
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Anaya-Saavedra G, Flores-Moreno B, García-Carrancá A, Irigoyen-Camacho E, Guido-Jiménez M, Ramírez-Amador V. HPV oral lesions in HIV-infected patients: the impact of long-term HAART. J Oral Pathol Med 2012; 42:443-9. [PMID: 23278731 DOI: 10.1111/jop.12032] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Since the introduction of highly active antiretroviral therapy (HAART), an increase in the frequency of human papillomavirus-associated oral lesions (HPV-OL) has been observed. Thus, the aim of this study was to determine the prevalence and factors associated with HPV-OL in Mexican HIV-infected patients, as well as its genotyping, in the HAART era. METHODS In a cross-sectional study developed at an HIV/AIDS referral center in Mexico City, HIV-infected patients were consecutively included from 2004 to 2011. An oral exam was performed; lymphocyte CD4(+) count, HIV-viral load, CDC-stage, and HAART use were recorded. HPV-OL samples were taken for routine histopathological analysis (H-E) and HPV-DNA amplification/sequencing. Logistic regression models were performed and the interactions tested using the STATA software. RESULTS Among 787 HIV patients, 55 (6.9%) showed HPV-OL. HPV-OLs were independently associated with age (≥40 years) and with a longer time of HAART use (≥12 months). The most frequent lesion was squamous cell papilloma in 22 (40%) cases, followed by multifocal epithelial hyperplasia in 15 (27.3%) cases. Labial mucosa was the most common site involved (56.4%). Of the sequences obtained, 65.4% corresponded to low risk and 11.5% to high risk. Mixed high- and low-risk infection were identified in 7.7% of the cases. CONCLUSIONS Human papillomavirus-associated oral lesions were associated with older age and longer HAART use. All lesions were benign in nature and most of the HPV sequences corresponded to low-risk types. The rise of HPV-OLs in HIV patients on HAART may be related with the longer life expectancy of individuals with an impaired immune system rather than a direct effect of HAART.
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Baio G, Capone A, Marcellusi A, Mennini FS, Favato G. Economic burden of human papillomavirus-related diseases in Italy. PLoS One 2012; 7:e49699. [PMID: 23185412 PMCID: PMC3504125 DOI: 10.1371/journal.pone.0049699] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 10/11/2012] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Human papilloma virus (HPV) genotypes 6, 11, 16, and 18 impose a substantial burden of direct costs on the Italian National Health Service that has never been quantified fully. The main objective of the present study was to address this gap: (1) by estimating the total direct medical costs associated with nine major HPV-related diseases, namely invasive cervical cancer, cervical dysplasia, cancer of the vulva, vagina, anus, penis, and head and neck, anogenital warts, and recurrent respiratory papillomatosis, and (2) by providing an aggregate measure of the total economic burden attributable to HPV 6, 11, 16, and 18 infection. METHODS For each of the nine conditions, we used available Italian secondary data to estimate the lifetime cost per case, the number of incident cases of each disease, the total economic burden, and the relative prevalence of HPV types 6, 11, 16, and 18, in order to estimate the aggregate fraction of the total economic burden attributable to HPV infection. RESULTS The total direct costs (expressed in 2011 Euro) associated with the annual incident cases of the nine HPV-related conditions included in the analysis were estimated to be €528.6 million, with a plausible range of €480.1-686.2 million. The fraction attributable to HPV 6, 11, 16, and 18 was €291.0 (range €274.5-315.7 million), accounting for approximately 55% of the total annual burden of HPV-related disease in Italy. CONCLUSIONS The results provided a plausible estimate of the significant economic burden imposed by the most prevalent HPV-related diseases on the Italian welfare system. The fraction of the total direct lifetime costs attributable to HPV 6, 11, 16, and 18 infections, and the economic burden of noncervical HPV-related diseases carried by men, were found to be cost drivers relevant to the making of informed decisions about future investments in programmes of HPV prevention.
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Affiliation(s)
- Gianluca Baio
- Department of Statistical Science, University College London, London, United Kingdom
- Biostatistics Unit, Department of Statistics, University of Milano–Bicocca, Milan, Italy
| | - Alessandro Capone
- Institute of Leadership and Management in Health (ILMH), Kingston University London, London, United Kingdom
| | - Andrea Marcellusi
- CEIS Sanità (CHEM – Centre for Health Economics and Management), Faculty of Economics, University of Tor Vergata, Rome, Italy
| | - Francesco Saverio Mennini
- Institute of Leadership and Management in Health (ILMH), Kingston University London, London, United Kingdom
- CEIS Sanità (CHEM – Centre for Health Economics and Management), Faculty of Economics, University of Tor Vergata, Rome, Italy
| | - Giampiero Favato
- Institute of Leadership and Management in Health (ILMH), Kingston University London, London, United Kingdom
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Vargas-Ferreira F, Nedel F, Etges A, Gomes APN, Furuse C, Tarquinio SBC. Etiologic factors associated with oral squamous cell carcinoma in non-smokers and non-alcoholic drinkers: a brief approach. Braz Dent J 2012; 23:586-90. [DOI: 10.1590/s0103-64402012000500020] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 09/21/2012] [Indexed: 11/22/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the fifth most common type of cancer in the world. The effect of some etiological factors is well established in the literature, such as consumption of tobacco and alcohol. However, approximately 15 to 20% of all oral cancer cases occur in patients without the traditional risk factors, reflecting in numerous cases of OSCC in non-smokers and non-alcoholic drinkers. Also, several studies have suggested a possible association between human papillomavirus and OSCC. Under these aspects, the purpose of this study is to address cases of oral cancer in non-smokers and non-drinkers focusing on the role of HPV, thus contributing to improve the diagnosis and monitoring of OSCC. A computer database search was performed using the Pubmed database. The search key words were: epidemiology, oral squamous cell carcinoma, risk factors and human papillomavirus. It is important to assess patients without the potential risk factors, since this knowledge may help identifying other features associated with the occurrence of oral cancer, enabling an appropriate clinical management and monitoring.
