1
|
de Lima MAP, Cavalcante RB, da Silva CGL, Nogueira RLM, Macedo GEC, de Galiza LE, Pinheiro JV, Maia Filho PHB, Santos SF, Rabenhorst SHB. Evaluation of HPV and EBV in OSCC and the expression of p53, p16, E-cadherin, COX-2, MYC, and MLH1. Oral Dis 2021; 28:1104-1122. [PMID: 33660890 DOI: 10.1111/odi.13814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 02/09/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate the presence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) and the expression of p53, p16, E-cadherin, COX-2, MLH1, and MYC in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS One hundred OSCC specimens were submitted to in situ hybridization for HPV and EBV, and immunohistochemistry for detection of the human proteins. RESULTS Thirty-one cases showed HPV in tumor tissue. EBV was not detected in any case investigated. The HPV(+) group demonstrated an increase of staining scores for nuclear p16 (p = .047), cytoplasmic MYC (p = .002), while a decrease for nuclear MLH1 (p = .048), suggesting that HPV may upregulate the expression of the first two proteins and down-regulate the latter. CONCLUSION Our findings reinforce the hypothesis of the HPV-related oral carcinogenesis involving the expression of p16 and MYC, and MLH1 suppression. Exclusively cytoplasmic stainings for p16, MLH1, and MYC were also associated with more advanced tumors. Finally, in view of the lack of studies correlating the HPV or EBV infection to the expression of oncoproteins, more researches assessing a broader panel of markers and employing different approaches are still necessary in order to understand the role of these viruses as well as the molecular mechanisms involved in the development and progression of oral carcinomas.
Collapse
|
2
|
Sahovaler A, Kim MH, Mendez A, Palma D, Fung K, Yoo J, Nichols AC, MacNeil SD. Survival Outcomes in Human Papillomavirus-Associated Nonoropharyngeal Squamous Cell Carcinomas: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 146:1158-1166. [PMID: 33057610 DOI: 10.1001/jamaoto.2020.3382] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Although the survival impact of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well known, there has been conflicting and scarce evidence on the role of HPV in non-OPSCC. Objective To undertake a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review and meta-analysis of all published studies on the association between HPV status and survival outcomes in patients with non-OPSCC, analyzing each site separately. Data Sources PubMed, CINAHL, and Embase were searched from 1946 to December 16, 2019, for English-language articles. Study Selection Analysis comprised randomized clinical trials or observational studies that each included at least 10 patients with non-OPSCC in which the presence of HPV was analyzed, survival outcomes were reported, and a clinical follow-up of 1 year or more was performed. Studies excluded were those in which data on OPSCC and non-OPSCC were not distinguished between both cohorts and studies on patients with distant metastatic tumors at diagnosis. Final analysis included outcomes that were analyzed in at least 3 studies. Data Extraction and Synthesis Two reviewers independently abstracted the data. Risk of bias was estimated with the Newcastle-Ottawa Scale. Meta-analysis was performed using the random-effects model. Main Outcomes and Measures The primary end point was overall survival (OS); secondary end points were disease-specific survival (DSS) and disease-free survival (DFS). Results Of the 3947 articles screened, a total of 22 observational and 2 randomized clinical trials were included in the analysis, representing 24 854 patients. In oral cavity locations, OS was not significantly associated with HPV positivity (hazard ratio [HR], 1.16; 95% CI, 0.83-1.61; I2 = 71%); however, HPV-positive tumors showed worse DFS (HR, 1.81; 95% CI, 1.12-2.91; I2 = 47%). Laryngeal and hypopharyngeal HPV-positive tumors were associated with improved OS (HR, 0.71; 95% CI, 0.54-0.92; I2 = 38% and HR, 0.60; 95% CI, 0.47-0.76; I2 = 0%), respectively, whereas, in nasopharyngeal locations HPV was not associated with OS (HR, 0.82; 95% CI, 0.49-1.38; I2 = 46%) or DSS (HR, 0.55; 95% CI, 0.22-1.42; I2 = 65%). Conclusions and Relevance In this meta-analysis of 24 studies, HPV was associated with improved OS in laryngeal and hypopharyngeal locations but not in the oral cavity and the nasopharynx. This information may be useful for future clinical studies of laryngeal and hypopharyngeal tumors and whether HPV status should be incorporated in prognostication of patients with these cancers.
Collapse
Affiliation(s)
- Axel Sahovaler
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.,Guided Therapeutics Program, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Min Hui Kim
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Adrian Mendez
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - David Palma
- Department of Radiation Oncology, Western University, London, Ontario, Canada
| | - Kevin Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Anthony C Nichols
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| |
Collapse
|
3
|
Chen S, Lin Z, Chen J, Yang A, Zhang Q, Xie C, Zhang X, Yang Z, Chen W, Song M. Older age is a risk factor associated with poor prognosis of patients with squamous cell carcinoma of the oral cavity. Eur Arch Otorhinolaryngol 2020; 277:2573-2580. [PMID: 32322960 PMCID: PMC7410825 DOI: 10.1007/s00405-020-05963-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/01/2020] [Indexed: 12/24/2022]
Abstract
Purpose Whether or not young patients with squamous cell carcinoma of oral cavity (OC-SCC) have a difference in prognosis remains a controversy. This study aimed to analyze the clinical characteristics and difference of survival rates between adult patients less than 40 years of age and those 40 years of age and older. Methods A retrospective analysis was conducted using the database of patients diagnosed with OC-SCC between 1990 and 2013 in the Sun Yat-sen University Cancer Center, but patients older than 85 years, younger than 18 years, or died within 6 months of diagnosis were excluded. Patients were categorized into two groups: the young group (< 40 years of age) and the older group (≥ 40 years of age). Cox regression, survival and subgroups analyses were performed. The primary endpoints included the rates of 5-year overall survival (OS) and disease-specific survival (DSS). Results A total of 1902 OC-SCC patients were identified. The percentage of female in the young group was significantly higher than that in the older group (40.27% vs 31.03%, p < 0.001). This study failed to find the difference in TNM classification or tumor stage between the two groups (p > 0.05). The young group was more likely to receive adjuvant radiotherapy and/or chemotherapy (42.48% vs 26.91%, p < 0.001). The 5-year OS rate (71% vs. 57%, p < 0.001) and DSS rate (72% vs 58%, p < 0.001) in patients under 40 years were significantly higher than those for the older group. Conclusion Our findings suggested that OC-SCC in younger patients did not present at a more advanced stage. In addition, young age is an independent predictor for better survival.
Collapse
Affiliation(s)
- Shuwei Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Zhu Lin
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Jingtao Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Ankui Yang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Quan Zhang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Chuanbo Xie
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Cancer Prevention Center, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Xing Zhang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Zhongyuan Yang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Wenkuan Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.
| | - Ming Song
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.
| |
Collapse
|