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Epidemiological, Clinical, and Genomic Profile in Head and Neck Cancer Patients and Their Families. Biomedicines 2022; 10:biomedicines10123278. [PMID: 36552033 PMCID: PMC9775590 DOI: 10.3390/biomedicines10123278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Inherited cancer predisposition genes are described as risk factors in head and neck cancer (HNC) families. To explore the clinical and epidemiological data and their association with a family history of cancer, we recruited 74 patients and 164 relatives affected by cancer. The germline copy number alterations were evaluated in 18 patients using array comparative genomic hybridization. Two or more first-degree relatives with HNC, tobacco-associated tumor sites (lung, esophagus, and pancreas), or other related tumors (breast, colon, kidney, bladder, cervix, stomach carcinomas, and melanoma) were reported in 74 families. Ten index patients had no exposure to any known risk factors. Family members presented tumors of 19 topographies (30 head and neck, 26 breast, 21 colon). In first-degree relatives, siblings were frequently affected by cancer (n = 58, 13 had HNC). Breast cancer (n = 21), HNC (n = 19), and uterine carcinoma (n = 15) were commonly found in first-degree relatives and HNC in second-degree relatives (n = 11). Nineteen germline genomic imbalances were detected in 13 patients; three presented gains of WRD genes. The number of HNC patients, the degree of kinship, and the tumor types detected in each relative support the role of heredity in these families. Germline alterations may potentially contribute to cancer development.
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Straetmans JMJAA, Stuut M, Lacko M, Hoebers F, Speel EJM, Kremer B. Additional parameters to improve the prognostic value of the 8th edition of the UICC classification for human papillomavirus-related oropharyngeal tumors. Head Neck 2022; 44:1799-1815. [PMID: 35579041 PMCID: PMC9544856 DOI: 10.1002/hed.27084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/17/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background The prognostic reliability of the UICC's TNM classification (8th edition) for human papillomavirus (HPV)‐positive tonsillar squamous cell carcinomas (TSCCs) compared to the 7th edition was explored, and its improvement by using additional anatomical and nonanatomical parameters. Methods One hundred and ten HPV‐positive and 225 HPV‐negative TSCCs were retrospectively analyzed. Survival was correlated with patient and tumor characteristics (7th and 8th edition UICC TNM classification). Results In HPV‐positive TSCCs, the 8th edition UICC's TNM classification correlated better with prognosis than the 7th edition. Also, smoking status was a stronger prognosticator of survival than UICC staging. Non‐ or former smokers had a 5‐year overall survival of 95.1% regardless of tumor stage. Furthermore, age (>65 years), cN3, and M1 classification were significant prognostic factors. Conclusion The prognostic value of the 8th edition UICC's TNM classification improved significantly when compared to the 7th edition. Nonetheless, further improvement is possible by adding nonanatomical factors (smoking, age >65 year) and separating N0‐N2 from N3.
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Affiliation(s)
- Jos M J A A Straetmans
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Marijn Stuut
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Ernst-Jan M Speel
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Bernd Kremer
- Department of Otorhinolaryngology and Head and Neck Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
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Giraldi L, Collatuzzo G, Hashim D, Franceschi S, Herrero R, Chen C, Schwartz SM, Smith E, Kelsey K, McClean M, Gillison M, Boccia S, Hashibe M, Amy Lee YC, Boffetta P. Infection with Human Papilloma Virus (HPV) and risk of subsites within the oral cancer. Cancer Epidemiol 2021; 75:102020. [PMID: 34509873 DOI: 10.1016/j.canep.2021.102020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to investigate the relationship between high-risk genotypes of Human Papilloma Virus (HPV) and cancer of different subsites of the oral cavity. MATERIAL AND METHODS A pooled analysis of five studies included on the International Head and Neck Cancer Epidemiology (INHANCE) Consortium was conducted. HPV 16 and HPV 18 were considered. Adjusted odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for HPV and each oral cavity subsites were simultaneously estimated using multinomial logistic regression models. RESULTS The analysis included 1157 cases and 3272 controls. This study showed a slightly higher prevalence of HPV infection among oral cancer cases than controls. In particular, an increased risk of other and not otherwise specified (NOS) sites within the oral cavity, oral tongue, palate and floor of mouth cancer was observed for overall HPV16 positivity (OR = 1.66, 95 % CI: 1.01-2.72; OR = 1.97, 95 % CI: 1.36-2.85; OR = 2.48, 95 % CI: 1.50-4.11; OR = 2.71, 95 % CI: 1.06-6.95, respectively). In particular, HPV16E7 was related to cancer of floor of mouth, oral cavity NOS and palate (OR = 2.71, 95 % CI: 1.06-6.95; OR = 3.32, 95 % CI:1.53-7.19; OR = 3.34, 95 % CI:1.38-8.06). Results were inconsistent for HPV18 due to low prevalence of infection. CONCLUSION Our study suggests that HPV16 infection may increase the risk of developing floor of mouth, gum, tongue, and palate cancers. CLINICAL RELEVANCE Subjects with HPV infection have a higher risk of cancer from all sites of the oral cavity.
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Affiliation(s)
- Luca Giraldi
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dana Hashim
- Norwegian Institute of Public Health, Department of Genetics and Bioinformatics, Oslo, Norway; Norwegian Institute of Public Health, Center of Fertility and Health, Oslo, Norway
| | - Silvia Franceschi
- Scientific Directorate, Aviano Oncologic Center (CRO) IRCCS, Aviano, Italy
| | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | | | | | - Maura Gillison
- Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Stefania Boccia
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
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Sager R, Frei P, Steiner UC, Fink D, Betschart C. Genital Dysplasia and Immunosuppression: Why Organ-Specific Therapy Is Important. Inflamm Intest Dis 2019; 4:154-160. [PMID: 31768388 PMCID: PMC6873019 DOI: 10.1159/000502687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/12/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Young patients with Crohn's disease (CD) show a high prevalence of human papillomavirus (HPV) which is the main cause of high-grade squamous intraepithelial lesions (HSIL). A major complication for patients undergoing immunocompromising therapy is the development of genital dysplasia. METHODS We report the case of a 32-year-old patient with recurrent genital dysplasia under long-term therapy for CD with a focus on different drug-related, immunosuppressive mechanisms. RESULTS Gynecological examination and biopsy revealed high-grade vulvar intraepithelial neoplasia (VIN) positive for HPV 16 treated with laser vaporization. Due to the combination of HPV positivity, intraoperative multilocularity, and CD, follow-up examinations were performed every 6 months. One year later, the patient showed a VIN at a new location and additionally, a cervical intraepithelial neoplasia (CIN), which were surgically treated. Catch-up HPV vaccination was applied accessorily. After the switch from a TNF-α blocker to vedolizumab, which acts as a gut-selective anti-integrin, the subsequent PAP smear, vulvoscopy, and colposcopy showed no more evidence of dysplasia. CONCLUSIONS This case report highlights that gut-selective immunosuppression with vedolizumab might be favorable in young HPV-positive patients due to a good side effect profile. Regular screening and HPV vaccination are a mainstay of dysplasia prevention and control. The risk for HPV-associated dysplasia in immunosuppressed patients is highly dependent on the choice of immunosuppressive therapy.
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Affiliation(s)
- Raphael Sager
- Department of Gynecology, University Hospital of Zurich, Zurich, Switzerland
| | - Pascal Frei
- Gastroenterology, Clinic Bethanien, Zurich, Switzerland
| | - Urs C. Steiner
- Department of Immunology, University Hospital of Zurich, Zurich, Switzerland
| | - Daniel Fink
- Department of Gynecology, University Hospital of Zurich, Zurich, Switzerland
| | - Cornelia Betschart
- Department of Gynecology, University Hospital of Zurich, Zurich, Switzerland
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Chauhan S, Sen S, Singh N, Sharma A, Pushker N, Kashyap S, Chawla B. Human papillomavirus in ocular malignant tumours: a study from a tertiary eye care centre in North India. Can J Ophthalmol 2019; 54:688-693. [PMID: 31836101 DOI: 10.1016/j.jcjo.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/17/2019] [Accepted: 03/03/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The present study aims to detect the presence of human papillomavirus (HPV) in ocular malignant tumours, including retinoblastoma, eyelid squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC), in the North Indian population. DESIGN Prospective observational non randomized study. PARTICIPANTS In this study, 142 prospective cases of ocular malignant tumours (retinoblastoma, SGC, and SCC) were included. METHODS HPV was detected by multiplex PCR using PGMY09/11 primers in 142 patients with ocular malignancies. This was followed by genotyping using linear array (reverse hybridization). RESULTS Of the 142 tumours studied, 72 were retinoblastoma, 30 SGC, and 40 SCC. The HPV genome was detected in 2.8% (4 of 142) of cases by multiplex PCR; all positive cases (4 of 40) were SCC. Genotyping revealed that all positives belonged to the high-risk HPV16 genotype. HPV-positive SCC patients had better disease-free survival. Retinoblastoma and SGC cases were negative for HPV. CONCLUSIONS Low prevalence of HPV in ocular malignancies was observed in this study. The HPV genome was detected only in ocular squamous cell carcinoma cases and these patients were associated with better prognosis. HPV may not have a role in retinoblastoma and SGC in the North Indian population.