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Metgud R, Astekar M, Verma M, Sharma A. Role of viruses in oral squamous cell carcinoma. Oncol Rev 2012; 6:e21. [PMID: 25992219 PMCID: PMC4419625 DOI: 10.4081/oncol.2012.e21] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 09/03/2012] [Accepted: 09/04/2012] [Indexed: 01/06/2023] Open
Abstract
The etiology of oral squamous cell carcinoma (OSCC) is complex and involves many factors. The most clearly defined risk factors are smoking and alcohol, which substantially increase the risk of oral SCC. However, despite this clear association, a substantial proportion of patients develop OSCC without exposure to them, emphasizing the role of other risk factors such as genetic susceptibility and oncogenic viruses. Some viruses are strongly associated with OSCC while the association of others is less frequent and may depend on co-factors for their carcinogenic effects. Therefore, the exact role of viruses must be evaluated with care in order to improve the diagnosis and treatment of OSCC.
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Affiliation(s)
- Rashmi Metgud
- Department of Oral and Maxillofacial Pathology, Pacific Dental College and Hospital, Debari, Udaipur (Rajasthan), India
| | - Madhusudan Astekar
- Department of Oral and Maxillofacial Pathology, Pacific Dental College and Hospital, Debari, Udaipur (Rajasthan), India
| | - Meenal Verma
- Department of Oral and Maxillofacial Pathology, Pacific Dental College and Hospital, Debari, Udaipur (Rajasthan), India
| | - Ashish Sharma
- Department of Oral and Maxillofacial Pathology, Pacific Dental College and Hospital, Debari, Udaipur (Rajasthan), India
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Chaturvedi P, Vaishampayan SS, Nair S, Nair D, Agarwal JP, Kane SV, Pawar P, Datta S. Oral squamous cell carcinoma arising in background of oral submucous fibrosis: A clinicopathologically distinct disease. Head Neck 2012; 35:1404-9. [DOI: 10.1002/hed.23143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 11/10/2022] Open
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de Freitas Cordeiro-Silva M, Stur E, Agostini LP, de Podestá JRV, de Oliveira JC, Soares MS, Mendonça EF, Gouvea SA, Von Zeidler SV, Louro ID. Promoter hypermethylation in primary squamous cell carcinoma of the oral cavity and oropharynx: a study of a Brazilian cohort. Mol Biol Rep 2012; 39:10111-9. [PMID: 22936053 DOI: 10.1007/s11033-012-1885-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 08/22/2012] [Indexed: 12/20/2022]
Abstract
Epigenetic silencing of cancer-related genes plays an important role in oral/oropharyngeal squamous cell carcinoma (OSCC). We evaluated promoter hypermethylation of 4 cancer-related genes in OSCCs of a Brazilian cohort and determined its relationship with exposure to alcohol, tobacco, HPV infection and clinicopathological parameters. CDKN2A (cyclin-dependent kinase inhibitor 2A or p16), SFN (stratifin or 14-3-3 σ), EDNRB (endothelin receptor B) and RUNX3 (runt-related transcript factor-3) had their methylation patterns evaluated by MSP analysis in OSCC tumors (n = 45). HPV detection was carried out by PCR/RFLP. Aberrant methylation was detected in 44/45 (97.8 %) OSCC; 24.4 % at CDKN2A, 77.8 % at EDNRB, 17.8 % at RUNX3 and 97.8 % at SFN gene. There was no significant association between methylation patterns and clinical parameters. HPV (subtype 16) was detected in 3 out of 45 patients (6 %). Our findings indicate that HPV infection is uncommon and methylation is frequent in Brazilian OSCCs, however, EDNRB and SFN gene methylation are not suitable OSCC biomarkers due to indistinct methylation in tumoral and normal samples. In contrast, CDKN2A and RUNX3 genes could be considered differentially methylated genes and potential tumor markers in OSCCs.
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Affiliation(s)
- Melissa de Freitas Cordeiro-Silva
- Núcleo de Genética Humana e Molecular Departamento de Ciências Biológicas, Centro de Ciências Humanas e Naturais Universidade Federal do Espírito Santo, Av. Marechal Campos, 1468. Maruípe, Vitoria, ES, CEP: 29040-090, Brazil
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Radoï L, Luce D. A review of risk factors for oral cavity cancer: the importance of a standardized case definition. Community Dent Oral Epidemiol 2012; 41:97-109, e78-91. [PMID: 22882534 DOI: 10.1111/j.1600-0528.2012.00710.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 06/17/2012] [Indexed: 12/16/2022]
Abstract
The aim of this work is to review the literature on risk factors of oral cavity cancer with a special attention to the definition of the cases, in order to highlight special features of these cancers and of their subsites. PubMed database was systematically searched to access relevant articles published between 1980 and 2010. Reference lists of selected papers were examined to identify further articles. One hundred and two studies met the inclusion criteria. Their results were difficult to compare because of the lack of uniformity in defining oral cavity. In addition, few studies examined risk factors other than alcohol and tobacco, and studies differentiating between subsites were rare. Despite these limitations, some characteristics of oral cavity cancers may be emphasized: smoked tobacco seems to be a stronger risk factor for oral cavity cancer than alcohol, and the floor of the mouth seems to be more sensitive to the harmful effects of alcohol and smoked tobacco. Studies limited strictly to oral cavity cancers and distinguishing between subsites are needed to better understand the aetiology of these cancers, and better define risk groups to target prevention efforts and screening.
