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Liu S, Wang S, Zhang N, Li P. The oral microbiome and oral and upper gastrointestinal diseases. J Oral Microbiol 2024; 16:2355823. [PMID: 38835339 PMCID: PMC11149586 DOI: 10.1080/20002297.2024.2355823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/10/2024] [Indexed: 06/06/2024] Open
Abstract
Background Microbiomes are essential components of the human body, and their populations are substantial. Under normal circumstances, microbiomes coexist harmoniously with the human body, but disturbances in this equilibrium can lead to various diseases. The oral microbiome is involved in the occurrence and development of many oral and gastrointestinal diseases. This review focuses on the relationship between oral microbiomes and oral and upper gastrointestinal diseases, and therapeutic strategies aiming to provide valuable insights for clinical prevention and treatment. Methods To identify relevant studies, we conducted searches in PubMed, Google Scholar, and Web of Science using keywords such as "oral microbiome," "oral flora, " "gastrointestinal disease, " without any date restrictions. Subsequently, the retrieved publications were subject to a narrative review. Results In this review, we found that oral microbiomes are closely related to oral and gastrointestinal diseases such as periodontitis, dental caries, reflux esophagitis, gastritis, and upper gastrointestinal tumors (mainly the malignant ones). Oral samples like saliva and buccal mucosa are not only easy to collect, but also display superior sample stability compared to gastrointestinal tissues. Consequently, analysis of the oral microbiome could potentially serve as an efficient preliminary screening method for high-risk groups before undergoing endoscopic examination. Besides, treatments based on the oral microbiomes could aid early diagnosis and treatment of these diseases. Conclusions Oral microbiomes are essential to oral and gastrointestinal diseases. Therapies centered on the oral microbiomes could facilitate the early detection and management of these conditions.
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Affiliation(s)
- Sifan Liu
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; State Key Laboratory for Digestive Health; National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Shidong Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nan Zhang
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; State Key Laboratory for Digestive Health; National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Peng Li
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University; State Key Laboratory for Digestive Health; National Clinical Research Center for Digestive Diseases, Beijing, China
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Sun T, He X, Chen X, Huaqing Y, Zhang H, Zhao M, Du L, Zhao B, Hou J, Li X, Liu Y. Delaying age at first sexual intercourse provides protection against oral cavity cancer: a mendelian randomization study. Front Oncol 2024; 14:1361527. [PMID: 38699645 PMCID: PMC11063229 DOI: 10.3389/fonc.2024.1361527] [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: 12/26/2023] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Aim To investigate whether age at first sexual intercourse could lead to any changes in the risk of oral cavity cancer. Methods A two-sample mendelian randomization was conducted using genetic variants associated with age at first sexual intercourse in UK biobank as instrumental variables. Summary data of Northern American from a previous genome-wide association study aimed at oral cavity cancer was served as outcome. Three analytical methods: inverse variance-weighted, mendelian randomization Egger, and weighted median were used to perform the analysis, among which inverse variance-weighted was set as the primary method. Robustness of the results was assessed through Cochran Q test, mendelian randomization Egger intercept tests, MR PRESSO, leave one out analysis and funnel plot. Results The primary analysis provided substantial evidence of a positive causal relationship age at first sexual intercourse and the risk of oral cavity cancer (p = 0.0002), while a delayed age at first sexual intercourse would lead to a decreased risk of suffering oral cavity cancer (β = -1.013). The secondary outcomes confirmed the results (all β < 0) and all assessments supported the robustness, too (all p > 0.05). Conclusion The study demonstrates that a delayed sexual debut would provide protection against OCC, thus education on delaying sexual intercourse should be recommended.
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Affiliation(s)
- Ting Sun
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Xin He
- Department of Emergency, Guangyuan Central Hospital, Guangyuan, China
| | - Xing Chen
- Department of Dentistry and Oral Surgery, Guangyuan Central Hospital, Guangyuan, China
- Department of Dentistry and Oral Surgery, North Sichuan Medical College, Nanchong, China
| | - Yang Huaqing
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Haimei Zhang
- Department of Dentistry and Oral Surgery, Guangyuan Central Hospital, Guangyuan, China
| | - Min Zhao
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Li Du
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Bin Zhao
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Junping Hou
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Xudong Li
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
| | - Yu Liu
- Department of Oncology, Guangyuan Central Hospital, Guangyuan, China
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Condrat CE, Cretoiu D, Radoi VE, Mihele DM, Tovaru M, Bordea CI, Voinea SC, Suciu N. Unraveling Immunological Dynamics: HPV Infection in Women-Insights from Pregnancy. Viruses 2023; 15:2011. [PMID: 37896788 PMCID: PMC10611104 DOI: 10.3390/v15102011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
During pregnancy, hormonal and immune adaptations are vital for supporting the genetically distinct fetus during elevated infection risks. The global prevalence of HPV necessitates its consideration during pregnancy. Despite a seemingly mild immune response, historical gestational viral infections underscore its significance. Acknowledging the established HPV infection risks during pregnancy, our review explores the unfolding immunological changes in pregnant women with HPV. Our analysis aims to uncover strategies for safely modulating the immune system, mitigating adverse pregnancy consequences, and enhancing maternal and child health. This comprehensive narrative review delves into the existing knowledge and studies on this topic.
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Affiliation(s)
- Carmen Elena Condrat
- Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.E.C.)
| | - Dragos Cretoiu
- Department of Genetics, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (D.C.); (V.E.R.)
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Viorica Elena Radoi
- Department of Genetics, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (D.C.); (V.E.R.)
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
| | - Dana Mihaela Mihele
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
- Dermatology Department, Victor Babes Clinical Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Mihaela Tovaru
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania
- Dermatology Department, Victor Babes Clinical Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Cristian Ioan Bordea
- Department of Surgical Oncology, Prof. Dr. Alexandru Trestioreanu Oncology Institute, Carol Davila University of Medicine and Pharmacy, 252 Fundeni Rd., 022328 Bucharest, Romania
| | - Silviu Cristian Voinea
- Department of Surgical Oncology, Prof. Dr. Alexandru Trestioreanu Oncology Institute, Carol Davila University of Medicine and Pharmacy, 252 Fundeni Rd., 022328 Bucharest, Romania
| | - Nicolae Suciu
- Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (C.E.C.)
- Fetal Medicine Excellence Research Center, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
- Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Alessandrescu-Rusescu National Institute for Mother and Child Health, 020395 Bucharest, Romania
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Wichmann G, Rudolph J, Henger S, Engel C, Wirkner K, Wenning JR, Zeynalova S, Wiegand S, Loeffler M, Wald T, Dietz A. Is High-Risk Sexual Behavior a Risk Factor for Oropharyngeal Cancer? Cancers (Basel) 2023; 15:3356. [PMID: 37444466 DOI: 10.3390/cancers15133356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/12/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Several lines of evidence established a link between high-risk (HR) sexual behavior (SB), the persistence of human papillomavirus (HPV) DNA in saliva, and the presence of oncogenic HR-HPV subtypes in oropharyngeal squamous cell carcinoma (OPSCC). A highly influential case-control study by D'Souza et al. comparing OPSCC patients and ENT patients with benign diseases (hospital controls) established HR-SB as a putative etiological risk factor for OPSCC. Aiming to replicate their findings in a nested case-control study of OPSCC patients and propensity score (PS)-matched unaffected controls from a large population-based German cohort study, we here demonstrate discrepant findings regarding HR-SB in OPSCC. (2) Methods: According to the main risk factors for HNSCC (age, sex, tobacco smoking, and alcohol consumption) PS-matched healthy controls invited from the population-based cohort study LIFE and HNSCC (including OPSCC) patients underwent interviews, using AUDIT and Fagerström, as well as questionnaires asking for SB categories as published. Afterwards, by newly calculating PSs for the same four risk factors, we matched each OPSCC patient with two healthy controls and compared responses utilizing chi-squared tests and logistic regression. (3) Results: The HNSCC patients and controls showed significant differences in sex distribution, chronologic age, tobacco-smoking history (pack years), and alcohol dependence (based on AUDIT score). However, PS-matching decreased the differences between OPSCC patients and controls substantially. Despite confirming that OPSCC patients were more likely to self-report their first sexual intercourse before age 18, we found no association between OPSCC and HR-SB, neither for practicing oral-sex, having an increased number of oral- or vaginal-sex partners, nor for having casual sex or having any sexually transmitted disease. (4) Conclusions: Our data, by showing a low prevalence of HR-SB in OPSCC patients, confirm findings from other European studies that differ substantially from North American case-control studies. HR-SB alone may not add excess risk for developing OPSCC.