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Affiliation(s)
- Sheetal Chauhan
- Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sen
- Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Neeta Singh
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Anjana Sharma
- Department of Ocular Microbiology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neelam Pushker
- Ophthalmoplasty Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bhavna Chawla
- Ocular Oncology Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences New Delhi, India
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Windon MJ, Waterboer T, Hillel AT, Chien W, Best S, Stewart C, Akst L, Troy T, Bender N, Miles B, Ryan WR, Mandal R, Pitman K, Eisele DW, Fakhry C, D'Souza G. Sex differences in HPV immunity among adults without cancer. Hum Vaccin Immunother 2019; 15:1935-1941. [PMID: 30650013 DOI: 10.1080/21645515.2019.1568157] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The incidence of human papillomavirus (HPV)-associated head and neck cancers is rising, particularly among men. Whether observed epidemiological differences in sex are explained by differences in sexual exposure and/or by immune response is unclear. In this cross-sectional, multi-institutional study, seroprevalence of antibodies to HPV L1 capsid antigen was compared by patient characteristics among 374 adult patients without cancer. A significantly higher seroprevalence was observed among women compared with men for HPV16 (OR = 2.96, 95% CI = 1.21-7.21) and HPV18 (OR = 2.84, 95% CI = 1.06-7.60) L1 antibodies. This difference persisted for HPV16 after controlling for lifetime and recent sexual behavior. After controlling for sex, HPV16 and HPV18 L1 seroprevalence was also significantly associated with higher number of lifetime (HPV16 OR = 1.05, 95% CI = 1.01-1.08; HPV18 OR = 1.04, 95% CI = 1.01-1.08) and recent (HPV16 OR = 1.54, 95% CI = 1.15-2.07; HPV18 OR = 1.40, 95% CI = 1.07-1.82) oral but not vaginal sexual partners. These findings potentially suggest a more robust immune response to HPV16/18 among women compared with men that may not be explained by differences in number of sexual partners, and thereby presumably HPV exposure. The independent association of HPV16/18 L1 seroprevalence with higher number of oral sexual partners suggests a possible role for site of mucosal exposure in the HPV immune response.
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Affiliation(s)
- Melina J Windon
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Tim Waterboer
- b Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Alexander T Hillel
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Wade Chien
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Simon Best
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Charles Stewart
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Lee Akst
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Tanya Troy
- c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - Noemi Bender
- b Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Brett Miles
- d Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - William R Ryan
- e Head and Neck Surgery, Department of Otolaryngology, University of California San Francisco , San Francisco , CA , USA
| | - Rajarsi Mandal
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Karen Pitman
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - David W Eisele
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA
| | - Carole Fakhry
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA.,c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.,f Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Gypsyamber D'Souza
- a Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, School of Medicine , Baltimore , MD , USA.,c Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
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7
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Reuschenbach M, Tinhofer I, Wittekindt C, Wagner S, Klussmann JP. A systematic review of the HPV-attributable fraction of oropharyngeal squamous cell carcinomas in Germany. Cancer Med 2019; 8:1908-1918. [PMID: 30821126 PMCID: PMC6488137 DOI: 10.1002/cam4.2039] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/09/2019] [Accepted: 01/29/2019] [Indexed: 12/14/2022] Open
Abstract
The prevalence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally while the prevalence of other head and neck cancers is decreasing. The most likely reasons for this are a decreasing influence of smoking and the growing relevance of infections with the human papilloma virus (HPV) as a risk factor. A rise in the HPV‐attributable fraction (HPV‐AF) of OPSCC has been observed in many countries, yet a comprehensive review of prevalence rates and trends in Germany is lacking. To determine the current HPV‐AF of OPSCC in Germany and to assess whether it has changed during the last decades, we performed a systematic literature review. We screened Medline and EMBASE for studies that reported the tumor HPV status of newly diagnosed OPSCC patients treated at medical centers in Germany by testing for both HPV DNA and p16INK4a overexpression to confirm involvement of HPV in tumorigenesis. Out of 287 screened studies, 14 studies with data from a total of 1819 OPSCC patients treated between 1988 and 2015 were included in the data synthesis. The reported average HPV‐AF varied considerably between the studies, ranging from 11.5% (1988‐2008) to 55.0% (2004‐2009). Two of the included studies did not only provide the HPV‐AF for the entire observed calendar period but also for separate years, allowing to more accurately assess changes over time. These studies reported increases in the HPV‐AF from 21% in 2000 to 53% in 2015 and from 38% in 2004 to 71% in 2013, respectively.
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Affiliation(s)
| | - Ingeborg Tinhofer
- German Cancer Consortium (DKTK), Partner Site BerlinBerlinGermany
- Department of Radiation Oncology and RadiotherapyCharité University Medicine BerlinBerlinGermany
| | - Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of GiessenGiessenGermany
| | - Steffen Wagner
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of GiessenGiessenGermany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical FacultyUniversity of CologneCologneGermany
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Massey C, Dharmarajan A, Bannuru RR, Rebeiz E. Management of N0 neck in early oral squamous cell carcinoma: A systematic review and meta-analysis. Laryngoscope 2018; 129:E284-E298. [DOI: 10.1002/lary.27627] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Conner Massey
- Department of Otolaryngology; University of Colorado School of Medicine; Aurora Colorado
| | - Anbuselvan Dharmarajan
- Center for Treatment Comparison and Integrative Analysis; Tufts Medical Center; Boston Massachusetts U.S.A
| | - Raveendhara R. Bannuru
- Center for Treatment Comparison and Integrative Analysis; Tufts Medical Center; Boston Massachusetts U.S.A
| | - Elie Rebeiz
- Department of Otolaryngology-Head and Neck Surgery; Tufts Medical Center; Boston Massachusetts U.S.A
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9
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Predicting miRNA targets for head and neck squamous cell carcinoma using an ensemble method. Int J Biol Markers 2018; 33:87-93. [PMID: 28665450 DOI: 10.5301/ijbm.5000285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study aimed to uncover potential microRNA (miRNA) targets in head and neck squamous cell carcinoma (HNSCC) using an ensemble method which combined 3 different methods: Pearson's correlation coefficient (PCC), Lasso and a causal inference method (i.e., intervention calculus when the directed acyclic graph (DAG) is absent [IDA]), based on Borda count election. METHODS The Borda count election method was used to integrate the top 100 predicted targets of each miRNA generated by individual methods. Afterwards, to validate the performance ability of our method, we checked the TarBase v6.0, miRecords v2013, miRWalk v2.0 and miRTarBase v4.5 databases to validate predictions for miRNAs. Pathway enrichment analysis of target genes in the top 1,000 miRNA-messenger RNA (mRNA) interactions was conducted to focus on significant KEGG pathways. Finally, we extracted target genes based on occurrence frequency ≥3. RESULTS Based on an absolute value of PCC >0.7, we found 33 miRNAs and 288 mRNAs for further analysis. We extracted 10 target genes with predicted frequencies not less than 3. The target gene MYO5C possessed the highest frequency, which was predicted by 7 different miRNAs. Significantly, a total of 8 pathways were identified; the pathways of cytokine-cytokine receptor interaction and chemokine signaling pathway were the most significant. CONCLUSIONS We successfully predicted target genes and pathways for HNSCC relying on miRNA expression data, mRNA expression profile, an ensemble method and pathway information. Our results may offer new information for the diagnosis and estimation of the prognosis of HNSCC.
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10
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Wilkins OM, Titus AJ, Salas LA, Gui J, Eliot M, Butler RA, Sturgis EM, Li G, Kelsey KT, Christensen BC. MicroRNA-Related Genetic Variants Associated with Survival of Head and Neck Squamous Cell Carcinoma. Cancer Epidemiol Biomarkers Prev 2018; 28:127-136. [PMID: 29880533 DOI: 10.1158/1055-9965.epi-18-0002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 03/23/2018] [Accepted: 06/04/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) is commonly diagnosed at an advanced stage, and prognosis for such patients is poor. There remains a gap in our understanding of genetic variants related with HNSCC prognosis. miRNA-related single nucleotide polymorphisms (miR-SNPs) are a class of genetic variants with gene-regulatory potential. METHODS We used a genome-scale approach and independent patient populations in a two-stage approach to test 40,286 common miR-SNPs for association with HNSCC survival in the discovery population (n = 847), and selected the strongest associations for replication in validation phase cases (n = 1,236). Furthermore, we leveraged miRNA interaction databases and miRNA expression data from The Cancer Genome Atlas, to provide functional insight for the identified and replicated associations. RESULTS Joint population analyses identified novel miR-SNPs associated with overall survival in oral and laryngeal cancers. rs1816158, located within long noncoding RNA MIR100HG, was associated with overall survival in oral cavity cancer (HR, 1.56; 95% confidence interval (CI), 1.21-2.00). In addition, expression of MIR100HG-embedded miRNA, miR-100, was significantly associated with overall survival in an independent cohort of HNSCC cases (HR, 1.25; 95% CI, 1.06-1.49). A SNP in the 3'UTR of SH3BP4 (rs56161233) that overlaps predicted miRNA-binding sites and is predicted to disrupt several miRNA-mRNA interactions was associated with overall survival of laryngeal cancer (HR, 2.57; 95% CI, 1.71-3.86). CONCLUSIONS This work reveals novel miR-SNPs associated with HNSCC survival, and utilizes miRNA-mRNA interaction and expression data to provide functional support for these associations. IMPACT These findings extend our understanding of how genetic variation contributes to HNSCC survival, and may contribute to future prognostic models for improved risk stratification.
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Affiliation(s)
- Owen M Wilkins
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Alexander J Titus
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Lucas A Salas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Jiang Gui
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, Rhode Island
| | - Rondi A Butler
- Department of Epidemiology, Brown University, Providence, Rhode Island
| | - Erich M Sturgis
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Karl T Kelsey
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island
| | - Brock C Christensen
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
- Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
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11
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Zhang S, Hu F, Liang H, Liu Y, Yang J, Zhou W. Association between a miRNA-146a polymorphism and susceptibility to head and neck squamous cell carcinoma in Chinese patients: A meta-analysis of 8 case-control studies. PLoS One 2017; 12:e0186609. [PMID: 29049342 PMCID: PMC5648221 DOI: 10.1371/journal.pone.0186609] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/04/2017] [Indexed: 12/14/2022] Open
Abstract
A closer association has been found between the microRNA-146a rs2910164 polymorphism and the risk of head and neck carcinoma in some molecular epidemiological studies. Recently two meta-analyses were performed to explore the relationship between miRNA-146a polymorphisms and the susceptibility of squamous cell carcinoma of the head and neck (SCCHN); however, they yielded conflicting results in susceptibility regarding ethnic variations. Hence, the present study was performed to explain the relationship between the miRNA-146a rs2910164 polymorphism and the risk of SCCHN development of Chinese patients. We retrieved databases and screened eligible papers up to March 10, 2017 and then we extracted the essential data. The subgroup analyses were also performed based on the tumor site, region, and genotyping means. Crude odds ratios (OR) at 95% confidence intervals (CI) were chosen to describe the strength of the association. As a result, 6 publications were included in our study which involved 8 independent case-control studies. A significant association was found between miR-146a rs2910164 polymorphisms and the risk of SCCHN in Chinese patients according to the overall data [CC+CG vs. GG: OR = 1.13; 95%CI = 1.00-1.29; CC vs. GG: OR = 1.19; 95%CI = 1.03-1.38]. According to the subgroup analysis based on tumor site, the risk of cancer was significantly increased among laryngeal cancer (dominant model: OR = 1.76, 95%CI = 1.26~2.46, P = 0.001; homozygote model: OR = 1.83, 95%CI = 1.25~2.67, P = 0.002) and nasopharyngeal carcinoma (homozygote model: OR = 1.41, 95%CI = 1.05~1.90, P = 0.022). In summary, variant alleles of miR-146a rs2910164 alleles may have an association with the increased risk of SCCHN in Chinese patients, and these associations differed based on tumor site. Further studies including a larger sample size will be necessary to clarify these results.