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Affiliation(s)
- Loredana Radoï
- Inserm U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France
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66
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Prabhu SR, Wilson D, Johnson NW. Re: national prevalence of oral HPV infection and related risk factors in the U.S. adult population. Oral Dis 2012; 19:107-8. [PMID: 22748114 DOI: 10.1111/j.1601-0825.2012.01956.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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67
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Imano R. [Human papillomavirus infection, cervical cancer and their involvement in head and neck cancer]. ACTA ACUST UNITED AC 2012; 115:73-84. [PMID: 22690401 DOI: 10.3950/jibiinkoka.115.73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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68
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Joseph AW, D'Souza G. Epidemiology of human papillomavirus-related head and neck cancer. Otolaryngol Clin North Am 2012; 45:739-64. [PMID: 22793850 DOI: 10.1016/j.otc.2012.04.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Human papillomavirus (HPV) is now recognized to cause a subset of head and neck squamous cell carcinomas (HNSCC). Although excessive tobacco and alcohol use continue to be important risk factors for HNSCC, epidemiologic studies suggest that more than 25% of HNSCC are now caused by HPV. The incidence of HPV-related HNSCC is increasing, highlighting the need to understand the oral HPV infections causing these cancers. This article reviews the evidence for a causal association between HPV and HNSCC, examines the changing epidemiologic trends of HNSCC, and discusses what is currently known about oral HPV infection, natural history, and transmission.
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Affiliation(s)
- Andrew W Joseph
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, JHOC 6th Floor, 601 North Caroline Street, Baltimore, MD 21287, USA
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69
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Brew MC, Trapp R, Hilgert JB, Schmitt VM. Human papillomavirus and oral squamous cell carcinoma in a south Brazilian population. Exp Mol Pathol 2012; 93:61-5. [PMID: 22554808 DOI: 10.1016/j.yexmp.2012.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 03/07/2012] [Accepted: 04/10/2012] [Indexed: 11/18/2022]
Affiliation(s)
- Myrian Camara Brew
- Curso de Odontologia, Universidade Luterana do Brasil-ULBRA, Av. Farroupilha, 8001, Pd 59, Bairro São José, CEP 92425-900, Canoas/RS, Brazil.
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70
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Ginawi IAM, Mahgoub EA, Ahmed HG. Immunophenotyping of HPV Types 16 and 18 among Sudanese Patients with Oral Lesions. Oman Med J 2012; 27:201-6. [PMID: 22811767 PMCID: PMC3394353 DOI: 10.5001/omj.2012.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 03/19/2012] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to screen patients with oral lesions for the presence of Human Papilloma Virus (HPV) types 16 and 18. METHODS Sixty patients aged between 11-80 years with a mean age of 46 years were examined using immunohistological techniques. All samples were retrieved from RICK during the period from August 2009 to August 2010. Out of 60 patients, 50 had Oral Squamous Cell Carcinomas (OSCCs) and the remaining ten had benign oral lesions, included as internal control. RESULTS Of the 50 patients with OSCCs, 10 (20%) showed positive immunohistochemical results for HPV types 16 and 18 of which 50% were detected among males and 50% were demonstrated among females. The ten positive findings were Immunophenotyped as follows: five were positive with HPV type 16, four with type 18 and one was positive for HPV types 16 and18. All patients with benign oral lesions were negative for HPV immunohistochemistry. CONCLUSION The study suggests the role of HPV 16 and 18 in the etiology of oral cancers in different parts of Sudan. However, the use of molecular techniques such as PCR are needed to confirm the results of immunohistochemistry in the role of the HPV in developing of OSCC in Sudan.
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Affiliation(s)
| | | | - Hussain G. Ahmed
- Department of Histopathology and Cytology, FMLs, University of Khartoum
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71
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Sanders AE, Slade GD, Patton LL. National prevalence of oral HPV infection and related risk factors in the U.S. adult population. Oral Dis 2012; 18:430-41. [PMID: 22251072 DOI: 10.1111/j.1601-0825.2011.01892.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This article reviews the rapidly growing evidence that oral human papilloma viruses (HPV) infection contributes to the risk of oral squamous cell carcinoma. It also reports the first nationally representative estimates of oral HPV prevalence in the United States adult population. An estimated 7.3% (95% CI: 6.0, 8.9) of the U.S. population had one or more oral HPV types detected in oral rinse; 3.1% (95%CI: 2.4, 3.9) of the U.S. population had one or more oncogenic HPV types. A substantial excess risk of HPV infection in men is not explained by education, smoking, age of sexual debut, or number of lifetime sex partners. Based on the published finding from a case-control study, where there was an odds ratio of 2.6 (95% CI: 1.5, 4.2) for the association of head and neck cancer oncogenic oral HPV infection, the estimated population attributable risk for head and neck cancer in the U.S. population was 4.7%. In other words, there would be a 4.7% reduction in incidence rate of head and neck cancer in the United States if oncogenic HPV infection could be prevented. The results also provide population data that help evaluate the likely public health benefits of prophylactic vaccination against oral HPV acquisition.