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Affiliation(s)
- Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Jasmin Rudolph
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Sylvia Henger
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Christoph Engel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Kerstin Wirkner
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - John Ross Wenning
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Samira Zeynalova
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Markus Loeffler
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Härtelstr. 16-18, 04107 Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Liebigstr. 10-14, 04103 Leipzig, Germany
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
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Modifiable risk factors for oral cavity cancer in non-smokers: A systematic review and meta-analysis. Oral Oncol 2023; 137:106300. [PMID: 36638697 DOI: 10.1016/j.oraloncology.2022.106300] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Oral cavity cancer (OCC) is traditionally associated with smoking, but there is an increasing prevalence of the disease among non-smokers. This review investigates possible modifiable risk factors in the development of OCC in non-smokers (OCCNS). METHODS PubMed, EMBASE, Web of Science, and Scopus were searched for publications prior to June 2021. Comparative studies investigating modifiable OCCNS risk factors were identified following PRISMA guidelines. Publication date, population size, and results were indexed. Study quality was assessed using MINORS (Methodological Index for Non-Randomized Studies). Factors examined by multiple studies were analyzed using random-effect meta-analysis framework. RESULTS Literature search resulted in 1,625 unique publications. 52 records met inclusion criterion, investigating alcohol (n = 22), chewing products (n = 18), diet (n = 7), dental health (n = 11), and medical comorbidities (n = 6). CONCLUSION This review demonstrates the paucity of large studies investigating OCCNS risk factors. Further investigation is warranted to help clinicians risk-stratify patients without traditional risk factors.
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Antunović M, Raonić J, Vučković L. Prognostic significance of HPV16 infection in oral squamous cell carcinoma. BALKAN JOURNAL OF DENTAL MEDICINE 2023. [DOI: 10.5937/bjdm2301038a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Background/Aim: Many studies confirmed strong association between oncogenic genotypes of Human Papillomaviruses (HPVs) and some oropharyngeal and oral squamous cell carcinomas (OSCCs). The aim of this study was to determine the prognostic significance of HPV16 infection in OSCC in population of Montenegro i.e. correlation between HPV16 infection and disease free interval (DFI), disease recurrence and metastasis occurrence. Material and Methods: We examined surgically obtained specimens from 60 patients with OSCC (localized on the lower lip, tongue or/and floor of the mouth) in six years period. Tumor tissue samples were used for histological analysis and HPV16 genome PCR detection (primers for detection of E6 gene). Patients were followed up for the 3 years. Results: HPV16 infection was more commonly detected in females with OSCC (p=0.038), while no correlation between this infection and disease recurrence (p= 0.122) and/or metastasis occurrence (p= 0.934) was found. DFI was not significantly different between patients with or without HPV16 infection (p= 0.427), but DFI was significantly shorter (p= 0.003) in females with oral HPV16 infection compared to male patients with this infection. Conclusions: Counting that HPV16 infection has a negative prognostic significance in OSCC, the HPV immunization program against genital HPV infection, would also have a positive impact on the frequency of HPV-mediated OSCC in Montenegrin population.
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7
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Antunović M, Lopičić M, Vučković L, Raonić J, Mugoša S. Prevalence and clinical implications of the HPV16 infection in oral cancer in Montenegro – Evidence to support the immunization program. Acta Microbiol Immunol Hung 2022; 69:241-246. [PMID: 35895465 DOI: 10.1556/030.2022.01794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
Abstract
Oral squamous cell carcinoma (OSCC) makes 85–95% of all malignances in the oral cavity. Increasing evidence shows that the Human Papillomaviruses (HPVs) are preferentially associated with some oropharyngeal and OSCCs, namely the genotype 16. The aim of the present study was to determine the prevalence and clinical implications of HPV16 infection in oral squamous cell carcinoma in population of Montenegro.
This study included 60 patients with OSCC (localized on the lower lip, tongue or/and floor of the mouth), surgically treated at the Clinical Centre of Montenegro from 2012 to 2018. Surgically obtained formalin-fixed and paraffin-embedded specimens were used for histopathological analysis and HPV16 genome detection using standard Polymerase Chain Reaction (primers for detection of E6 gene). Each individual was further followed up for the period of three years and for different clinico-pathological characteristics, including disease free interval (DFI).
The prevalence of HPV16 infection in OSCCs was 23.3% and the infection was significantly more common in female patients (P = 0.038). No significant correlation was detectable between HPV16 infection and the patients' age (P = 0.302), tumor site (P = 0.125), tumor grade (P = 0.363) and disease stage (P = 0.995). Observing the total sample the DFI was not significantly different for HPV16-positive versus HPV16-negative patients (P = 0.427), but a gender-based difference in DFI was observed, with the significantly shorter DFI (Log Rank test, P = 0.003) in HPV16 positive female patients compared to male patients (P = 0.003).
The results obtained in this study provide scientific evidence for the development of national HPV vaccination program in Montenegro.
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Affiliation(s)
| | - Milena Lopičić
- Institute of Public Health of Montenegro, Podgorica, Montenegro
| | | | - Janja Raonić
- Clinical Centre of Montenegro, Podgorica, Montenegro
| | - Snežana Mugoša
- Institute for Medicines and Medical Devices of Montenegro, Podgorica, Montenegro
- Medical Faculty of the University of Montenegro, Podgorica, Montenegro
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Morán-Torres A, Pazos-Salazar NG, Téllez-Lorenzo S, Jiménez-Lima R, Lizano M, Reyes-Hernández DO, Marin-Aquino JDJ, Manzo-Merino J. HPV oral and oropharynx infection dynamics in young population. Braz J Microbiol 2021; 52:1991-2000. [PMID: 34482527 PMCID: PMC8578222 DOI: 10.1007/s42770-021-00602-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 08/27/2021] [Indexed: 12/24/2022] Open
Abstract
The incidence of human papillomavirus (HPV)-associated cancers, especially those from the head and neck region, has increased. The relatively early age of presentation of HPV-positive head and neck cancer (HNC) indicates that viral infection might be acquired early in life. Persistent HPV infection has been recognized as the main risk factor for cancer development, but most studies have focused on evaluating HPV persistence in the genital region. Thus, in this work, we aimed to evaluate the prevalence of HPV in oral cavity and oropharynx in a young population, as well as the possible persistence of the infection after 12 months. Our results indicate that almost half (46.8%) of the analyzed population harbors an HPV infection either in the oral cavity or in the oropharynx. Furthermore, after 1 year of initial identification, half of them eliminated the infection, and only one person (5.26%) exhibited persistence. Interestingly, 50% of the individuals who successfully eliminated the infection acquired a new viral type, indicating that even when the primary infection is effectively eliminated by the immune system, there is a dynamic circulation of HR-HPV types that produce reinfection. This dynamic HPV infection among young individuals could influence the future establishment of cancer in some proportion of the cases.