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Affiliation(s)
- Silin Zhang
- Department of Otolaryngology, Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Fangling Hu
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hongxing Liang
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yuanzhou Liu
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianqiang Yang
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wensheng Zhou
- Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- * E-mail:
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12
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Wilkins OM, Titus AJ, Gui J, Eliot M, Butler RA, Sturgis EM, Li G, Kelsey KT, Christensen BC. Genome-scale identification of microRNA-related SNPs associated with risk of head and neck squamous cell carcinoma. Carcinogenesis 2017; 38:986-993. [PMID: 28582492 PMCID: PMC5862295 DOI: 10.1093/carcin/bgx056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Polymorphisms in microRNAs and their target sites can disrupt microRNA-dependent gene regulation, and have been associated with cancer susceptibility. However, genome-scale analyses of microRNA-related genetic variation in cancer are lacking. We tested the associations of ~40 000 common [minor allele frequency (MAF) ≥5%], microRNA-related single nucleotide polymorphisms (miR-SNPs), with risk of head and neck squamous cell carcinoma (HNSCC) in a discovery population, and validated selected loci in an independent population among a total of 2198 cases and 2180 controls. Joint analyses across the discovery and validation populations revealed six novel miR-SNP associations with risk of HNSCC. An upstream variant of MIR548H4 (rs7834169), replicated its association with overall HNSCC risk as well as risk of oral cavity cancer. Four other variants were specifically associated with oral cavity cancer risk (rs16914640, rs1134367, rs7306991 and rs1373756). 3'UTR variant of HADH, rs221347 and rs4975616, located within known cancer risk locus 5p15.33, were specific to risk of laryngeal cancer. High confidence predicted microRNA binding sites were identified for CLEC2D, LOC37443, KDM8 and HADH overlapping rs16914640, rs7306991, rs1134367 and rs221347, respectively. Furthermore, we identified several microRNA interactions with KDM8 and HADH predicted to be disrupted by genetic variation at rs1134367 and rs221347. These results suggest microRNA-related genetic variation may contribute to the genetic susceptibility of HNSCC, and that more powerful evaluation of this class of genetic variation and their relationship with cancer risk is warranted.
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Affiliation(s)
| | | | - Jiang Gui
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Melissa Eliot
- Department of Epidemiology, Brown University, Providence, RI 02912, USA
| | - Rondi A Butler
- Department of Epidemiology, Brown University, Providence, RI 02912, USA
| | - Erich M Sturgis
- Department of Head and Neck Surgery
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, TX 77030, USA
| | - Guojun Li
- Department of Head and Neck Surgery
- Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, TX 77030, USA
| | - Karl T Kelsey
- Department of Epidemiology, Brown University, Providence, RI 02912, USA
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI 02912, USA
| | - Brock C Christensen
- Department of Epidemiology
- Department of Molecular and Systems Biology and
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
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13
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Chancellor JA, Ioannides SJ, Elwood JM. Oral and oropharyngeal cancer and the role of sexual behaviour: a systematic review. Community Dent Oral Epidemiol 2016; 45:20-34. [PMID: 27642003 DOI: 10.1111/cdoe.12255] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/08/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This systematic review identified and evaluated the evidence for the role of sexual behaviours in the development of oropharyngeal cancers (OPCs) and oral cavity cancers (OCCs). METHODS Following the PRISMA guidelines, we identified observational and interventional studies reporting associations between several different sexual behaviours and OPC or OCC. Study quality was assessed independently by two reviewers using a validated scoring system. RESULTS From 513 papers identified, 21, reporting on 20 studies, fulfilled the inclusion criteria. Two cohort studies were rated as moderate quality. The 18 case-control studies were rated as weak; nine comparing people with OPC or OCC to people without cancer, eight comparing HPV-positive to HPV-negative cancer patients and one comparing OPCs to other head and neck cancers. One study was a pooled analysis of seven of the included studies with some additional information. Twelve sexual behaviours were assessed and 69 associations reported. The studies differed in the comparisons made, the sexual behaviours assessed, and how these were reported and categorized, so no quantitative meta-analyses were appropriate. Most studies combined OPC and OCC. Several significantly increased risks were seen with a high number of lifetime sexual partners (nine studies) and with the practice of oral sex (five studies), although two studies found a significant negative association with OCC and ever performing oral sex. Two cohort studies of men and women in homosexual relationships found increases in oral cancer risk, and a cohort study of men married to women who had a history of cervical cancer also showed an increased risk of oral cancers. Results for other sexual behaviours were limited and inconsistent, and these included the following: younger age at first sexual intercourse, number of lifetime oral sex partners, the practice of oral-anal sex, the number of oral-anal sex partners, and ever performing anal sex. Only one study assessed casual sex, never or rare use of a condom and having a sexual partner with a history of genital warts, finding significant associations in the two former behaviours. CONCLUSION The current evidence for sexual behaviours being risk factors for oral and oropharyngeal cancer is limited and inconsistent. Evidence suggests that the number of sexual partners and performing oral sex are associated with a greater risk. Furthermore men whose partners have had cervical cancer may have an increased risk. More studies looking at OPC specifically will be useful to determine whether these behaviours are subsite-selective.
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Affiliation(s)
- James A Chancellor
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Sally J Ioannides
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - James M Elwood
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
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14
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Tsimplaki E, Argyri E, Sakellaridis A, Kyrodimos E, Xesfyngi D, Panotopoulou E. Oropharyngeal and laryngeal but not oral cancers are strongly associated with high-risk human papillomavirus in 172 Greek patients. J Med Virol 2016; 89:170-176. [PMID: 27335246 DOI: 10.1002/jmv.24614] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2016] [Indexed: 11/07/2022]
Abstract
A strong and consistent association has been reported between human papillomavirus (HPV) infection and oropharyngeal cancer, whereas a similar link has not yet been clarified in oral and laryngeal cancer. The purpose of this study was to investigate the association between HPV infection and head and neck squamous cell carcinoma (HNSCC) in Greek patients. Cytological or tissue specimens from 172 cases patients with HNSCC and cytological specimens from 91 control subjects were analyzed for HPV DNA detection and genotyping using a microarray-based assay. Multivariate logistic regression was used to estimate odds ratios (ORs) for the association between the presence of HPV infection and HNSCC for each of the tumor site, after adjustment for potential confounders. The adjusted ORs for positivity to high-risk HPV infection for oropharyngeal and laryngeal cancer were 20.3 (95% CI: 1.7-250.1) and 22.8 (95% CI: 2.5-206.2), respectively. High-risk HPV infection was not significantly associated with oral cancer. HPV infection was independently associated with poorly differentiated tumors (OR = 2.8; 95% CI: 1.1-7.5). Our results suggest a strong association of high-risk HPV infection with oropharyngeal and laryngeal cancer. J. Med. Virol. 89:170-176, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Elpida Tsimplaki
- Department of Virology, "St. Savvas" Regional Anticancer Oncology Hospital of Athens, Athens, Greece
| | - Elena Argyri
- Department of Virology, "St. Savvas" Regional Anticancer Oncology Hospital of Athens, Athens, Greece
| | - Athanassios Sakellaridis
- Department of Otolaryngology, Head and Neck Surgery, "St. Savvas" Regional Anticancer Oncology Hospital of Athens, Athens, Greece
| | - Efthimios Kyrodimos
- Department of Otolaryngology, Head and Neck Surgery, "Hippokration" General Hospital, National University of Athens, Athens, Greece
| | - Dimitra Xesfyngi
- Department of Radiotherapy, "St. Savvas" Regional Anticancer Oncology Hospital of Athens, Athens, Greece
| | - Efstathia Panotopoulou
- Department of Virology, "St. Savvas" Regional Anticancer Oncology Hospital of Athens, Athens, Greece.
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15
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Nguyen NP, Nguyen LM, Thomas S, Hong-Ly B, Chi A, Vos P, Karlsson U, Vinh-Hung V. Oral sex and oropharyngeal cancer: The role of the primary care physicians. Medicine (Baltimore) 2016; 95:e4228. [PMID: 27428229 PMCID: PMC4956823 DOI: 10.1097/md.0000000000004228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/29/2016] [Accepted: 06/20/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention. METHODS We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer. RESULTS Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination. CONCLUSION Family physicians will play a key role in prevention and educating the public about the risk of oral sex.