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Affiliation(s)
- A E Sanders
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7450, USA.
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72
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Health beliefs and attitudes associated with HPV vaccine intention among young gay and bisexual men in the southeastern United States. Vaccine 2011; 29:8060-5. [DOI: 10.1016/j.vaccine.2011.08.045] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 08/08/2011] [Accepted: 08/08/2011] [Indexed: 11/19/2022]
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73
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Syrjänen S, Lodi G, von Bültzingslöwen I, Aliko A, Arduino P, Campisi G, Challacombe S, Ficarra G, Flaitz C, Zhou HM, Maeda H, Miller C, Jontell M. Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review. Oral Dis 2011; 17 Suppl 1:58-72. [PMID: 21382139 DOI: 10.1111/j.1601-0825.2011.01792.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) in oral carcinoma (OSCC) and potentially malignant disorders (OPMD) is controversial. The primary aim was to calculate pooled risk estimates for the association of HPV with OSCC and OPMD when compared with healthy oral mucosa as controls. We also examined the effects of sampling techniques on HPV detection rates. METHODS Systematic review was performed using PubMed (January 1966-September 2010) and EMBASE (January 1990-September 2010). Eligible studies included randomized controlled, cohort and cross-sectional studies. Pooled data were analysed by calculating odds ratios, using a random effects model. Risk of bias was based on characteristics of study group, appropriateness of the control group and prospective design. RESULTS Of the 1121 publications identified, 39 cross-sectional studies met the inclusion criteria. Collectively, 1885 cases and 2248 controls of OSCC and 956 cases and 675 controls of OPMD were available for analysis. Significant association was found between pooled HPV-DNA detection and OSCC (OR = 3.98; 95% CI: 2.62-6.02) and even for HPV16 only (OR = 3.86; 95% CI: 2.16-6.86). HPV was also associated with OPMD (OR = 3.87; 95% CI: 2.87-5.21). In a subgroup analysis of OPMD, HPV was also associated with oral leukoplakia (OR = 4.03; 95% CI: 2.34-6.92), oral lichen planus (OR = 5.12; 95% CI: 2.40-10.93), and epithelial dysplasia (OR = 5.10; 95% CI: 2.03-12.80). CONCLUSIONS The results suggest a potentially important causal association between HPV and OSCC and OPMD.
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Affiliation(s)
- S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.
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74
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Pereira KMA, Soares RC, Oliveira MC, Pinto LP, Costa ADLL. Immunohistochemical staining of Langerhans cells in HPV-positive and HPV-negative cases of oral squamous cells carcinoma. J Appl Oral Sci 2011; 19:378-83. [PMID: 21710097 PMCID: PMC4223790 DOI: 10.1590/s1678-77572011005000013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2009] [Accepted: 10/26/2010] [Indexed: 11/21/2022] Open
Abstract
The Human Papillomavirus (HPV) has been strongly implicated in development of
some cases of oral squamous cell carcinoma (OSCC). However, the immunological
system somehow reacts against the presence of this virus. Among the cells
involved in such mechanism of defense Langerhans cells (LC) stand out, which are
responsible for processing and presenting antigens.
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75
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Abstract
Patients with HPV-positive cancer were young and lacked traditional risk factors. Oropharyngeal Cancer Epidemic and HPV A growing body of research shows that human papillomavirus (HPV) is a common and increasing cause of oropharyngeal squamous cell carcinoma (OSCC). Thus, the International Agency for Research against Cancer has acknowledged HPV as a risk factor for OSCC, in addition to smoking and alcohol consumption. Recently, in Finland, the United Kingdom, the Netherlands, the United States, and Sweden, incidence of OSCC has increased, and an increase in the proportion of HPV-positive tumors was noted. On the basis of these data and reports indicating that patients with HPV-positive cancer have their first sexual experience at a young age and have multiple partners, we postulate that increased incidence of OSCC in the United States and some countries in northern Europe is because of a new, primarily sexually transmitted HPV epidemic. We also suggest that individualized treatment modalities and preventive vaccination should be further explored.
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76
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Buonomo T, Carraresi L, Rossini M, Martinelli R. Involvement of aryl hydrocarbon receptor signaling in the development of small cell lung cancer induced by HPV E6/E7 oncoproteins. J Transl Med 2011; 9:2. [PMID: 21205295 PMCID: PMC3022727 DOI: 10.1186/1479-5876-9-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 01/04/2011] [Indexed: 12/30/2022] Open
Abstract
Background Lung cancers consist of four major types that and for clinical-pathological reasons are often divided into two broad categories: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). All major histological types of lung cancer are associated with smoking, although the association is stronger for SCLC and squamous cell carcinoma than adenocarcinoma. To date, epidemiological studies have identified several environmental, genetic, hormonal and viral factors associated with lung cancer risk. It has been estimated that 15-25% of human cancers may have a viral etiology. The human papillomavirus (HPV) is a proven cause of most human cervical cancers, and might have a role in other malignancies including vulva, skin, oesophagus, head and neck cancer. HPV has also been speculated to have a role in the pathogenesis of lung cancer. To validate the hypothesis of HPV involvement in small cell lung cancer pathogenesis we performed a gene expression profile of transgenic mouse model of SCLC induced by HPV-16 E6/E7 oncoproteins. Methods Gene expression profile of SCLC has been performed using Agilent whole mouse genome (4 × 44k) representing ~ 41000 genes and mouse transcripts. Samples were obtained from two HPV16-E6/E7 transgenic mouse models and from littermate's normal lung. Data analyses were performed using GeneSpring 10 and the functional classification of deregulated genes was performed using Ingenuity Pathway Analysis (Ingenuity® Systems, http://www.ingenuity.com). Results Analysis of deregulated genes induced by the expression of E6/E7 oncoproteins supports the hypothesis of a linkage between HPV infection and SCLC development. As a matter of fact, comparison of deregulated genes in our system and those in human SCLC showed that many of them are located in the Aryl Hydrocarbon Receptor Signal transduction pathway. Conclusions In this study, the global gene expression of transgenic mouse model of SCLC induced by HPV-16 E6/E7 oncoproteins led us to identification of several genes involved in SCLC tumor development. Furthermore, our study reveled that the Aryl Hydrocarbon Receptor Signaling is the primarily affected pathway by the E6/E7 oncoproteins expression and that this pathway is also deregulated in human SCLC. Our results provide the basis for the development of new therapeutic approaches against human SCLC.