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Affiliation(s)
- Adriana Morán-Torres
- Departamento de Microbiología, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Av. San Claudio, Edificio FCQ1, Ciudad Universitaria, 72570, Puebla, Mexico
- Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Nidia G Pazos-Salazar
- Departamento de Microbiología, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Av. San Claudio, Edificio FCQ1, Ciudad Universitaria, 72570, Puebla, Mexico
| | - Susana Téllez-Lorenzo
- Departamento de Microbiología, Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Av. San Claudio, Edificio FCQ1, Ciudad Universitaria, 72570, Puebla, Mexico
| | - Roberto Jiménez-Lima
- Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Marcela Lizano
- Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico
| | - Diego O Reyes-Hernández
- Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - José de J Marin-Aquino
- Departamento de Patologia, Hospital General "Dr. Manuel Gea Gonzalez", Calzada de Tlalpan 4800, Belisario Dominguez secc 1, Tlalpan, 14080, Mexico City, , Mexico
| | - Joaquín Manzo-Merino
- Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
- Cátedras CONACyT-Instituto Nacional de Cancerología, San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
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Prevalence of HPV in Mexican Patients with Head and Neck Squamous Carcinoma and Identification of Potential Prognostic Biomarkers. Cancers (Basel) 2021; 13:cancers13225602. [PMID: 34830760 PMCID: PMC8616077 DOI: 10.3390/cancers13225602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Head and neck squamous cell carcinomas (HNSCC) are a heterogeneous group of neoplasms that show diverse clinical and biological characteristics associated with human papillomavirus (HPV). Biological and clinical characterization is essential to stratify patients based on prognostic and predictive factors. The biological features of HNSCC may change according to geography and population characteristics. Studies on the molecular biology of HNSCC in Mexico are scarce. In the present study, we analyzed 414 Mexican patients with HNSCC and determined the presence and genotype of HPV, p16 expression, and global gene expression profiles. Twenty-two percent of total cases were HPV+, and 32% were p16+. We identified genes associated with survival, such as SLIRP, KLF10, AREG, ACT1, and LIMA. In addition, CSF1R, MYC, and SRC genes were identified as potential therapeutic targets. This study offers information that may be relevant for our understanding of the biology of HNSCC and the development of therapeutic strategies. Abstract Head and neck squamous cell carcinomas (HNSCC) show a variety of biological and clinical characteristics that could depend on the association with the human papillomavirus (HPV). Biological and clinical characterization is essential to stratify patients based on prognostic and predictive factors. Reports on HNSCC are scarce in Mexico. Herein, we analyzed 414 Mexican patients with HNSCC, including oropharynx (OPSCC), larynx (LASCC), and oral cavity (OCSCC), and identified HPV DNA and p16 expression. Global gene expression profiles were analyzed in 25 HPV+/p16+ vs. HPV−/p16− cases. We found 32.3% p16+ and 22.3% HPV+ samples, HPV 16, 18, 39, 52, and 31 being the most frequent genotypes. For OPSCC, LASCC and OCSCC, 39.2, 14.7, and 9.6% were HPV+/p16+, respectively. High expression of SLIRP, KLF10, AREG, and LIMA was associated with poor survival; in contrast, high expression of MYB and SYCP2 correlated with better survival. In HPV+ cases, high expression of SLC25A39 and GJB2 was associated with poor survival. Likewise, EGFR, IL-1, IL-6, JAK-STAT, WNT, NOTCH, and ESR1 signaling pathways were downregulated in HPV+ cases. CSF1R, MYC, and SRC genes were identified as key hubs and therapeutic targets. Our study offers information regarding the molecular and clinical characteristics of HNSCC in Mexican patients.
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10
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Oral squamous cell carcinoma in patients aged 45 and younger: Prognosis, survival, and quality of life. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:518-525. [PMID: 34758935 DOI: 10.1016/j.oooo.2021.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To perform a detailed analysis of the epidemiology, tumor biology, treatment, overall survival, and quality of life in a young patient (age ≤45 years) cohort with oral squamous cell carcinoma (OSCC). STUDY DESIGN A retrospective cohort study between 1992 and 2017 at an academic tertiary care center. RESULTS In total, 80 patients were included (36 female and 44 male) with stage I (American Joint Committee on Cancer eighth ed.) disease and lateral tongue was most common presentation. Mean follow-up was 6.28 years. The overall disease recurrence rate was 28.7% (23 of 80). Human papillomavirus was positive in 22% of patients tested. Free flap reconstruction was not associated with improved margin status (P = .62) but significant for recurrent disease (P < .04). Overall 2-year survival was significantly poorer in patients with close/positive margin status and free flap reconstruction. Patients with early-stage disease (stage II) requiring adjuvant radiotherapy, chemotherapy (all stages), or flap reconstruction (Stage III patients) had significantly worse 5-year survival rates. CONCLUSIONS OSCC in young patients (age ≤45 years) is an increasingly more common disease that occurs in patients without known risk factors. Despite their earlier presentation of disease pathology, constant vigilance and standard aggressive treatment similar to other age groups will result in similar and improved outcomes and survival.
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11
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Human papillomavirus co-infection and survival in oral and oropharyngeal squamous cell carcinoma: A study in 235 Brazilian patients. Auris Nasus Larynx 2021; 49:258-270. [PMID: 34274177 DOI: 10.1016/j.anl.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES While unknown for oropharyngeal squamous cell carcinoma (OPSCC) and oral squamous cell carcinoma (OSCC), some studies assessing cervical carcinoma have shown that human papillomavirus (HPV) co-infection can be associated with its prognosis. METHODS Through in situ hybridization (HPV and Epstein-Barr virus [EBV] probes) and immunohistochemistry (p16INK4a, cyclin D1, p53, and Ki-67 antibodies), 126 OPSCC and 109 OSCC samples were assessed. RESULTS All patients were EBV-negative. OPSCC (25%) showed a significant association with HPV compared to OSCC (11%). Almost all HPV-associated cases were p16INK4a-positive. Regarding OPSCC and OSCC, 23 and 7 cases were positive for high-risk HPV (HRHPV) only, 6 and 3 cases for low-risk HPV (LRHPV) only, and 3 and 2 cases for HRHPV/LRHPV, respectively. HPV-associated carcinomas showed a significantly higher proliferative index than HPV-unassociated carcinomas. Both carcinomas showed a similar overall survival rate, which was not affected by the HPV status. However, when comparing HPV-associated subgroups, patients with HRHPV/LRHPV-associated carcinomas showed worse survival. CONCLUSION LRHPV-associated and HRHPV/LRHPV-associated cases can also be detected when assessing OSCC and OPSCC. Further studies, especially in populations with a high prevalence of HPV-associated OPSCC, are necessary to understand the clinicopathological behavior of these neoplasm subgroups.