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Affiliation(s)
- Nam P. Nguyen
- Department of Radiation Oncology, Howard University, Washington, DC
| | | | - Sroka Thomas
- Department of Radiation Oncology, Darmouth College of Medicine, New Lebanon, NH
| | - Bevan Hong-Ly
- Department of Radiation Oncology, University of Miami, Miami, FL
| | - Alexander Chi
- Department of Radiation Oncology, University of West Virginia, Morgantown, WV
| | - Paul Vos
- Department of Biostatistics, East Carolina University, Greenville, NC
| | - Ulf Karlsson
- Department of Radiation Oncology, Marshfield Clinic, Marshfield, WI
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, University of Martinique, Martinique, France
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16
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Oral squamous cell carcinoma: Key clinical questions, biomarker discovery, and the role of proteomics. Arch Oral Biol 2016; 63:53-65. [DOI: 10.1016/j.archoralbio.2015.11.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 09/08/2015] [Accepted: 11/20/2015] [Indexed: 12/19/2022]
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17
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Gama RR, Carvalho AL, Filho AL, Scorsato AP, López RVM, Rautava J, Syrjänen S, Syrjänen K. Detection of human papillomavirus in laryngeal squamous cell carcinoma: Systematic review and meta-analysis. Laryngoscope 2015; 126:885-93. [DOI: 10.1002/lary.25738] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Ricardo Ribeiro Gama
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - André Lopes Carvalho
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - Adhemar Longatto Filho
- Laboratory of Medical Investigation (LIM) 14; Department of Pathology; University of São Paulo School of Medicine; São Paulo Brazil
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital; Barretos Brazil
| | | | | | - Jaana Rautava
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Kari Syrjänen
- Department of Clinical Research; Biohit HealthCare Plc; Helsinki Finland
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18
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Human papillomavirus E7 serology and association with p16 immunohistochemistry in squamous cell carcinoma of the head and neck. Exp Mol Pathol 2015; 99:335-40. [DOI: 10.1016/j.yexmp.2015.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 12/14/2022]
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19
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Farsi NJ, El-Zein M, Gaied H, Lee YCA, Hashibe M, Nicolau B, Rousseau MC. Sexual behaviours and head and neck cancer: A systematic review and meta-analysis. Cancer Epidemiol 2015; 39:1036-46. [PMID: 26372414 DOI: 10.1016/j.canep.2015.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/06/2015] [Indexed: 01/01/2023]
Abstract
Human papillomaviruses (HPV) are associated with head and neck cancers (H&NC). Transmission of HPV to the upper aerodigestive tract occurs plausibly through sexual contact, although epidemiologic evidence on the role of sexual behaviours in H&NC aetiology is inconsistent. We conducted a meta-analysis of studies examining the association between four indicators of sexual behaviours (number of sexual partners and oral sex partners, oral sex practice, and age at first intercourse) and H&NC. Summary odds ratios (OR) and 95% confidence intervals (CI) were estimated using fixed and random effects models for each indicator, contrasting 'highest' to 'lowest', 'ever' to 'never', or 'youngest' to 'oldest' categories. Twenty case-control studies were included out of 3838 identified publications. Using random effects models, summary ORs suggested an increased risk of H&NC for number of sexual partners [OR=1.29, 95% CI: 1.02-1.63] (19 studies) and number of oral sex partners [OR=1.69, 95% CI: 1.00-2.84] (5 studies), whereas no effect was observed with oral sex practice [OR=1.09, 95% CI: 0.88-1.35] (17 studies) and age at first intercourse [OR=1.40, 95% CI: 0.71-2.79] (6 studies). For number of sexual partners and oral sex practice, which were assessed in more studies, we further excluded studies contributing to heterogeneity and those not adjusted for age, sex, smoking, and alcohol consumption. The summary ORs were 0.95 (95% CI: 0.75-1.20) for number of sexual partners and 1.03 (95% CI: 0.84-1.26) for oral sex practice. Our findings highlight that observed associations might be partly attributed to confounding effects of sociodemographic and behavioural factors.
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Affiliation(s)
- N J Farsi
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Montréal, Québec, Canada; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | - M El-Zein
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | - H Gaied
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - Y C A Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - M Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - B Nicolau
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Montréal, Québec, Canada
| | - M-C Rousseau
- Oral Health and Society Division, Faculty of Dentistry, McGill University, Montréal, Québec, Canada; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada.
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20
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Lanzer M, Bachna-Rotter S, Graupp M, Bredell M, Rücker M, Huber G, Reinisch S, Schumann P. Unknown primary of the head and neck: A long-term follow-up. J Craniomaxillofac Surg 2015; 43:574-9. [DOI: 10.1016/j.jcms.2015.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 12/20/2022] Open
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21
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Gunasekera SK, Perera KA, Fernando C, Udagama PV. A shifting paradigm in the aetiology of oral and pharyngeal cancer in Sri Lanka: a case-control study providing serologic evidence for the role of oncogenic HPV types 16 and 18. Infect Agent Cancer 2015; 10:12. [PMID: 25908938 PMCID: PMC4407420 DOI: 10.1186/s13027-015-0007-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 03/31/2015] [Indexed: 02/08/2023] Open
Abstract
Background Oral and pharyngeal cancer (OPC) of multifactorial aetiology is a major health problem globally. Ranking first in all cancers, OPC poses a significant impact on the Sri Lankan male population. As Human Papillomavirus (HPV) high risk (HR) types are found to be significant risk factors for OPC globally, the current study was undertaken to examine the association between HR-HPV16 and 18 types with OPC in Sri Lanka. Materials and methods Serum samples of 78 OPC patients and 51 non-cancer controls were assayed for the presence of anti-HPV16 and anti-HPV18 IgG antibodies using in-house established Enzyme Linked Immunosorbent Assays (ELISAs). The association between OPC and its risk factors i.e. HPV, smoking, alcohol, betel quid, poor dentition, was established using Chi-square test. Logistic regression was used to calculate odds ratios (OR), adjusted for the influence of other risk factors. Results This prototype study in Sri Lanka showed a significant risk of 15 fold in developing OPC due to HPV16/18 seropositivity after removing variability due to other factors. Oncogenic HPV18 showed a higher rate of seropositivity being detected in 32% of OPC patients, and also in 2% of non-cancer control subjects. HR-HPV16 was detected in 23% of OPC patients and in 5.88% of controls. Moreover, seven OPC patients were detected with both anti-HPV16 and anti-HPV18 antibodies. According to the logistic regression models HPV18 seropositivity was associated with a 28 fold risk in developing OPC while that of HPV16 was associated with a 6 fold increase in risk for the development of OPC. A 5 fold risk of developing OPC was also pronounced among smokers while alcohol, betel and poor dentition was not significantly associated with OPC. Statistically significant differences with regard to age, gender, smoking, alcohol, betel use, poor dentition and site specificity of the tumour was not observed between HPV seropositive and seronegative OPC patients. Conclusions Both in-house developed ELISAs detected significant proportions of HPV seropositives within the OPC study population suggestive of HPV as a strong risk factor for oral and pharyngeal carcinogenesis in Sri Lanka.
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Affiliation(s)
| | | | | | - Preethi Vidya Udagama
- Department of Zoology, Faculty of Science, University of Colombo, Colombo 03, Sri Lanka
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22
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Lang Kuhs KA, Anantharaman D, Waterboer T, Johansson M, Brennan P, Michel A, Willhauck-Fleckenstein M, Purdue MP, Holcátová I, Ahrens W, Lagiou P, Polesel J, Simonato L, Merletti F, Healy CM, Kjaerheim K, Conway DI, Macfarlane TV, Thomson P, Castellsagué X, Znaor A, Black A, Huang WY, Krogh V, Trichopoulou A, Bueno-de-Mesquita HBA, Clavel-Chapelon F, Weiderpass E, Ekström J, Riboli E, Tjønneland A, Sánchez MJ, Travis RC, Hildesheim A, Pawlita M, Kreimer AR. Human Papillomavirus 16 E6 Antibodies in Individuals without Diagnosed Cancer: A Pooled Analysis. Cancer Epidemiol Biomarkers Prev 2015; 24:683-9. [PMID: 25623733 PMCID: PMC4383678 DOI: 10.1158/1055-9965.epi-14-1217] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/16/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The increasing incidence of oropharyngeal cancer in many developed countries has been attributed to human papillomavirus type 16 (HPV16) infections. Recently, HPV16 E6 serology has been identified as a promising early marker for oropharyngeal cancer. Therefore, characterization of HPV16 E6 seropositivity among individuals without cancer is warranted. METHODS A total of 4,666 controls were pooled from several studies of cancer and HPV seropositivity, all tested within the same laboratory. HPV16 E6 seropositive controls were classified as having (i) moderate [mean fluorescent intensity (MFI) ≥ 484 and <1,000] or (ii) high seroreactivity (MFI ≥ 1,000). Associations of moderate and high HPV16 E6 seroreactivity with (i) demographic risk factors; and seropositivity for (ii) other HPV16 proteins (E1, E2, E4, E7, and L1), and (iii) E6 proteins from non-HPV16 types (HPV6, 11, 18, 31, 33, 45, and 52) were evaluated. RESULTS Thirty-two (0.7%) HPV16 E6 seropositive controls were identified; 17 (0.4%) with moderate and 15 (0.3%) with high seroreactivity. High HPV16 E6 seroreactivity was associated with former smoking [odds ratio (OR), 5.5; 95% confidence interval (CI), 1.2-51.8], and seropositivity against HPV16 L1 (OR, 4.8; 95% CI, 1.3-15.4); E2 (OR, 7.7; 95% CI, 1.4-29.1); multiple HPV16 proteins (OR, 25.3; 95% CI, 2.6-119.6 for three HPV16 proteins beside E6) and HPV33 E6 (OR, 17.7; 95% CI, 1.9-81.8). No associations were observed with moderate HPV16 E6 seroreactivity. CONCLUSIONS High HPV16 E6 seroreactivity is rare among individuals without diagnosed cancer and was not explained by demographic factors. IMPACT Some HPV16 E6 seropositive individuals without diagnosed HPV-driven cancer, especially those with seropositivity against other HPV16 proteins, may harbor a biologically relevant HPV16 infection.