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Affiliation(s)
- Tonia Buonomo
- CEINGE Biotecnologie Avanzate, Via Comunale Margherita 482, 80145 Napoli, Italy
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77
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González-Ramírez I, Ramírez-Amador V, Irigoyen-Camacho M, Sánchez-Pérez Y, Anaya-Saavedra G, Granados-García M, García-Vázquez F, García-Cuellar C. hMLH1 promoter methylation is an early event in oral cancer. Oral Oncol 2011; 47:22-6. [DOI: 10.1016/j.oraloncology.2010.10.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2010] [Revised: 10/04/2010] [Accepted: 10/05/2010] [Indexed: 12/21/2022]
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78
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Chen X, Sturgis EM, Lei D, Dahlstrom K, Wei Q, Li G. Human papillomavirus seropositivity synergizes with MDM2 variants to increase the risk of oral squamous cell carcinoma. Cancer Res 2010; 70:7199-208. [PMID: 20736372 DOI: 10.1158/0008-5472.can-09-4733] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The increasing incidence of oral squamous cell carcinoma (OSCC) in young adults has been associated with sexually transmitted infections of human papillomavirus (HPV), particularly HPV16. Given the roles of p53 in tumor suppression and of HPV E6 and MDM2 oncoproteins in p53 degradation, we evaluated HPV16 L1 seropositivity and MDM2 promoter variants to examine their possible associations with OSCC risk in a case-control study of 325 patients and 335 cancer-free matched controls. Compared with individuals having MDM2-rs2279744 GT or GG genotypes and HPV16 L1 seronegativity, the TT genotype and HPV16 L1 seronegativity were found to be associated with an odds ratio (OR) of 1.25 [95% confidence interval (CI), 1.06-2.19] for OSCC risk, and GT/GG and HPV16 L1 seropositivity were associated with an OR of 2.81 (95% CI, 1.67-4.74). For those with both the TT genotype and HPV16 L1 seropositivity, the associated OR was 5.57 (95% CI, 2.93-10.6). Similar results were observed for the MDM2-rs937283 polymorphism. Moreover, there was a borderline significant or significant interaction between the individual or combined MDM2 genotypes of the two polymorphisms and HPV16 L1 seropositivity (P(int) = 0.060 for MDM2-rs2279744, P(int) = 0.009 for MDM2-rs937283, and P(int) = 0.005 for the combined MDM2 genotypes) on risk of OSCC. Notably, that effect modification was particularly pronounced in never smokers and never drinkers, and for oropharyngeal as opposed to oral cavity cancer. Taken together, our results indicate that the risk of OSCC associated with HPV16 L1 seropositivity is modified by MDM2 promoter polymorphisms.
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Affiliation(s)
- Xingming Chen
- Departments of Head and Neck Surgery and Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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79
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Marur S, D'Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 2010; 11:781-9. [PMID: 20451455 PMCID: PMC5242182 DOI: 10.1016/s1470-2045(10)70017-6] [Citation(s) in RCA: 1291] [Impact Index Per Article: 92.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A rise in incidence of oropharyngeal squamous cell cancer--specifically of the lingual and palatine tonsils--in white men younger than age 50 years who have no history of alcohol or tobacco use has been recorded over the past decade. This malignant disease is associated with human papillomavirus (HPV) 16 infection. The biology of HPV-positive oropharyngeal cancer is distinct with P53 degradation, retinoblastoma RB pathway inactivation, and P16 upregulation. By contrast, tobacco-related oropharyngeal cancer is characterised by TP53 mutation and downregulation of CDKN2A (encoding P16). The best method to detect virus in tumour is controversial, and both in-situ hybridisation and PCR are commonly used; P16 immunohistochemistry could serve as a potential surrogate marker. HPV-positive oropharyngeal cancer seems to be more responsive to chemotherapy and radiation than HPV-negative disease. HPV 16 is a prognostic marker for enhanced overall and disease-free survival, but its use as a predictive marker has not yet been proven. Many questions about the natural history of oral HPV infection remain under investigation. For example, why does the increase in HPV-related oropharyngeal cancer dominate in men? What is the potential of HPV vaccines for primary prevention? Could an accurate method to detect HPV in tumour be developed? Which treatment strategies reduce toxic effects without compromising survival? Our aim with this review is to highlight current understanding of the epidemiology, biology, detection, and management of HPV-related oropharyngeal head and neck squamous cell carcinoma, and to describe unresolved issues.
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Affiliation(s)
- Shanthi Marur
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA.