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Tokuzen N, Nakashiro KI, Tojo S, Goda H, Kuribayashi N, Uchida D. Human papillomavirus-16 infection and p16 expression in oral squamous cell carcinoma. Oncol Lett 2021; 22:528. [PMID: 34055093 PMCID: PMC8138897 DOI: 10.3892/ol.2021.12789] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Abstract
Human papillomavirus (HPV) is a possible carcinogenetic factor in oral squamous cell carcinoma (OSCC). Previous studies have reported the prevalence of HPV in patients with OSCC. However, the association between HPV and OSCC remains controversial. The present study aimed to clarify the association between HPV infection, p16 protein expression and the clinicopathological characteristics of OSCC. The expression level of HPV-16E6 mRNA and p16 protein, a known surrogate marker of HPV infection, was investigated in 100 OSCC cases using TaqMan reverse transcription-quantitative PCR and immunohistochemistry staining, respectively. HPV-16E6 mRNA expression level was only detected in one case (1%), and positive expression of p16 was found in 10 cases (10%), including an HPV-positive case. Subsequently, the association between p16 expression level and clinicopathological characteristic factors were analyzed; however, no significant association was found. These results suggested that HPV-16 infection was less likely to cause OSCC in Japan and p16 expression was not a suitable marker for HPV infection in OSCC.
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Affiliation(s)
- Norihiko Tokuzen
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Koh-Ichi Nakashiro
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Shin Tojo
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Hiroyuki Goda
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Nobuyuki Kuribayashi
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Daisuke Uchida
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
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Cortés-Gutiérrez EI, Garza Molina JG, Dávila-Rodríguez MI, Zapata Benavides P, Faz Eguía JM, Cerda-Flores RM. DBD-FISH, an effective marker for detecting genotoxicity in buccal mucosa exfoliated cells of patients with oral cancer. Toxicol Mech Methods 2021; 31:343-348. [PMID: 33297797 DOI: 10.1080/15376516.2020.1862379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is characterized by increased genetic instability as an essential variable of event of neoplastic transformation. The aim of this study was to evaluate genomic instability in exfoliated cells from the buccal mucosa of patients with OSCC vs. the control group, using DNA Breakage Detection/Fluorescence In Situ hybridization (DBD-FISH). Exfoliated cells from the buccal mucosa were obtained from 38 patients with oral cancer (case group) and from 10 individuals without oral lesions (control group). DNA damage was evaluated by DBD-FISH using the whole-genome DNA probe and digital imaging analysis. Collaterally, HPV infection was determined utilizing the INNO-LiPA HPV kit. Patients with OSCC showed an increase in the hybridization signal five times more intense than that of the baseline level of DNA damage detected in control individuals. The best cutoff value for predicting oral squamous cell carcinoma was 67.46, and an Odds Ratio (OR) value of 87. HPV detection analysis revealed than one patient with OSCC (2.6%) was positive for HPV. All controls were negative HPV. In conclusion, DBD-FISH permitted the clear visualization of level high of DNA damage in the buccal epithelial cells of patients with OSSC respect to control group. Chromosome instability in oral mucosa may be an individual marker of malignant transformation in OSCC.
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Affiliation(s)
| | - Jorge G Garza Molina
- Faculty of Biological Sciences, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | | | - José M Faz Eguía
- Instituto Mexicano del Seguro Social Medical Unit of Specialty High No. 25 (UMAE-25), Monterrey, México
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Rodrigues MSA, Nascimento RS, Fonseca RRS, Silva-Oliveira GC, Machado LFA, Kupek E, Fischer B, Oliveira-Filho AB. Oral HPV among people who use crack-cocaine: prevalence, genotypes, risk factors, and key interventions in a remote Northern Brazilian region. Clin Oral Investig 2020; 25:759-767. [PMID: 33222054 DOI: 10.1007/s00784-020-03698-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/17/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study estimated the prevalence, genotype distribution, and the factors associated with oral human papillomavirus (HPV) in people who use crack-cocaine (PWUCC) in a remote Brazilian region. MATERIALS AND METHODS This cross-sectional study used community-based snowball sampling methods for participant recruitment. Socio-demographic, economic, drug use, and health-related information was collected from 278 PWUCC in the cities of Bragança and Capanema in northern Brazil. HPV diagnosis and genotyping were performed by a real-time polymerase chain reaction. Logistic regression identified the factors independently associated with oral HPV. RESULTS In total, 111 (39.9%) PWUCC had HPV DNA. Several genotypes were identified, some of them with high oncogenic potential. Crack-cocaine use ≥40 months, unprotected sex, more than 10 sexual partners in the last 12 months, oral sex, exchange of sex for money or illicit drugs, oral mucosa lesions, not having access to public health services, and the absence of vaccination against HPV was all associated with HPV DNA. CONCLUSIONS This study identified important epidemiological characteristics of oral HPV infection among PWUCC-a highly marginalized risk population-underlining the high prevalence of oral HPV with oncogenic potential and the urgent need for control and prevention measures, especially vaccination against this virus. CLINICAL RELEVANCE It is necessary to understand the prevalence and risk factors of oral HPV in risk populations as people who use crack-cocaine.
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Affiliation(s)
- Mayara Sabrina A Rodrigues
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Rua Leandro Ribeiro, s/n. Aldeia, Bragança, PA, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Bragança, PA, Brazil
| | - Raquel Silva Nascimento
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Rua Leandro Ribeiro, s/n. Aldeia, Bragança, PA, Brazil
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança, PA, Brazil
| | - Ricardo Roberto S Fonseca
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, PA, Brazil
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brazil
| | - Gláucia C Silva-Oliveira
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Rua Leandro Ribeiro, s/n. Aldeia, Bragança, PA, Brazil
| | - Luiz Fernando A Machado
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, PA, Brazil
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Grafton, New Zealand
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
- Departamento de Psiquiatria, Federal Universidade de São Paulo, São Paulo, SP, Brazil
| | - Aldemir B Oliveira-Filho
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Rua Leandro Ribeiro, s/n. Aldeia, Bragança, PA, Brazil.
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança, PA, Brazil.
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Jung K, Narwal M, Min SY, Keam B, Kang H. Squamous cell carcinoma of head and neck: what internists should know. Korean J Intern Med 2020; 35:1031-1044. [PMID: 32663913 PMCID: PMC7487309 DOI: 10.3904/kjim.2020.078] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
Squamous cell carcinoma of head and neck (SCCHN) is a group of cancer arising from mucosal surfaces of the head and neck. Optimal management of SCCHN requires a multidisciplinary team of surgical oncologists, radiation oncologists, medical oncologists, nutritionist, and speech-language pathologists, due to the complexity of anatomical structure and importance of functional outcome. Human papilloma virus (HPV)-related SCCHN represents a distinct subset from HPV negative SCCHN which is associated with carcinogen exposure such as cigarette smoking, betel nut use and alcohol. HPV related SCCHN responds better to concurrent chemoradiation and has better overall prognosis, compared to HPV negative SCCHN. Radiation therapy has been introduced to the treatment of SCCHN, administered concurrently with systemic chemotherapy for locoregional SCCHN, as well as a palliative measure for recurrent and/or metastatic (R/M) SCCHN. Recently, immune checkpoint inhibitors have been shown to improve overall survival in R/M-SCCHN and have been incorporated into the standard of care. Combination approaches with immune therapy and targeted therapy for biomarker enriched population based on genomics are being actively investigated and will shape the future of SCCHN treatment.