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Affiliation(s)
| | | | - Tim Waterboer
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France
| | | | | | - Mark P Purdue
- National Cancer Institute, NIH, Bethesda, Maryland. Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Ivana Holcátová
- Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | | | | | - Lorenzo Simonato
- Laboratory of Public Health and Population Studies, Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Franco Merletti
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | | | - David I Conway
- University of Glasgow, Glasgow, United Kingdom. University of Aberdeen, Aberdeen, United Kingdom
| | | | - Peter Thomson
- University of Newcastle on Tyne, Newcastle, United Kingdom
| | - Xavier Castellsagué
- Unit of Infections and Cancer, Institut Català d'Oncologia (ICO), IDIBELL, CIBERESP, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Ariana Znaor
- Croatian National Institute of Public Health, Zagreb, Croatia
| | - Amanda Black
- National Cancer Institute, NIH, Bethesda, Maryland
| | - Wen-Yi Huang
- National Cancer Institute, NIH, Bethesda, Maryland
| | - Vittorio Krogh
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece. Academy of Athens, Athens, Greece. University of Athens Medical School, Athens, Greece
| | - H B As Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. University Medical Centre, Utrecht, the Netherlands. The School of Public Health, Imperial College London, London, United Kingdom. University of Malaya, Kuala Lumpur, Malaysia
| | - Françoise Clavel-Chapelon
- Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France. Université Paris Sud, Villejuif, France. Institut Gustave Roussy, Villejuif, France
| | - Elisabete Weiderpass
- Department of Research, Cancer Registry of Norway, Oslo, Norway. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Johanna Ekström
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Elio Riboli
- Imperial College London, London, United Kingdom
| | | | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Trivedi S, Concha-Benavente F, Srivastava RM, Jie HB, Gibson SP, Schmitt NC, Ferris RL. Immune biomarkers of anti-EGFR monoclonal antibody therapy. Ann Oncol 2015; 26:40-47. [PMID: 24997207 PMCID: PMC4269339 DOI: 10.1093/annonc/mdu156] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 04/08/2014] [Accepted: 04/09/2014] [Indexed: 12/23/2022] Open
Abstract
The tumor antigen (TA)-targeted monoclonal antibodies (mAb) cetuximab and panitumumab target the human epidermal growth factor receptor and have been integrated into treatment regimens for advanced squamous cell carcinoma of the head and neck (SCCHN). The therapeutic efficacy of these mAbs has been found to be enhanced when combined with radiotherapy and chemotherapy. However, clinical trials indicate that these findings are limited to fewer than 20% of treated patients. Therefore, identifying patients who are likely to benefit from these agents is crucial to improving therapeutic strategies. Interestingly, it has been noted that TA-targeted mAbs mediate their effects by contributing to cell-mediated cytotoxicity in addition to inhibition of downstream signaling pathways. Here, we describe the potential immunogenic mechanisms underlying these clinical findings, their role in the varied clinical response and identify the putative biomarkers of antitumor activity. We review potential immunological biomarkers that affect mAb therapy in SCCHN patients, the implications of these findings and how they translate to the clinical scenario, which are critical to improving patient selection and ultimately outcomes for patients undergoing therapy.
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Affiliation(s)
- S Trivedi
- Department of Otolaryngology, University of Pittsburgh School of Medicine
| | | | - R M Srivastava
- Department of Otolaryngology, University of Pittsburgh School of Medicine
| | - H B Jie
- Department of Otolaryngology, University of Pittsburgh School of Medicine
| | - S P Gibson
- Department of Otolaryngology, University of Pittsburgh School of Medicine
| | - N C Schmitt
- Department of Otolaryngology, University of Pittsburgh School of Medicine
| | - R L Ferris
- Department of Otolaryngology, University of Pittsburgh School of Medicine; Department of Immunology, University of Pittsburgh; Cancer Immunology Program, University of Pittsburgh Cancer Institute, Pittsburgh, USA.
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Obesity and head and neck cancer risk and survival by human papillomavirus serology. Cancer Causes Control 2014; 26:111-9. [PMID: 25398682 DOI: 10.1007/s10552-014-0490-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/03/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE Previous studies examining the association of body mass index (BMI) with risk of and survival from head and neck squamous cell carcinoma (HNSCC) have been inconsistent, although an inverse association has been noted for obesity and risk of HNSCC in several studies. Previous studies have not examined whether these associations differ by human papillomavirus (HPV) status. METHODS We utilized the resources of a population-based case-control study of HNSCC from the greater Boston area (959 cases and 1,208 controls were eligible for this analysis). Anthropometric history was collected through personal interviews, and HPV status was assessed using serology. We analyzed the association between BMI (assessed 5 years prior to disease incidence) and disease risk and survival using logistic regression and Cox proportional hazards regression, respectively. RESULTS After adjusting for known risk factors, the association between obesity and overall risk of HNSCC was not significant (OR 0.79, 95 % CI 0.60-1.04). However, obesity (BMI ≥30 kg/m(2)) was inversely associated with HNSCC risk among HPV-seronegative cases (OR 0.48, 95 % CI 0.32-0.70), but not among HPV-seropositive cases (OR 0.91, 95 % CI 0.68-1.21). BMI was not associated with survival overall or by HPV status. However, being overweight (BMI 25-29.9 kg/m(2)) was associated with longer survival among HPV-seropositive smokers (HR 0.48, 95 % CI 0.31-0.74). CONCLUSIONS Our findings are consistent with previous observations that obesity is inversely associated with the risk of HNSCC; however, this association appears to be confined to HPV-seronegative cases. Overall, obesity was not associated with HNSCC survival overall or by HPV status. IMPACT Obesity is associated with risk of non-HPV HNSCC, but not HPV HNSCC.
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25
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Saulle R, Semyonov L, Mannocci A, Careri A, Saburri F, Ottolenghi L, Guerra F, La Torre G. Human papillomavirus and cancerous diseases of the head and neck: a systematic review and meta-analysis. Oral Dis 2014; 21:417-31. [PMID: 24962169 DOI: 10.1111/odi.12269] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/30/2014] [Indexed: 12/21/2022]
Abstract
The increasing incidence of head and neck cancer (HNSCC) highlights the need to better understand the role of human papillomavirus (HPV) in the development of these cancers. The aims of this study were to conduct a systematic review and a meta-analysis concerning observational studies on the association between HPV infection and HNSCC and to quantify this association, thereby obtaining a reliable estimation of the risk of HPV infection in the development of head and neck cancer. Literature searches were performed using PubMed and Scopus databases. StatsDirect 2.7.8 program was used for the analysis. We found 15 case-control studies, 63 prevalence studies, and no cohort studies. The pooled odds ratio (OR) for all the included case-control studies resulted in a value of 1.63 (95% CI 1.27-2.09; P < 0.0001). The highest pooled OR resulted from the analysis of all the studies that examined HPV 16 genotype in association oral cavity (OR 5.36; 95% CI 1.4-20). The strong evidence of association between HPV infection and HNSCC highlights the importance of the introduction of specific tests in the cancer prevention practices to evaluate the presence of the virus, especially in the oral cavity, and the possibility of an extension of the vaccine anti-HPV in the male population too.
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Affiliation(s)
- R Saulle
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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26
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Maier M, Kraft K, Steinestel K, Schramm A, Lorenz KJ, Tisch M, Schwerer M, Maier H. [Human papillomavirus in squamous cell cancer of the head and neck. A study at the Ulm Military Hospital, Germany]. HNO 2014; 61:593-601. [PMID: 23842698 DOI: 10.1007/s00106-013-2676-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There is increasing evidence worldwide that human papillomavirus is a major risk factor for head and neck cancer. Only few studies on this association have been performed in Germany to date. For the purposes of the present study, tumor specimens from 223 patients with squamous cell cancer of the oral cavity, oropharynx, hypopharynx and larynx were analyzed for HPV DNA and p16INK4a expression. The prevalence of HPV genotype 16 (HPV16) DNA in the study population was 17.5%. Further high-risk HPV types were not detected. All HPV16-positive tumors showed intense p16INK4a expression. HPV16 prevalence was highest in tonsillar carcinoma (37.5%) and lowest in laryngeal cancer (2.8%). We observed a significantly higher incidence of cervical lymph node metastases in patients with HPV16-positive tonsillar carcinoma in comparison to HPV-negative tumors (p < 0.016). Tobacco and/or alcohol consumption was significantly lower in patients with HPV-positive tumors (p < 0.0001).
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Affiliation(s)
- M Maier
- Univ.-HNO-Klinik Heidelberg.
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27
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Head and neck cancer. Mol Oncol 2013. [DOI: 10.1017/cbo9781139046947.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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28
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Langevin SM, O'Sullivan MH, Valerio JL, Pawlita M, Applebaum KM, Eliot M, McClean MD, Kelsey KT. Occupational asbestos exposure is associated with pharyngeal squamous cell carcinoma in men from the greater Boston area. Occup Environ Med 2013; 70:858-63. [PMID: 24142981 DOI: 10.1136/oemed-2013-101528] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Asbestos is the name given to a group of naturally occurring silicate mineral fibres that were widely used in industry during the 20th century due to their desirable physical properties. Although use in the USA has fallen over the last three decades, significant exposure in the developing world continues and the burden of disease is considerable. Asbestos is a known risk factor for several malignant diseases, including lung cancer and mesothelioma, and has more recently been implicated in pharyngeal and laryngeal cancer. However, studies of asbestos and cancers of the larynx or pharynx with adequate sample size that control for major head and neck squamous cell carcinoma (HNSCC) risk factors remain relatively sparse. METHODS We report findings from a case-control study of 674 incident male HNSCC cases from the greater Boston region and 857 population-based male controls, matched on age (±3 years), sex, and town or neighbourhood of residence. Multivariable logistic regression was used to assess the association between occupational asbestos exposure and HNSCC by primary tumour site. RESULTS 190 cases (28.2%) and 203 controls (23.7%) reported occupational exposure to asbestos. Occupational asbestos exposure was associated with elevated risk of pharyngeal carcinoma in men (OR 1.41, 95% CI 1.01 to 1.97), adjusted for age, race, smoking, alcohol consumption, education, income and HPV16 serology, with borderline increasing risk for each decade in the exposed occupation (OR 1.10, 95% CI 0.99 to 1.23). CONCLUSIONS These observations are consistent with mounting evidence that asbestos is a risk factor for pharyngeal cancer.