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80
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Montaldo C, Mastinu A, Zorco S, Santini N, Pisano E, Piras V, Denotti G, Peluffo C, Erriu M, Garau V, Orrù G. Distribution of human papillomavirus genotypes in sardinian patients with oral squamous cell carcinoma. Open Virol J 2010; 4:163-8. [PMID: 21249161 PMCID: PMC3023062 DOI: 10.2174/1874357901004010163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 04/15/2010] [Accepted: 05/10/2010] [Indexed: 11/22/2022] Open
Abstract
Human papillomaviruses (HPVs) seem to play an important role in the pathogenesis of gynecological carcinomas and in head and neck carcinomas. The aim of this study was to detect and genotype HPVs in fresh oral squamous cell carcinoma (OSCC) from a Sardinian population, and to determine whether HPV presence was significantly associated with the development of OSCC. The oral mucosa tissues were obtained from 120 samples (68 OSCC and 52 control samples) taken from a Sardinian population seen at the Dental Clinic of the Department of Surgery and Odontostomatological Sciences, University of Cagliari (Italy) and the “ Ospedale SS Trinità”, Cagliari (A.S.L. 8) between 2007 and 2008. PCR was used for the detection of HPV DNA and the genotype was determined by DNA sequencing. The frequency of HPV infection was evaluated in relation to age, sex, smoking and alcohol use. Statistical analysis was performed using the SPSS 11.5 software. The results showed the presence of HPV-DNA in 60.3% of OSCC with HPV-16 (51.2%) being the most frequent genotype. In these Sardinian OSCC patients, HPV-DNA was detected more in males (65.8%) than in females (34.1%) while controls show a 0% of HPV presence. HPV positive was highly associated with OSCC among subjects with a history of heavy tobacco and alcohol use and among those with no such history. A greater frequency of high risk HPV presence was observed in patients with OSCC compared to health control patients. In addition these results suggested that oral HPV presence could be associated in OSCC subjects. Our results need more analyses to detect the HPV-DNA integration into tumoral cells.
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Affiliation(s)
- Caterina Montaldo
- Surgery Department of Odontostomatological Sciences, Odontostomatology Section, O.B.L., University of Cagliari, Cagliari, Italy
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81
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Marur S, Forastiere AA. Update on role of chemotherapy in head and neck squamous cell cancer. Indian J Surg Oncol 2010; 1:85-95. [PMID: 22930623 PMCID: PMC3421005 DOI: 10.1007/s13193-010-0021-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 06/07/2010] [Indexed: 12/31/2022] Open
Abstract
Head and neck squamous cell cancer (HNSCC) is most commonly a tobacco-related disease, affecting nearly 600,000 people worldwide each year. For decades, HNSCC has been treated successfully with multimodality treatments including, surgery, radiation, and chemotherapy, though the 'perfect' treatment paradigm remains elusive. This review will discuss a number of clinical trials, comparing various combinations of chemotherapy and the settings in which they are most successful. Promising research and recent data on the combination of cytotoxic chemotherapy with new biological agents indicate chemotherapy plays a critical role in treatment of HNSCC and will only continue to improve.
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Affiliation(s)
- S. Marur
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Bunting-Blaustein CRB1 G92 1650 Orleans Street, Baltimore, MD 21231-1000 USA
| | - A. A. Forastiere
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Bunting-Blaustein CRB1 G92 1650 Orleans Street, Baltimore, MD 21231-1000 USA
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Cantu G, Riccio S, Colombo S, Pompilio M, Formillo P. Recent advances in managing human papillomavirus-positive oropharyngeal tumors. F1000 MEDICINE REPORTS 2010; 2. [PMID: 20948869 PMCID: PMC2948388 DOI: 10.3410/m2-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Human papillomavirus (HPV) is detected in a subset of patients with head and neck squamous cell carcinoma, most frequently in tumors in the Waldeyer's ring (palatine tonsil and base of tongue). Several studies suggest that patients with HPV-positive tumors have better survival with either concurrent chemoradiation therapy or surgery followed by radiation compared with HPV-negative patients. However, some possible confounding clinicopathologic variables may challenge the validity of this statement, for example, some authors used the TNM (tumor, node, metastasis) grouping stage while others used the primary tumor (T stage), and other studies have demonstrated that tumors with advanced T stage were less likely to be infected with HPV. A large clinical trial with stratification of patients according to all known tumor prognostic factors is crucial to solve the question.
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Affiliation(s)
- Giulio Cantu
- National Cancer Institute of Milan Via Venezian, 1, 20133 Milano Italy
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83
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Machado J, Reis PP, Zhang T, Simpson C, Xu W, Perez-Ordonez B, Goldstein DP, Brown DH, Gilbert RW, Gullane PJ, Irish JC, Kamel-Reid S. Low prevalence of human papillomavirus in oral cavity carcinomas. HEAD & NECK ONCOLOGY 2010; 2:6. [PMID: 20226055 PMCID: PMC2851586 DOI: 10.1186/1758-3284-2-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 03/12/2010] [Indexed: 11/10/2022]
Abstract
BACKGROUND Increasing evidence shows that Human Papillomavirus (HPV) is preferentially associated with some head and neck squamous cell carcinomas (HNSCCs), with variable infection rates reported. METHODS We assessed HPV involvement in HNSCC using the Roche Linear Array HPV Genotyping Test, which can detect 37 different HPV types. We examined the prevalence of HPV infection in 92 HNSCCs (oropharynx, oral cavity, and other HNSCC sites). RESULTS HPV was frequently detected in oropharyngeal cancers (OPCs) (16/22, 73%), but was uncommon in oral cavity cancers (2/53, 4%), and in other HNSCC subsites (1/17, 6%). HPV positive tumors were associated with patients that were 40-60 years old (p = 0.02), and node positive (p = < 0.0001). HPV 16 was the most prevalent type, but other types detected included 6, 18, 33, 35, 45, and 52/58. CONCLUSION Our results show that in contrast to oropharyngeal cancers, oral cancers and other HNSCCs infrequently harbor HPV.