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Affiliation(s)
- Kyungsuk Jung
- Department of Medicine, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Manpreet Narwal
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Seon Young Min
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyunseok Kang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Correspondence to Hyunseok Kang, M.D. Department of Medicine, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, USA Tel: +1-4158857356 Fax: +1-4153337984 E-mail:
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Bettampadi D, Villa LL, Ponce EL, Salmeron J, Sirak BA, Abrahamsen M, Rathwell JA, Reich RR, Giuliano AR. Oral human papillomavirus prevalence and type distribution by country (Brazil, Mexico and the United States) and age among HPV infection in men study participants. Int J Cancer 2020; 146:3026-3033. [PMID: 31583681 PMCID: PMC7117984 DOI: 10.1002/ijc.32713] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/03/2019] [Accepted: 09/13/2019] [Indexed: 01/20/2023]
Abstract
Incidence of human papillomavirus (HPV) attributable oropharyngeal cancers (OPCs) has been increasing globally, especially among men in high-income countries. There is a lack of studies comparing oral HPV prevalence by age and country among healthy men. The purpose of our study was to assess oral HPV prevalence by country and age. Participants of the HPV Infection in Men Study (HIM), a cohort of 3,098 healthy men from São Paulo, Brazil, Cuernavaca, Mexico and Tampa, USA, were studied. Oral HPV prevalence and type distribution were assessed using the SPF10 PCR-DEIA-LiPA25 system. The prevalence of any HPV in Brazil, Mexico and the US was 8.7% (95% CI: 7.1%, 10.4%), 10.0% (95% CI: 8.3%, 12.1%) and 7.6% (95% CI: 5.9%, 9.5%), respectively, while the prevalence of high-risk HPV was 5.3% (95% CI: 4.1%, 6.7%), 7.3% (95% CI: 5.7%, 9.0%) and 5.4% (95% CI: 4.0%, 7.0%), respectively. No significant differences in prevalence of grouped HPV types were observed by country despite significant differences in sexual behaviors. However, the age-specific prevalence of oral HPV differed by country. Brazilian (6.0% [95% CI: 3.4%, 9.7%]) and Mexican (9.2% [95% CI: 5.6%, 14.0%]) participants had peak high-risk HPV prevalence among men aged 41-50 years whereas the US participants had peak prevalence at ages 31-40 years (11.0% [95% CI: 6.4%, 17.3%]). In conclusion, oral HPV prevalence was low with no difference in overall prevalence observed by country. Factors associated with the differences in oral HPV age-patterning by country and sexual orientation require further study.
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Affiliation(s)
- Deepti Bettampadi
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Luisa L. Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eduardo L. Ponce
- Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico
| | - Jorge Salmeron
- Mexican Institute of Social Security, Mexico City, Mexico
| | - Bradley A. Sirak
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Martha Abrahamsen
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Julie A. Rathwell
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Anna R. Giuliano
- Center for Immunization and Infection Research in Cancer (CIIRC), H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Freitag J, Wald T, Kuhnt T, Gradistanac T, Kolb M, Dietz A, Wiegand S, Wichmann G. Extracapsular extension of neck nodes and absence of human papillomavirus 16-DNA are predictors of impaired survival in p16-positive oropharyngeal squamous cell carcinoma. Cancer 2020; 126:1856-1872. [PMID: 32032442 DOI: 10.1002/cncr.32667] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinomas (OPSCCs) demonstrate superior outcome compared with HPV-negative OPSCCs. The eighth edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor, lymph node, metastasis (TNM) classification (TNM 2017) modifies OPSCC staging based on p16 positivity as a surrogate for HPV-driven disease. In p16-negative OPSCCs, lymph node (N) categories include extracapsular/extranodal extension (ECE); and, in p16-positive OPSCCs, N categories are based on the number of positive neck lymph nodes omitting ECE status. The objective of the current study was to assess the prognostic impact of positive ECE status and the detection of HPV16 DNA in patients with p16-positive OPSCC. METHODS In a cohort of 92 patients with p16-positive, lymph node (N)-positive (stage III-IVB) OPSCC who underwent surgery and neck dissection, allowing for a pathologic examination of positive lymph nodes, 66 of 92 patients (71.4%) were p16-positive/HPV16 DNA-positive, 62 of 92 (67%) were ECE-positive, and 45 of 62 (72.6%) were ECE-positive, p16-positive, and HPV16 DNA-positive. Differences in outcome were assessed using Kaplan-Meier plots and Cox proportional hazard regression (CoxR) for tumor-specific survival and overall survival (OS). RESULTS The mean numbers of positive lymph nodes in ECE-positive patients (5.0 positive lymph nodes; 95% CI, 3.8-6.4 positive lymph nodes) and ECE-negative patients (2.4 positive lymph nodes; 95% CI, 1.8-2.9 positive lymph nodes) were different (P = .0007). ECE affected OS and tumor-specific survival in p16-positive patients (P = .007 and P = .047, respectively) and in p16-positive/HPV16 DNA-positive patients (P = .013 and P = .026, respectively). Related to the unequal distributions of ECE-positive/HPV16 DNA-negative tumors, the TNM 2017 failed to discriminate OS in patients with UICC stage I, II, and III disease (mean OS, 54.5, 73.4, and 45 months, respectively; median OS, 64.7 months, not reached, and 41.1 months, respectively). According to a univariate CoxR, the presence of ECE predicted impaired OS in patients with p16-positive OPSCC (hazard ratio, 3.40; 95% CI, 1.17-9.89; P = .025) and even greater impaired OS in those with p16-positive/HPV16 DNA-positive OPSCC (HR, 8.64; 95% CI, 1.12-66.40; P = .038). Multivariate CoxR confirmed ECE and HPV16 DNA detection as independent predictors. CONCLUSIONS ECE and HPV16 DNA status should be included in the prognostic staging of patients with p16-positive OPSCC because several lines of evidence demonstrate their impact on survival.
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Affiliation(s)
- Josefine Freitag
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Theresa Wald
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Thomas Kuhnt
- Department for Radiation Oncology, University Hospital Leipzig, Leipzig, Germany
| | - Tanja Gradistanac
- Department of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - Marlen Kolb
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Dietz
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Wiegand
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Gunnar Wichmann
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig, Leipzig, Germany
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Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, Huang KH, Tsai WC. Assessment of the Risk of Oral Cancer Incidence in A High-Risk Population and Establishment of A Predictive Model for Oral Cancer Incidence Using A Population-Based Cohort in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E665. [PMID: 31968579 PMCID: PMC7014279 DOI: 10.3390/ijerph17020665] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 12/13/2022]
Abstract
We aimed to assess the risk of oral cancer incidence in a high-risk population, establish a predictive model for oral cancer among these high-risk individuals, and assess the predictive ability of the constructed model. Individuals aged ≥30 years who had a habit of smoking or betel nut chewing and had undergone oral cancer screening in 2010 or 2011 were selected as study subjects. The incidence of oral cancer among the subjects at the end of 2014 was determined. The annual oral cancer incidence among individuals with a positive screening result was 624 per 100,000 persons, which was 6.5 times that of the annual oral cancer incidence among all individuals screened. Male sex, aged 45-64 years, divorce, low educational level, presence of diabetes, presence of other cancers, high comorbidity severity, a habit of smoking or betel nut chewing, and low monthly salary were high-risk factors for oral cancer incidence (p < 0.05). The area under the curve of the predictive model for oral cancer incidence was 0.73, which indicated a good predictive ability. Therefore, the oral cancer screening policy for the high-risk population with a habit of smoking and/or betel nut chewing is beneficial for the early diagnosis of oral cancer.