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Affiliation(s)
- Scott M Langevin
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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29
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Andersen AS, Koldjaer Sølling AS, Ovesen T, Rusan M. The interplay between HPV and host immunity in head and neck squamous cell carcinoma. Int J Cancer 2013; 134:2755-63. [PMID: 23913554 DOI: 10.1002/ijc.28411] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 07/15/2013] [Indexed: 12/13/2022]
Abstract
Persistent infection with human papillomavirus (HPV) type 16 is a major risk factor for the development of head and neck squamous cell carcinoma (HNSCC), in particular oropharyngeal squamous cell carcinoma (OPSCC). The oropharyngeal epithelium differs from the mucosal epithelium at other commonly HPV16-infected sites (i.e., cervix and anogenital region) in that it is juxtaposed with the underlying lymphatic tissue, serving a key immunologic function in the surveillance of inhaled and ingested pathogens. Therefore, the natural history of infection and immune response to HPV at this site may differ from that at other anatomic locations. This review summarizes the literature concerning the adaptive immune response against HPV in the context of HNSCC, with a focus on the T-cell response. Recent studies have shown that a broad repertoire of tumor-infiltrating HPV-specific T-cells are found in nearly all patients with HPV-positive tumors. A systemic response is found in only a proportion of these. Furthermore, the local response is more frequent in OPSCC patients than in cervical cancer patients and HPV-negative OPSCC patients. Despite this, tumor persistence may be facilitated by abnormalities in antigen processing, a skewed T-helper cell response, and an increased local prevalence of T-regulatory cells. Nonetheless, the immunologic profile of HPV-positive vs. HPV-negative HNSCC is associated with a significantly better outcome, and the HPV-specific immune response is suggested to play a role in the significantly better response to therapy of HPV-positive patients. Immunoprofiling may prove a valuable prognostic tool, and immunotherapy trials targeting HPV are underway, providing hope for decreasing treatment-related toxicity.
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Affiliation(s)
- Anne Skou Andersen
- Department of Otorhinolaryngology, Aarhus University Hospital, Aarhus, Denmark
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Human papillomavirus type 16 E6/E7-specific cytotoxic T lymphocytes for adoptive immunotherapy of HPV-associated malignancies. J Immunother 2013; 36:66-76. [PMID: 23211628 DOI: 10.1097/cji.0b013e318279652e] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vaccines prevent human papillomavirus (HPV)-associated cancer but, although these tumors express foreign, viral antigens (E6 and E7 proteins), they have little benefit in established malignancies, likely due to negative environmental cues that block tumor recognition and induce T-cell anergy in vivo. We postulated that we could identify mechanisms by which ex vivo stimulation of T cells could reactivate and expand tumor-directed T-cell lines from HPV cancer patients for subsequent adoptive immunotherapy. A total of 68 patients with HPV-associated cancers were studied. Peripheral blood T cells were stimulated with monocyte-derived dendritic cells loaded with pepmixes [peptide libraries of 15-mers overlapping by 11 amino acids (aa)] spanning E6/E7, in the presence or absence of specific accessory cytokines. The resulting T-cell lines were further expanded with pepmix-loaded activated B-cell blasts. Interferon-γ release and cytotoxic responses to E6/E7 were assessed. We successfully reactivated and expanded (>1200-fold) E6-specific/E7-specific T cells from 8/16 cervical and 33/52 oropharyngeal cancer patients. The presence of the cytokines interleukin (IL)-6, IL-7, IL-12, and IL-15 is critical for this process. These T-cell lines possess the desirable characteristics of polyclonality, multiple T-cell subset representation (including the memory compartment) and a TH1 bias, and may eliminate E6/E7 targets. In conclusion, we have shown it is possible to robustly generate HPV16 E6/E7-directed T-cell lines from patients with HPV16-associated cancers. Because our technique is scalable and good-manufacturing procedures-compliant, these lines could be used for adoptive cellular immunotherapy of patients with HPV16 cancers.
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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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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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Lugo-Trampe Á, Trujillo-Murillo KDC, Rodriguez-Sanchez IP, Barboza-Cerda MDC, Lugo-Trampe JDJ, Hernández-Ramirez LC, Canseco-Avila LM, Espinoza-Ruiz M, Domínguez-Arrevillaga S, Delgado-Enciso I. A PCR-RFLP method for typing human papillomavirus type 16 variants. J Virol Methods 2013; 187:338-44. [DOI: 10.1016/j.jviromet.2012.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 09/19/2012] [Accepted: 10/25/2012] [Indexed: 11/26/2022]
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Affiliation(s)
- Alan R. Shaw
- Vedantra Pharmaceuticals, Cambridge, Massachusetts 02139;
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35
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Recommendations for the diagnosis of human papilloma virus (HPV) high and low risk in the prevention and treatment of diseases of the oral cavity, pharynx and larynx. Guide of experts PTORL and KIDL. Otolaryngol Pol 2013; 67:113-34. [PMID: 23719268 DOI: 10.1016/j.otpol.2013.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/09/2013] [Indexed: 11/20/2022]
Abstract
The role of human papilloma viruses (HPV) in malignant and nonmalignant ENT diseases and the corresponding epidemiological burden has been widely described. International head and neck oncology community discussed growing evidence that oral HPV infection contributes to the risk of oro-pharyngeal carcinoma (OPC) and recommended HPV testing as a part of the work up for patients with OPC. Polish Society of ENT Head Neck Surgery and National Chamber of Laboratory Diagnosticians have worked together to define the minimum requirements for assigning a diagnosis of HPV-related conditions and testing strategy that include HPV specific tests in our country. This paper briefly frames the literature information concerning low risk (LR) and high risk (HR) HPV, reviews the epidemiology, general guidance on the most appropriate biomarkers for clinical assessment of HPV. The definition of HPV-related cancer was presented. The article is aiming to highlight some of major issues for the clinician dealing with patients with HPV-related morbidities and to introduce the diagnostic algorithm in Poland.
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Liang C, Marsit CJ, McClean MD, Nelson HH, Christensen BC, Haddad RI, Clark JR, Wein RO, Grillone GA, Houseman EA, Halec G, Waterboer T, Pawlita M, Krane JF, Kelsey KT. Biomarkers of HPV in head and neck squamous cell carcinoma. Cancer Res 2012; 72:5004-13. [PMID: 22991304 DOI: 10.1158/0008-5472.can-11-3277] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Human papillomavirus (HPV) is an accepted cause of head and neck squamous cell carcinoma (HNSCC), and patients with HPV-associated HNSCC have a favorable prognosis. Currently, there is no general guidance on the most appropriate biomarkers for clinical assessment of HPV in these malignancies. We compared PCR-based and serologic HPV assays, as well as p16 immunohistochemistry, individually and in combination in a single population-based study to assess their associations with overall survival among patients with HNSCC, and thus their potential value as biomarkers. HPV16 serology was determined for 488 patients; immunohistochemical detection of p16 expression in tumors was conducted in a subset of 233 cases, and PCR-based methods to assess the presence of HPV16 DNA in a subset of 179 cases of tumors. Considering each biomarker individually in the subset of patients studied for all endpoints, seropositivity for the E6 and E7 proteins was significantly associated with enhanced all-cause survival in oropharyngeal disease [HR(E6/E7+) = 0.1, 95% confidence interval (CI) = 0.02-0.3]. Neither the presence of HPV16 DNA nor p16 immunostaining was associated with significant enhanced overall survival in oropharyngeal disease (HR(DNA) = 0.9, 95% CI = 0.3-2.9; HR(p16) = 0.3, 95% CI = 0.1-1.1). However, the combination of HPV-positive DNA and E6 or E7 serology was associated with enhanced overall survival in oropharyngeal disease (HR(DNA+/E6/E7+) = 0.1, 95% CI = 0.02-1.0), whereas E6/E7 seronegative patients with evidence of HPV in tumor DNA did not show any evidence of favorable survival (HR(DNA+/E6-/E7-) = 3.4, 95% CI = 0.6-18.1). Furthermore, patients with p16 staining and E6 or E7 seropositivity had favorable survival from oropharyngeal disease (HR(p16+/E6/E7+) = 0.1, 95% CI = 0.02-0.4), whereas patients who were p16 positive and E6/E7 seronegative had significantly increased hazard of all causes of death (HR(p16+/E6-/E7-) = 3.1, 95% CI = 1.2-7.7). A stronger association of HPV presence with prognosis (assessed by all-cause survival) is observed when "HPV-associated" HNSCC is defined using tumor status (HPV DNA status or P16) and HPV E6/E7 serology in combination rather using tumor HPV status alone.
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Affiliation(s)
- Caihua Liang
- Department of Epidemiology, Division of Biology and Medicine, Brown University, Providence, Rhode Island, USA
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O'Rorke MA, Ellison MV, Murray LJ, Moran M, James J, Anderson LA. Human papillomavirus related head and neck cancer survival: a systematic review and meta-analysis. Oral Oncol 2012; 48:1191-201. [PMID: 22841677 DOI: 10.1016/j.oraloncology.2012.06.019] [Citation(s) in RCA: 294] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 06/18/2012] [Accepted: 06/29/2012] [Indexed: 01/22/2023]
Abstract
Human Papillomavirus (HPV) related oropharyngeal squamous cell carcinomas (OPSCCs) are reported to have improved prognosis and survival in comparison to other head and neck squamous cell cancers (HNSCCs). This systematic review and meta-analysis examines survival differences in HPV-positive HNSCC and OPSCC subtypes including tonsillar carcinoma in studies not previously investigated. Four electronic databases were searched from their inception till April 2011. A random effects meta-analysis was used to pool study estimates evaluating disease-specific (death from HNSCC), overall (all-cause mortality), progression-free and disease-free (recurrence free) survival outcomes in HPV-positive vs. HPV-negative HNSCCs. All statistical tests were two-sided. Forty-two studies were included. Patients with HPV-positive HNSCC had a 54% better overall survival compared to HPV-negative patients HR 0.46 (95% CI 0.37-0.57); the pooled HR for tonsillar cancer and OPSCC was 0.50 (95% CI 0.33-0.77) and HR 0.47 (95% CI 0.35-0.62) respectively. The pooled HR for disease specific survival was 0.28 (95% CI 0.19-0.40); similar effect sizes were found irrespective of the adjustment for confounders, HPV detection methods or study location. Both progression-free survival and disease-free survival were significantly improved in HPV-positive HNSCCs. HPV-positive HNSCCs and OPSCCs patients have a significantly lower disease specific mortality and are less likely to experience progression or recurrence of their cancer than HPV-negative patients; findings which have connotations for treatment selection in these patients.