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Affiliation(s)
- Jerry Machado
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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84
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Abstract
PURPOSE OF REVIEW Oral human papillomavirus (HPV) infection is the principal cause of a distinct form of oropharyngeal cancer (OPCA) that has been rising in incidence in the United States since 1973, particularly among young men. The possible contribution of the HIV-epidemic to this increase is unclear. RECENT FINDINGS Incidence rates for HPV-related OPCA increased with age and were strongly influenced by year of birth in the United States (cohort effect). Persons with HIV/AIDS are at increased risk ( approximately two to six-fold) for OPCA relative to the general population. However, this excess risk may be attributable to tobacco smoking rather than the three-fold higher prevalence of oral HPV infection in this population. Consistent with a viral attribution, however, is the apparent increase in risk of OPCA with severity of AIDS-related immunosuppression. Analogous to other HPV-related cancers (e.g. cervical and anal cancer), trends over time do not appear to be influenced by highly active antiretroviral (HAART) therapy. SUMMARY Healthcare providers may encounter HPV-related OPCA more frequently among individuals with HIV/AIDS as this population ages and due to the strong birth cohort effects observed in the general population. However, there is no evidence in support of different incidence trends over time among persons with and without HIV/AIDS.
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85
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Characterization of initial clinical symptoms and risk factors for sinonasal adenocarcinomas: results of a case-control study. Int Arch Occup Environ Health 2009; 83:631-8. [PMID: 19885670 DOI: 10.1007/s00420-009-0479-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 10/16/2009] [Indexed: 11/27/2022]
Abstract
PURPOSE Sinonasal adenocarcinoma is a rare cancer, frequently associated with occupational exposure to inhalable wood dust. Among the EU member States, Germany was reported to have the highest number of exposed workers. Location and long latency make early diagnosis difficult. This case-control study was aimed at assessing potential risk factors and at characterizing initial clinical symptoms, both serving as matrix to identify persons at increased risk and to improve management of this cancer. METHODS Of 58 patients, 31 diagnosed with sinonasal adenocarcinoma (cases) between 1973 and 2007 were identified and underwent standardized interview on clinical data. A total of 85 patients diagnosed over the same period with carcinoma of the oral cavity served as controls. RESULTS The ethmoid was confirmed as the predominant site of adenocarcinoma associated with wood dust exposure, whereas the nasal cavity was most commonly affected in patients denying any exposure to wood dust. Cases were significantly engaged in mainly woodworking occupations compared to controls. The main initial clinical symptoms were nasal obstruction 6 months (71%) and epistaxis 4 years (41.9%) prior to diagnosis. Hardwood dust from beech and oak proved to be the most common occupational exposure, with a mean exposure period of 32.3 years and a latency of 43.5 (34-58) years. CONCLUSIONS Our investigation confirms the importance of regular screenings for persons exposed to wood dust even years after the end of occupational or private exposure. Banal clinical symptoms such as epistaxis and nasal obstruction might be predictive, requiring early and thorough investigation.
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86
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Gillespie MB, Rubinchik S, Hoel B, Sutkowski N. Human papillomavirus and oropharyngeal cancer: what you need to know in 2009. Curr Treat Options Oncol 2009; 10:296-307. [PMID: 19768554 DOI: 10.1007/s11864-009-0113-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 09/03/2009] [Indexed: 01/30/2023]
Abstract
OPINION STATEMENT Oropharyngeal cancer has demonstrated a steady increase in incidence over the past 20 years in contrast to declining numbers of head and neck squamous cell carcinoma (HNSCC) overall. Recent evidence has found that high-risk strains of human papillomavirus (HPV) are the likely cause of the changing epidemiology of oropharyngeal cancer. HPV-associated oropharyngeal cancer has a molecular, epidemiological, and clinical profile that is distinct from non-HPV HNSCC. Clinicians managing oropharyngeal HNSCC need to be aware of differences in the HPV HNSCC population which may impact treatment outcomes. Testing of HNSCC tumor tissue for HPV using validated and precise techniques should be performed when feasible.
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Affiliation(s)
- M Boyd Gillespie
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue MSC 550, Charleston, SC 29425-5500, USA,
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87
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Human papillomavirus in oral leukoplakia is no prognostic indicator of malignant transformation. Cancer Epidemiol 2009; 33:118-22. [DOI: 10.1016/j.canep.2009.05.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Revised: 05/09/2009] [Accepted: 05/11/2009] [Indexed: 11/19/2022]
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88
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DEBANTH S, SINGH PA, MEHROTRA R, SINGH M, GUPTA SC, PANDYA S, CHOWDHURY A, SINGH M. Human papillomavirus infection and premalignant lesions of the oral cavity: A cross-sectional study in Allahabad, North India. Asia Pac J Clin Oncol 2009. [DOI: 10.1111/j.1743-7563.2009.01200.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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89
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Abstract
Human papillomaviruses (HPVs) are small dsDNA tumor viruses, which are the etiologic agents of most cervical cancers and are associated with a growing percentage of oropharyngeal cancers. The HPV capsid is non-enveloped, having a T=7 icosahedral symmetry formed via the interaction among 72 pentamers of the major capsid protein, L1. The minor capsid protein L2 associates with L1 pentamers, although it is not known if each L1 pentamer contains a single L2 protein. The HPV life cycle strictly adheres to the host cell differentiation program, and as such, native HPV virions are only produced in vivo or in organotypic "raft" culture. Research producing synthetic papillomavirus particles--such as virus-like particles (VLPs), papillomavirus-based gene transfer vectors, known as pseudovirions (PsV), and papillomavirus genome-containing quasivirions (QV)--has bypassed the need for stratifying and differentiating host tissue in viral assembly and has allowed for the rapid analysis of HPV infectivity pathways, transmission, immunogenicity, and viral structure.