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Affiliation(s)
- Li-Chen Hung
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Chi-Hsuan Lung
- Department of Social Work, National Quemoy University, Quemoy 892, Taiwan;
| | - Ming-Hsui Tsai
- Department of Otolaryngology, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Shih-An Liu
- Department of ENT, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Li-Ting Chiu
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
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Zhu Y, Xia X, Gao L, Zhu X, Diao W, Liang Z, Gao Z, Chen X. Prognostic implications of human papillomavirus type 16 status in non-oropharyngeal head and neck cancer: a propensity score matching analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:759. [PMID: 32042775 DOI: 10.21037/atm.2019.11.72] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The purpose of this study was to investigate the association between HPV 16 status and survival outcomes in patients with non-oropharyngeal squamous carcinoma (non-OPSCC). Methods Patients with non-OPSCC diagnosed between 2006 and 2016 were included in this study. The presence of HPV 16 DNA was confirmed by quantitative real-time polymerase chain reaction. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching (PSM). Results Overall, 1,539 patients with adequate specimens were identified, of whom 131 (8.51%) were positive for HPV 16. Compared to HPV 16-negative patients, the adjusted hazard ratios (aHR) for HPV 16-positive non-OPSCC patients were 0.77 and 0.81 for disease-specific survival (DSS) and overall survival (OS), respectively. Additionally, the larynx was the only subsite in which DSS was significantly improved. After PSM, cohorts consisted of 129 patients in the HPV 16-positive group and 129 in the HPV 16-negative group. HPV 16-positive non-OPSCC patients had favorable survival outcomes, however, these outcomes were not significantly different compared to HPV 16-negative patients. Stratified analysis performed according to primary site showed that only in the larynx was HPV 16-positive status a significant factor for predicting favorable DSS. Conclusions Our findings indicate that HPV 16-positive non-OPSCC patients did not have significantly better survival outcomes compared to HPV 16-negative patients.
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Affiliation(s)
- Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Liming Gao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhiqiang Gao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, China
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Purwanto DJ, Soedarsono N, Reuwpassa JO, Adisasmita AC, Ramli M, Djuwita R. The prevalence of oral high‐risk HPV infection in Indonesian oral squamous cell carcinoma patients. Oral Dis 2019; 26:72-80. [DOI: 10.1111/odi.13221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Denni J. Purwanto
- Department of Surgical Oncology Dharmais National Cancer Hospital Jakarta Indonesia
| | - Nurtami Soedarsono
- Department of Oral Biology Faculty of Dentistry Universitas Indonesia Jakarta Indonesia
| | - Jauhari O. Reuwpassa
- Department of Surgical Oncology Dharmais National Cancer Hospital Jakarta Indonesia
| | - Asri C. Adisasmita
- Department of Epidemiology Faculty of Public Health Universitas Indonesia Depok Indonesia
| | - Muchlis Ramli
- Department of Surgical Oncology Cipto Mangunkusumo National Hospital‐Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Ratna Djuwita
- Department of Epidemiology Faculty of Public Health Universitas Indonesia Depok Indonesia
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21
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Zhu Y, Xia X, Gross N, Dahlstrom KR, Gao L, Liang Z, Gao Z, Wei P, Liu C, Li G, Li Y, Chen X. Prognostic implications of human papillomavirus status and p16 expression in laryngeal squamous cell carcinoma. Head Neck 2019; 41:4151-4163. [PMID: 31566825 DOI: 10.1002/hed.25961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/10/2019] [Accepted: 08/28/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate significance of HPV16 DNA/p16 for survival of patients with laryngeal squamous cell carcinoma (LSCC). METHODS HPV16 DNA and p16 status in 812 LSCC patients were determined. The survival was performed using Kaplan-Meier estimates and Cox model. RESULTS Compared with HPV negativity, adjusted HRs for HPV16 positivity were 0.57, 95% CI, 0.38 to 0.87; 0.60, 0.40 to 0.88; and 0.65, 0.46 to 0.94 for disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS), respectively. Additionally, for p16 expression, aHRs were 0.68, 95% CI, 0.48 to 0.96; 0.72, 0.52 to 0.98; and 0.73, 0.54 to 0.99 for DSS, RFS, and OS, respectively. Finally, for combined analysis, patients with both HPV16-positivity/p16-positivity had much better prognosis than those with either negativity. Such above survivals are more significantly better in never smokers. CONCLUSION Our findings suggest that HPV16/p16 may affect survival outcomes of LSCC patients, particularly in never smokers.
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Affiliation(s)
- Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Neil Gross
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristina R Dahlstrom
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Liming Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhiqiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Wei
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chuan Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guojun Li
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yuncheng Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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22
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Vidal Loustau AC, Dulguerov N, Curvoisier D, McKee T, Lombardi T. Low prevalence of HPV‐induced oral squamous cell carcinoma in Geneva, Switzerland. Oral Dis 2019; 25:1283-1290. [DOI: 10.1111/odi.13084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Ana C. Vidal Loustau
- Department of Surgery, Faculty of Medicine, Division of Oral Maxillofacial Surgery, Oral Maxillofacial Pathology Unit Geneva University Hospitals Geneva Switzerland
| | - Nicolas Dulguerov
- Department of Oto‐Rhino‐Laryngology – Head and Neck Surgery, Faculty of Medicine Geneva University Hospitals Geneva Switzerland
| | - Delphine Curvoisier
- Department of Surgery, Faculty of Medicine, Biostatistician, Division of Oral and Maxillofacial Surgery Geneva University Hospitals Geneva Switzerland
| | - Thomas McKee
- Faculty of Medicine, Division of Clinical Pathology Geneva University Hospitals Geneva Switzerland
| | - Tommaso Lombardi
- Department of Surgery, Faculty of Medicine, Division of Oral Maxillofacial Surgery, Oral Maxillofacial Pathology Unit Geneva University Hospitals Geneva Switzerland
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23
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Human Papillomavirus Detection in Head and Neck Squamous Cell Carcinomas at a Tertiary Hospital in Sub-Saharan Africa. ScientificWorldJournal 2019; 2019:2561530. [PMID: 31061653 PMCID: PMC6466863 DOI: 10.1155/2019/2561530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/23/2019] [Accepted: 03/12/2019] [Indexed: 01/03/2023] Open
Abstract
Fewer studies have been done over the years to establish the association of human papillomavirus (HPV) with head and neck squamous cell carcinoma (HNSSC) within the subregions of sub-Saharan Africa, and thus this study was designed to investigate the presence of HPV in HNSCC at a tertiary hospital in Ghana, providing additional evidence on the need to explore similar studies in other subregions. A retrospective cross-sectional study was employed to investigate the presence of the DNA of HPV genotypes in HNSCC archived tissue. A total of 100 HNSCC cases were classified as suitable for HPV genotyping. HPV-DNA was detected in 18% of the HNSCC cases, with 17 being HPV-16 and 1 dual infection with HPV-16 and HPV-18. HPV was prevalent in 50% of oropharyngeal cancers, 27% of laryngeal cancers, and 23% of oral cavity cancers. HPV E6/E7 oncogenic DNA was found in 18% of the HNSCC cases, with HPV-16 being the predominant genotype present. The pattern of HPV association was similar to earlier reported studies, recording a higher prevalence in oropharyngeal cancers, followed by laryngeal cancers and oral cavity cancers.