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Affiliation(s)
- M A O'Rorke
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queens University Belfast, Belfast, UK.
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Human papillomavirus in non-oropharyngeal head and neck cancers: a systematic literature review. Head Neck Pathol 2012; 6 Suppl 1:S104-20. [PMID: 22782230 PMCID: PMC3394168 DOI: 10.1007/s12105-012-0368-1] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 05/10/2012] [Indexed: 12/20/2022]
Abstract
Perhaps one of the most important developments in head and neck oncology of the past decade is the demonstration that patients with human papillomavirus (HPV)-mediated oropharyngeal cancers have significantly improved outcomes, compared to HPV-negative counterpart patients. This has become the basis for clinical trials investigating the impact on "treatment deintensification" for patients with HPV-mediated oropharyngeal cancers. Unfortunately, the significance of HPV in non-oropharyngeal head and neck cancers is much less certain. Our goal is to systematically review the published data regarding the role HPV in carcinomas of the oral cavity, larynx, sinonasal tract and nasopharynx with respect to HPV detection frequency, viral activity, and association with outcome. We also present preliminary data on HPV16/18 transcriptional status in oral cavity carcinomas, as well as salivary gland neoplasia, as determined by nested reverse transcription PCR for HPV E6/E7 RNA. The weighted prevalence (WP) of HPV DNA detection in 4,195 oral cavity cancer patients is 20.2 %, (95 % CI 16.0 %, 25.2 %). HPV16 is the most common type detected. Importantly, no data currently demonstrates a significant association between the presence of HPV DNA and improved outcome. The WP of HPV DNA in 1,712 laryngeal cancer patients is 23.6 %, (95 % CI 18.7 %, 29.3 %). Similarly, no association has yet been demonstrated between HPV DNA status and outcome. The WP of HPV DNA detection in 120 sinonasal cancer patients is 29.6 % (95 % CI 17.8 %, 44.9 %), and in 154 nasopharyngeal carcinoma patients is 31.1 %, (95 % CI 20.3 %, 44.5 %). Recent preliminary data also suggests an association between HPV and certain salivary gland neoplasms. The clinical significance of these findings is unclear. The published data strongly support the need for studies on patients with oral and laryngeal carcinomas that will be powered to find any differences in clinical outcome with respect to HR-HPV and p16 overexpression.
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Huang SF, Li HF, Liao CT, Wang HM, Chen IH, Chang JTC, Chen YJ, Cheng AJ. Association of HPV infections with second primary tumors in early-staged oral cavity cancer. Oral Dis 2012; 18:809-15. [DOI: 10.1111/j.1601-0825.2012.01950.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Different cellular p16(INK4a) localisation may signal different survival outcomes in head and neck cancer. Br J Cancer 2012; 107:482-90. [PMID: 22735904 PMCID: PMC3405208 DOI: 10.1038/bjc.2012.264] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recently, the management of head and neck squamous cell carcinoma (HNSCC) has focused considerable attention on biomarkers, which may influence outcomes. Tests for human papilloma infection, including direct assessment of the virus as well as an associated tumour suppressor gene p16, are considered reproducible. Tumours from familial melanoma syndromes have suggested that nuclear localisation of p16 might have a further role in risk stratification. We hypothesised p16 staining that considered nuclear localisation might be informative for predicting outcomes in a broader set of HNSCC tumours not limited to the oropharynx, human papilloma virus (HPV) status or by smoking status. METHODS Patients treated for HNSCC from 2002 to 2006 at UNC (University of North Carolina at Chapel Hill) hospitals that had banked tissue available were eligible for this study. Tissue microarrays (TMA) were generated in triplicate. Immunohistochemical (IHC) staining for p16 was performed and scored separately for nuclear and cytoplasmic staining. Human papilloma virus staining was also carried out using monoclonal antibody E6H4. p16 expression, HPV status and other clinical features were correlated with progression-free (PFS) and overall survival (OS). RESULTS A total of 135 patients had sufficient sample for this analysis. Median age at diagnosis was 57 years (range 20-82), with 68.9% males, 8.9% never smokers and 32.6% never drinkers. Three-year OS rate and PFS rate was 63.0% and 54.1%, respectively. Based on the p16 staining score, patients were divided into three groups: high nuclear, high cytoplasmic staining group (HN), low nuclear, low cytoplasmic staining group (LS) and high cytoplasmic, low nuclear staining group (HC). The HN and the LS groups had significantly better OS than the HC group with hazard ratios of 0.10 and 0.37, respectively, after controlling for other factors, including HPV status. These two groups also had significantly better PFS than the HC staining group. This finding was consistent for sites outside the oropharynx and did not require adjustment for smoking status. CONCLUSION Different p16 protein localisation suggested different survival outcomes in a manner that does not require limiting the biomarker to the oropharynx and does not require assessment of smoking status.
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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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Zhou Z, Sturgis EM, Liu Z, Wang LE, Wei Q, Li G. Genetic variants of NOXA and MCL1 modify the risk of HPV16-associated squamous cell carcinoma of the head and neck. BMC Cancer 2012; 12:159. [PMID: 22548841 PMCID: PMC3428689 DOI: 10.1186/1471-2407-12-159] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 05/01/2012] [Indexed: 11/10/2022] Open
Abstract
Abstracts
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Affiliation(s)
- Ziyuan Zhou
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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43
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Poage GM, Butler RA, Houseman EA, McClean MD, Nelson HH, Christensen BC, Marsit CJ, Kelsey KT. Identification of an epigenetic profile classifier that is associated with survival in head and neck cancer. Cancer Res 2012; 72:2728-37. [PMID: 22507853 DOI: 10.1158/0008-5472.can-11-4121-t] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Panels of prognostic biomarkers selected using candidate approaches often do not validate in independent populations, so additional strategies are needed to identify reliable classifiers. In this study, we used an array-based approach to measure DNA methylation and applied a novel method for grouping CpG dinucleotides according to well-characterized genomic sequence features. A hypermethylation profile among 13 CpG loci, characterized by polycomb group target genes, mammalian interspersed repeats, and transcription factor-binding sites (PcG/MIR/TFBS), was associated with reduced survival (HR, 3.98; P = 0.001) in patients with head and neck squamous cell carcinoma. This association was driven by CpGs associated with the TAP1 and ALDH3A1 genes, findings that were validated in an independent patient group (HR, 2.86; P = 0.04). Together, the data not only elucidate new potential targets for therapeutic intervention in head and neck cancer but also may aid in the identification of poor prognosis patients who may require more aggressive treatment regimens.
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Affiliation(s)
- Graham M Poage
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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44
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Dreyer T, Kreisel M. Potentially malignant lesions of the upper aerodigestive tract. JOURNAL OF BIOPHOTONICS 2012; 5:299-312. [PMID: 22170750 DOI: 10.1002/jbio.201100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/16/2011] [Accepted: 11/16/2011] [Indexed: 05/31/2023]
Abstract
Mucosal lesions of the upper aerodigestive tract usually concern the squamous epithelium of the surface. Many precancerous alterations now designated as potentially malignant are caused by DNA damage resulting from long term exposure to tobacco and alcohol consumption. The distinction from conditions with a similar phenotype but caused by different reasons such as viral infection may be difficult. Furthermore, a magnitude of similar appearing lesions with different clinical background and different biological behavior are discussed in this paper.
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Affiliation(s)
- Thomas Dreyer
- Institut für Pathologie am Universitätsklinikum Gießen & Marburg, Standort Gießen, Gießen, Germany
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45
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Cole L, Polfus L, Peters ES. Examining the incidence of human papillomavirus-associated head and neck cancers by race and ethnicity in the U.S., 1995-2005. PLoS One 2012; 7:e32657. [PMID: 22448226 PMCID: PMC3308956 DOI: 10.1371/journal.pone.0032657] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Accepted: 01/30/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) incidence, mortality and survival rates vary by sex and race, with men and African Americans disproportionately affected. Risk factors for HNC include tobacco and alcohol exposure, with a recent implication of human papillomavirus (HPV) in the pathogenesis of HNC. This study describes the epidemiology of HNC in the United States, examining variation of rates by age, sex, race/ethnicity and potential HPV-association. METHODS We used the North American Association of Central Cancer Registries (NAACCR) Cancer in North America (CINA) Deluxe Analytic Data to analyze HNC incidence for 1995-2005 from forty population-based cancer registries. We calculated age-adjusted incidence rates and incidence trends using annual percent change by age, sex, race/ethnicity and HPV-association. RESULTS Males and Non-Hispanic Blacks experienced greater HNC incidence compared to women and other race/ethnicity groupings. A significant overall increase in HNC incidence was observed among HPV-associated sites during 1995-2005, while non HPV-associated sites experienced a significant decline in HNC incidence. Overall, younger age groups, Non-Hispanic Whites and Hispanics experienced greater increases in incidence for HPV-associated sites, while HNC incidence declined for Non-Hispanic Blacks independent of HPV-association. In particular, for HPV-associated sites, HNC incidence for Non-Hispanic White males aged 45-54 increased at the greatest rate, with an APC of 6.28% (p<0.05). Among non HPV-associated sites, Non-Hispanic Black males aged 0-44 years experienced the greatest reduction in incidence (APC, -8.17%, p<0.05), while a greater decline among the older, 55-64 year age group (APC, -5.44%, p<0.05) occurred in females. CONCLUSIONS This study provides evidence that HPV-associated tumors are disproportionately affecting certain age, sex and race/ethnicity groups, representing a different disease process for HPV-associated tumors compared to non HPV-associated tumors. Our study suggests that HPV tumor status should be incorporated into treatment decisions for HNC patients to improve prognosis and survival.