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Affiliation(s)
- M J Conway
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA
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90
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:132-41. [PMID: 19363348 DOI: 10.1097/moo.0b013e32832ad5ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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91
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Graziottin A, Serafini A. HPV infection in women: psychosexual impact of genital warts and intraepithelial lesions. J Sex Med 2009; 6:633-45. [PMID: 19170869 DOI: 10.1111/j.1743-6109.2008.01151.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Genital Human Papillomavirus (HPV) infection is the most commonly occurring sexually transmitted viral infection in humans. HPV is a wide family of DNA viruses, which may cause benign skin and mucosal tumors (genital, anal, or oral warts), intraepithelial neoplasias, and/or malignant cancers in different organs. Women are more susceptible to the oncogenic effect of HPVs, mostly at the genital site on the uterine cervix. AIMS This review analyzes the impact of: (i) genital warts (GWs) and their treatment; (ii) HPV-related genital, oral, and anal precancerous lesions on women's sexual function. METHODS A Medline search was carried out. Search terms were HPV, GWs, intraepithelial neoplasia, cervical cancer, anal cancer, oral cancer, epidemiology, HPV risk factors, sexual dysfunctions, desire disorders, arousal disorders, dyspareunia, vulvar vestibulitis, vulvodynia, orgasmic difficulties, sexual repertoire, couple sexual problems, depression, anxiety, pap smear, screening program, therapy, and vaccines. MAIN OUTCOME MEASURES Sexual consequences of HPV infection in women, specifically GWs and intraepithelial HPV-related neoplasia. RESULTS Psychosexual vulnerability increases with number of recurrences of HPV infections. Depression, anxiety, and anger are the emotions most frequently reported. However, to date, there is no conclusive evidence of a specific correlation between HPV infection and a specific female sexual disorder. The relationship between HPV and vulvar vestibulitis/vulvodynia-related dyspareunia seems not to be direct. Counseling problems, the role of anti-HPV vaccine, and the concept of the high-risk partner are discussed. The reader is offered a practical approach with clinically relevant recommendations that may prove useful in his/her daily practice when dealing with HPV-infected women and couples. CONCLUSION The evidence of psychosexual consequences of HPV-related GWs and intraepithelial lesions is limited. Specific research on the sexual impact of GWs and intraepithelial HPV-related lesion in women is urgently needed.
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Matta A, DeSouza LV, Shukla NK, Gupta SD, Ralhan R, Siu KWM. Prognostic significance of head-and-neck cancer biomarkers previously discovered and identified using iTRAQ-labeling and multidimensional liquid chromatography-tandem mass spectrometry. J Proteome Res 2008; 7:2078-87. [PMID: 18407684 DOI: 10.1021/pr7007797] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Diagnostic oncoproteomics is an emerging field; at present, studies on evaluation of prognostic utility of potential biomarkers identified using proteomic techniques are limited. Analysis with isobaric mass tags (iTRAQ) by multidimensional liquid chromatography-mass spectrometry (LC-MS/MS) to identify proteins that are differentially expressed in human head-and-neck/oral squamous cell carcinomas (HNOSCCs) versus noncancerous head-and-neck tissues has led to the discovery, identification, and verification of consistently increased expression of a panel of proteins, including stratifin (14-3-3sigma) and YWHAZ (14-3-3zeta), that may serve as potential cancer biomarkers. Herein, we describe the prognostic utility of these two candidate biomarkers for head-and-neck/oral squamous cell carcinoma (HNOSCC). To determine the clinical significance of stratifin and YWHAZ in head-and-neck tumorigenesis, the expressions of these two proteins were analyzed in HNOSCCs (51 cases) and nonmalignant tissues (39 cases) using immunohistochemistry. Significant increase in stratifin expression was observed in the HNOSCCs as compared to the nonmalignant mucosa [p=0.003, Odd's Ratio (OR)=3.8, 95% CI=1.6-9.2]. Kaplan-Meier survival analysis reveals correlation of stratifin overexpression with reduced disease-free survival of HNOSCC patients (p=0.06). The most intriguing finding is the significant decrease in median disease-free survival (13 months) in HNOSCC patients showing overexpression of both stratifin and YWHAZ proteins, as compared to patients that did not show overexpression of these proteins (median disease-free survival=38 months, p=0.019), underscoring their utility as adverse prognosticators for HNOSCCs. Co-immunoprecipitation assays show the formation of stratifin-YWHAZ heterodimers in HNOSCC cells and tissue samples, and interactions with NFkappaB, beta-catenin, and Bcl-2 proteins. These results suggest the involvement of these proteins in the development of head-and-neck cancer and their association with adverse disease outcome.
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Affiliation(s)
- Ajay Matta
- Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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