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24
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Ledesma-Montes C, Hernández-Guerrero JC, Durán-Padilla MA, Alcántara-Vázquez A. Squamous cell carcinoma of the tongue in patients older than 45 years. Braz Oral Res 2018; 32:e123. [DOI: 10.1590/1807-3107bor-2018.vol32.0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/24/2018] [Indexed: 11/21/2022] Open
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25
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Kundu S, Ramshankar V, Verma AK, Thangaraj SV, Krishnamurthy A, Kumar R, Kannan R, Ghosh SK. Association of DFNA5, SYK, and NELL1 variants along with HPV infection in oral cancer among the prolonged tobacco-chewers. Tumour Biol 2018; 40:1010428318793023. [PMID: 30091681 DOI: 10.1177/1010428318793023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Southeast Asia, especially India, is well known for the highest use of smokeless tobacco. These products are known to induce oral squamous cell carcinoma. However, not all long-term tobacco-chewers develop oral squamous cell carcinoma. In addition, germline variants play a crucial role in susceptibility, prognosis, development, and progression of the disease. These prompted us to study the genetic susceptibility to oral squamous cell carcinoma among the long-term tobacco-chewers. Here, we presented a retrospective study on prolonged tobacco-chewers of Northeast India to identify the potential protective or risk-associated germline variants in tobacco-related oral squamous cell carcinoma along with HPV infection. Targeted re-sequencing (n = 60) of 170 genetic regions from 75 genes was carried out in Ion-PGM™ and validation (n = 116) of the observed variants was done using Sequenom iPLEX MassARRAY™ platform followed by polymerase chain reaction-based HPV genotyping and p16-immunohistochemistry study. Subsequently, estimation of population structure, different statistical and in silico approaches were undertaken. We identified one nonsense-mediated mRNA decay transcript variant in the DFNA5 region (rs2237306), associated with Benzo(a)pyrene, as a protective factor (odds ratio = 0.33; p = 0.009) and four harmful (odds ratio > 2.5; p < 0.05) intronic variants, rs182361, rs290974, and rs169724 in SYK and rs1670661 in NELL1 region, involved in genetic susceptibility to tobacco- and HPV-mediated oral oncogenesis. Among the oral squamous cell carcinoma patients, 12.6% (11/87) were HPV positive, out of which 45.5% (5/11) were HPV16-infected, 27.3% (3/11) were HPV18-infected, and 27.3% (3/11) had an infection of both subtypes. Multifactor dimensionality reduction analysis showed that the interactions among HPV and NELL1 variant rs1670661 with age and gender augmented the risk of both non-tobacco- and tobacco-related oral squamous cell carcinoma, respectively. These suggest that HPV infection may be one of the important risk factors for oral squamous cell carcinoma in this population. Finally, we newly report a DFNA5 variant probably conferring protection via nonsense-mediated mRNA decay pathway against tobacco-related oral squamous cell carcinoma. Thus, the analytical approach used here can be useful in predicting the population-specific significant variants associated with oral squamous cell carcinoma in any heterogeneous population.
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Affiliation(s)
- Sharbadeb Kundu
- 1 Department of Biotechnology, Assam University, Silchar, India
| | | | | | | | | | - Rajeev Kumar
- 5 Department of Molecular Oncology, Cachar Cancer Hospital & Research Centre, Silchar, India
| | - Ravi Kannan
- 5 Department of Molecular Oncology, Cachar Cancer Hospital & Research Centre, Silchar, India
| | - Sankar Kumar Ghosh
- 1 Department of Biotechnology, Assam University, Silchar, India.,6 University of Kalyani, Nadia, India
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26
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Chen F, Lin L, Yan L, Liu F, Qiu Y, Wang J, Hu Z, Wu J, Bao X, Lin L, Wang R, Cai G, Aoyagi K, Cai L, He B. Nomograms and risk scores for predicting the risk of oral cancer in different sexes: a large-scale case-control study. J Cancer 2018; 9:2543-2548. [PMID: 30026853 PMCID: PMC6036893 DOI: 10.7150/jca.24431] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/29/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Although previous studies have explored the associations of modifiable lifestyle factors with oral cancer risk, few studies integrated these factors and established predictive tools for oral cancer risk in different sexes. Methods: Using a case-control study design, a total of 978 oral cancer cases and 2646 healthy controls were recruited in this study. Nomograms were constructed according to significant factors in multivariable logistic regression. Risk scores were calculated based on the nomograms and quantified the risk of oral cancer using restricted cubic spline. Results: Multivariate analyses demonstrated that smoking, alcohol drinking, tea, intake of fish, seafood, vegetables, fruits, teeth loss, regular dental visits and repetitive dental ulcer were independent factors for male oral cancer. Passive smoking, age at first intercourse, cooking oil fumes exposure, tea, intake of beans, vegetables, fruits, teeth loss, regular dental visits and repetitive dental ulcer were associated with female oral cancer. Then, two nomograms were developed for predicting the probability of oral cancer in men and women with the C-index of 0.768 (95% CI: 0.723-0.813) and 0.700 (95% CI: 0.635-0.765), respectively. Restricted cubic splines graphically revealed the risk of oral cancer in individuals with different risk scores. Moreover, the risk escalated continuously with the increasing number of the risk scores among both sexes. Conclusions: Combining nomograms with risk scores developed in this study could precisely predict oral cancer occurrence and provide an accurate risk assessment.
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Affiliation(s)
- Fa Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Lisong Lin
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lingjun Yan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Fengqiong Liu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Yu Qiu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jing Wang
- Laboratory Center, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Junfeng Wu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Xiaodan Bao
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Liangkun Lin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Rui Wang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Guoxi Cai
- Nagasaki Prefectural Institute of Environmental Research and Public Health; Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Lin Cai
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Baochang He
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.,Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
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27
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Appah EO, Ballard BR, Izban MG, Jolin C, Lammers PE, Parrish Jr DD, Marshall DR. A rapidly growing human papillomavirus-positive oral tongue squamous cell carcinoma in a 21-year old female: A case report. Oncol Lett 2018; 15:7702-7706. [PMID: 29849799 PMCID: PMC5962839 DOI: 10.3892/ol.2018.8339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 08/01/2017] [Indexed: 11/06/2022] Open
Abstract
Oral tongue squamous cell carcinoma (OTSCC) has a median age at diagnosis of 62 years. The incidence of OTSCC in young adults has been increasing, and the reason is unclear. The present study describes a case, and molecular analysis, of OTSCC in a 21-year-old female. Clinical and pathological information were collected from medical records. Formalin-fixed paraffin-embedded biopsy tissue from the patient was reassessed using standard hematoxylin & eosin staining, and immunohistochemistry was used to assess the expression of cellular p16, MutL homolog (MLH)1, MLH2, MutS homolog 6 (MSH6) and PMS1 homolog 2 (PMS2). The human papilloma virus (HPV) genome was detected by PCR analysis of the extracted DNA. The young age of the patient with OTSCC was unusual. The original pathology report indicated koilocytotic atypia, a cellular abnormality associated with HPV. Although HPV-positive oral cancer tends to occur in 'younger' individuals, 21 years is unusual. The confirmation of biologically active HPV in the tumor was obtained via the observation of strong positive staining for cellular p16. The patient described a maternal family cluster of rare cancer types, thus the possibility that this rapidly growing cancer resulted from HPV infection combined with an underlying genetic mutation causing decreased DNA-mismatch repair was explored. However, MSH1, MSH2, MSH6 and PSM2, proteins that are associated with Lynch Syndrome, were expressed at normal levels. A rapidly growing OTSCC of a 21-year-old female was determined to be HPV-positive. The patient underwent combination chemotherapy and radiation and has experienced long-term survival without recurrence. The reason this tumor grew so quickly in such a young individual remains unknown. These types of cases warrant additional genomic and proteomic studies to improve understanding of this phenomenon.