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Affiliation(s)
- Lauren Cole
- Louisiana State University Health Sciences Center, School of Public Health, Epidemiology, New Orleans, Louisiana, United States of America.
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46
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Tiggelaar SM, Lin MJ, Viscidi RP, Ji J, Smith JS. Age-specific human papillomavirus antibody and deoxyribonucleic acid prevalence: a global review. J Adolesc Health 2012; 50:110-31. [PMID: 22265107 PMCID: PMC3572199 DOI: 10.1016/j.jadohealth.2011.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 10/14/2011] [Accepted: 10/15/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE Global data on human papillomavirus (HPV) serological and deoxyribonucleic acid (DNA) prevalence are essential to optimize HPV prophylactic vaccination strategies. METHODS We conducted a global review of age-specific HPV antibody and studies with both antibody and DNA prevalence for HPV-16, -18, -6, and -11. RESULTS One hundred seventeen studies were included; participants' ages ranged from several hours to >90 years. HPV-16 seroprevalence was generally higher in Africa, Central and South America, and North America, more prevalent among women than among men, and peaked around ages 25-40 years. HPV-18 seroprevalence was generally lower than HPV-16 with a later age peak. Data were limited for HPV-6 and -11, both of which peaked at ages similar to HPV-18. Among 9-26-year-old females, HPV-16 seroprevalence ranged from 0%-31% in North America, 21%-30% in Africa, 0%-23% in Asia/Australia, 0%-33% in Europe, and 13%-43% in Central and South America. HPV-16/-18 DNA prevalence peaked 10-15 years before corresponding HPV-16/-18 antibody prevalence. CONCLUSIONS Females within the HPV vaccine-eligible age-group (9-26 years) had a range of dual HPV-16 DNA and serology negativity from 81%-87%, whereas 90%-98% were HPV-16 DNA negative. Serology and DNA data are lacking worldwide for females younger than age 15 years, the prime target group for vaccination.
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Affiliation(s)
- Sarah M Tiggelaar
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Vanderbilt University, School of Medicine, Nashville, TN USA
| | - Margaret J Lin
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Washington University School of Medicine, Saint Louis, MO, USA
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Raphael P Viscidi
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jia Ji
- Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Division of Pharmaceutics, College of Pharmacy, Ohio State University, Columbus, OH, USA
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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47
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Van der Vorst S, Dekairelle AF, Weynand B, Hamoir M, Gala JL. Assessment of p53 functional activity in tumor cells and histologically normal mucosa from patients with head and neck squamous cell carcinoma. Head Neck 2011; 34:1542-50. [PMID: 22109999 DOI: 10.1002/hed.21960] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 08/04/2011] [Accepted: 09/06/2011] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the value of p53 functional analysis of separated alleles in yeast (FASAY) as a witness of p53/p21 pathway alteration in head and neck squamous cell carcinoma (HNSCC). METHODS The p53 transcriptional activity was prospectively analyzed in 82 newly diagnosed patients with HNSCC. FASAY and p53 immunostaining were carried out on paired tumoral and histologically normal tissues. The predictive value of FASAY for locoregional recurrence was assessed by Cox survival analysis. RESULTS Loss of p53/p21 transcriptional activity was encountered in 88% tumoral and 18% histologically normal samples, associated with mutations (79%) and insertions/deletions (21%). The p53 overexpression underestimated p53 transcriptional abnormalities. FASAY-positive histologically normal mucosa was significantly associated with locoregional recurrence. CONCLUSION FASAY positivity indicates field cancerization in a subgroup of patients with HNSCC, in which nonfunctional p53 was significantly associated with locoregional recurrence. This prompted us to pursue the study on the p53 functional status of normal mucosa in patients with HNSCC.
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Affiliation(s)
- Sébastien Van der Vorst
- Center for Applied Molecular Technologies, Institute for Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
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48
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Zhou Z, Sturgis EM, Liu Z, Wang LE, Wei Q, Li G. Genetic variants of a BH3-only pro-apoptotic gene, PUMA, and risk of HPV16-associated squamous cell carcinoma of the head and neck. Mol Carcinog 2011; 51 Suppl 1:E54-64. [PMID: 22086558 DOI: 10.1002/mc.21838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 10/13/2011] [Accepted: 10/19/2011] [Indexed: 11/11/2022]
Abstract
P53 up-regulated modulator of apoptosis (PUMA) is a critical factor in the intrinsic apoptotic pathway. Through PUMA-dependent mechanisms, human papillomavirus 16 (HPV16) oncoprotein may affect apoptosis by E6-mediated p53 degradation. To examine whether the PUMA variants modify the association between HPV16 serology and risk of squamous cell carcinoma of the head and neck (SCCHN), we genotyped two polymorphisms in the PUMA promoter (rs3810294 and rs2032809) in 380 cases and 335 cancer-free controls of non-Hispanic Whites, who were frequency-matched by age (±5 yr), sex, smoking, and drinking status. We found that each individual polymorphism had only a modest impact on risk of SCCHN, particularly in oropharyngeal cancer for rs3810294 and non-oropharyngeal cancer for rs2032809. After we stratified the individuals by HPV16 serology, and used those with the corresponding common homozygous genotype and HPV16 seronegativity as the reference group, for each polymorphism we found that the risk of SCCHN associated with HPV16 seropositivity was higher among those with variant genotypes than those with the corresponding common homozygous genotype. Notably, this effect modification was particularly pronounced in several subgroups including never smokers, never drinkers, younger patients, and patients with oropharyngeal cancer. Furthermore, we also characterized the functional relevance of the two polymorphisms to explore the genotype-phenotype correlation. Our results suggested that the PUMA promoter polymorphisms may be a biomarker for risk of HPV16-associated SCCHN, particularly in never smokers, never drinkers, younger patients, and patients with oropharyngeal cancer. Larger studies are needed to validate our findings.
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Affiliation(s)
- Ziyuan Zhou
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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49
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Anderson KS, Wong J, D'Souza G, Riemer AB, Lorch J, Haddad R, Pai SI, Longtine J, McClean M, LaBaer J, Kelsey KT, Posner M. Serum antibodies to the HPV16 proteome as biomarkers for head and neck cancer. Br J Cancer 2011; 104:1896-905. [PMID: 21654689 PMCID: PMC3111202 DOI: 10.1038/bjc.2011.171] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) type 16 is associated with oropharyngeal carcinomas (OPC). Antibodies (Abs) to HPV16 E6 and E7 oncoproteins have been detected in patient sera; however, Abs to other early HPV-derived proteins have not been well explored. METHODS Antibodies to the HPV16 proteome were quantified using a novel multiplexed bead assay, using C-terminal GST-fusion proteins captured onto Luminex beads. Sera were obtained from untreated patients with OPC (N=40), partners of patients with HPV16+ OPC (N=11), and healthy controls (N=50). RESULTS Oropharyngeal carcinomas patients with known virus-like capsid particle+ Abs had elevated serum Abs to HPV16 E1, E2, E4, E6, and E7, and L1 antibody levels, but not E5. The ratios of specific median fluorescence intensity to p21-GST compared with controls were E1: 50.7 vs 2.1; E4: 14.6 vs 1.3; E6: 11.3 vs 2.4; E7: 43.1 vs 2.6; and L1: 10.3 vs 2.6 (each P≤0.01). In a validation cohort, HPV16 E1, E2, and E7 antibody levels were significantly elevated compared with healthy control samples (P≤0.02) and partners of OPC patients (P≤0.01). CONCLUSION Patients with HPV16+ OPC have detectable Abs to E1, E2, and E7 proteins, which are potential biomarkers for HPV-associated OPC.
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Affiliation(s)
- K S Anderson
- Cancer Vaccine Center, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Engsig FN, Gerstoft J, Kronborg G, Larsen CS, Pedersen G, Pedersen C, Obel N. Head and neck cancer in HIV patients and their parents: a Danish cohort study. Clin Epidemiol 2011; 3:217-27. [PMID: 21857789 PMCID: PMC3157492 DOI: 10.2147/clep.s19875] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Indexed: 11/23/2022] Open
Abstract
Background: The mechanism for the increased risk of head and neck cancer (HNC) observed in HIV patients is controversial. We hypothesized that family-related risk factors increase the risk of HNC why we estimated the risk of this type of cancer in both HIV patients and their parents. Methods: We estimated the cumulative incidence and incidence rate ratios (IRRs) of HNC in 1) a population of all Danish HIV patients identified from the Danish HIV Cohort Study (n = 5053) and a cohort of population controls matched on age and gender (n = 50,530) (study period; 1995–2009) and 2) the parents of HIV patients and population controls (study period 1978–2009). To assess the possible impact of human papilloma virus (HPV)–associated cancers, the sites of squamous cell HNCs were categorized as HPV related, potentially HPV related, and potentially HPV unrelated. Results: Seventeen (0.3%) HIV patients vs 80 (0.2%) population controls were diagnosed with HNC cancer in the observation period. HIV patients had an increased risk of HNC (IRR 3.05 [95% CI 1.81–5.15]). The IRR was considerably increased in HIV patients older than 50 years (adjusted IRR; 4.58 [95% CI 2.24–9.35]), diagnosed after 1995 (adjusted IRR 6.31 [95% CI 2.82–14.08]), previous or current smoker (adjusted IRR 4.51 [95% CI 2.47–8.23]), with baseline CD4 count 350 cells/μL (adjusted IRR; 3.89 [95% CI 1.95–7.78]), and men heterosexually infected with HIV (adjusted IRR 5.54 [95% CI 1.96–15.66]). Fifteen (83%) of the HIV patients diagnosed with HNC were current or former smokers. The IRR of squamous cell HNC in HIV patients was high at HPV-relate sites, potentially HPV-related sites, and potentially HPV-unrelated sites. Both fathers and mothers of HIV patients had an increased risk of HNC (adjusted IRR for fathers 1.78 [95% CI 1.28–2.48], adjusted IRR for mothers 2.07 [95% CI 1.05–4.09]). Conclusion: HIV appears to be a marker of behavioral or family-related risk factors that affect the incidence of HNC in HIV patients.
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Affiliation(s)
- Frederik N Engsig
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
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