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Affiliation(s)
- Ebenezer O. Appah
- Department of Internal Medicine, Meharry Medical College, Nashville, TN 37208, USA
| | - Billy Ray Ballard
- Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, Nashville, TN 37208, USA
| | - Michael G. Izban
- Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, Nashville, TN 37208, USA
| | - Cassandra Jolin
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA
| | - Philip E. Lammers
- Department of Internal Medicine, Meharry Medical College, Nashville, TN 37208, USA
| | - Dwight D. Parrish Jr
- Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, Nashville, TN 37208, USA
| | - Dana R. Marshall
- Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, Nashville, TN 37208, USA,Correspondence to: Dr Dana R. Marshall, Department of Pathology, Anatomy and Cell Biology, Meharry Medical College, 1005 Dr. DB Todd Jr. Boulevard, Nashville, TN 37208, USA, E-mail:
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28
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Chen X, Gao L, Sturgis EM, Liang Z, Zhu Y, Xia X, Zhu X, Chen X, Li G, Gao Z. HPV16 DNA and integration in normal and malignant epithelium: implications for the etiology of laryngeal squamous cell carcinoma. Ann Oncol 2018; 28:1105-1110. [PMID: 28327951 PMCID: PMC5406756 DOI: 10.1093/annonc/mdx027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Molecular evidence suggests that human papillomavirus (HPV) has a role in the etiology of oropharyngeal squamous cell carcinoma. However, the role of HPV in laryngeal squamous cell carcinoma (LSCC) is unclear. Patients and methods We conducted a case–control study using tumor tissue specimens from 300 LSCC patients and vocal cord polyp specimens from 300 cancer-free controls. HPV genotype, HPV16 viral load and viral integration status, and p16 expression were determined. Results The prevalence of HPV (all types) was higher in cases than controls [21 (7.0%) versus 10 (3.3%), adjusted odds ratio (aOR) 2.37, 95% CI 1.08–5.21]. The prevalence of HPV16 was higher in cases than controls [20 (6.7%) versus 8 (2.7%), aOR 2.84, 95% CI 1.21–6.68]. The risk of LSCC associated with HPV16 DNA positivity was even higher in patients aged 55 years or younger (aOR 3.52, 95% CI 1.07–11.54), males (aOR 4.74, 95% CI 1.33–16.90), never-smokers (aOR 5.57, 95% CI 1.41–22.10), and never-drinkers (aOR 3.72, 95% CI 1.09–12.72). HPV DNA was partly or fully integrated in all 20 HPV16-positive cases but was episomal in all 8 HPV16-positive controls; however, the HPV16-positive cases and controls had similar viral loads (P = 0.28). P16 immunostaining was positive in 31 of the 300 cases (10.3%) and negative in all 300 controls. Conclusion These results suggest that prior infection with HPV16 may play a role in the etiology of some LSCC. This larger case–control study will offer for the first time the possibility to address in depth the understanding of a tissue-specific role of HPV in laryngeal carcinogenesis. Further studies with larger samples are needed to confirm these findings.
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Affiliation(s)
- X Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - L Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - E M Sturgis
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Z Liang
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Y Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - X Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - X Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - X Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - G Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Z Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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29
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Castillejos-García I, Ramírez-Amador VA, Carrillo-García A, García-Carrancá A, Lizano M, Anaya-Saavedra G. Type-specific persistence and clearance rates of HPV genotypes in the oral and oropharyngeal mucosa in an HIV/AIDS cohort. J Oral Pathol Med 2018; 47:396-402. [PMID: 29380908 DOI: 10.1111/jop.12687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral high-risk human papillomavirus (HR-HPV) infections are frequent and persistent among the HIV-positive population and are associated with an increased risk for head and neck cancer (HNC). In this study, we sought to determine the incidence, persistence and clearance of HPV infections in oral and oropharyngeal samples from HIV/AIDS subjects. METHODS A longitudinal, observational and analytical study was performed with an ongoing cohort of HIV/AIDS subjects in Mexico City (September 2013-February 2015). The study was approved by institutional committees, and demographic and clinical data were registered. At the baseline and three-month visits, oral examinations and cytobrush samples were obtained. DNA was purified, quantified and used to detect an HPV-L1 gene fragment by nested PCR, using MY09/MY11 and GP5 + /GP6 + primers. HPV DNA products were purified, sequenced and typed according to HPV databases. Risk factors were assessed, and a multivariate modelling approach was used to determine independent effects. RESULTS This study included 97 HIV/AIDS individuals (91% men [86.4% of which are men who have sex with men], median age: 36 years, 72.2% under HAART). From the baseline visit, HPV was observed in 55.7% (HR-HPV: 26.8%; HPV-18: 24.1%), with a higher HPV-positive samples for smokers (61.1 vs 32.6%, P = .005). The three-month overall HPV incidence was 33.9%; type-specific HPV persistence was 33.3% (HR-HPV: 13.3%); and 13 of the 33 (39.4%) baseline HPV-positive individuals cleared the infection (HR-HPV: 53.8%). CONCLUSIONS Although HR-HPV persistence was low, and clearance of the infection was observed in most cases, a close follow-up is necessary, given the increase in HNC among HIV-subjects, particularly HPV-related cancer.
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Affiliation(s)
- Itzel Castillejos-García
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Velia A Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Adela Carrillo-García
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Alejandro García-Carrancá
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Marcela Lizano
- Biomedical Research Unit, Instituto Nacional de Cancerología (INCan)/Instituto de Investigaciones Biomédicas, UNAM, México City, Mexico
| | - Gabriela Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana, Mexico City, Mexico
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30
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Prevalence of oral HPV infection among healthy individuals and head and neck cancer cases in the French West Indies. Cancer Causes Control 2017; 28:1333-1340. [PMID: 28948421 DOI: 10.1007/s10552-017-0966-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/16/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Human papillomavirus (HPV) is known to play a role in the development of head and neck squamous cell carcinomas (HNSCC) and to date, no study has reported on the association between oral HPV infection and HNSCC in the Caribbean. The objective was to determine the prevalence of oral HPV infection in the French West Indies (FWI), overall and by HPV genotype, among HNSCC cases and healthy population controls. METHOD We used data from a population-based case-control study conducted in the FWI. The prevalence of oral HPV was estimated separately among 100 HNSCC cases (mean age 59 years) and 308 population controls (mean age 57 years). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using a logistic regression adjusting for age, sex, tobacco, and alcohol consumption, to assess the association between oral HPV infection and HNSCC. RESULTS Prevalence of oral HPV infections was 26% in controls (30% in men and 14% in women) and 36% in HNSCC cases (36% in men, 33% in women). HPV52 was the most commonly detected genotype, in cases and in controls. The prevalence of HPV16, HPV33, and HPV51 was significantly higher in cases than in controls (p = 0.0340, p = 0.0472, and 0.0144, respectively). Oral infection with high-risk HPV was associated with an increase in risk of HNSCC (OR 1.99, 95% CI 0.95-4.15). HPV16 was only associated with oropharyngeal cancer (OR 16.01, 95% CI 1.67-153.64). CONCLUSION This study revealed a high prevalence of oral HPV infection in this middle-aged Afro-Caribbean population, and a specific distribution of HPV genotypes. These findings may provide insight into HNSCC etiology specific to the FWI.
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31
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Lin FPY, Pokorny A, Teng C, Epstein RJ. TEPAPA: a novel in silico feature learning pipeline for mining prognostic and associative factors from text-based electronic medical records. Sci Rep 2017; 7:6918. [PMID: 28761061 PMCID: PMC5537364 DOI: 10.1038/s41598-017-07111-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 06/21/2017] [Indexed: 12/13/2022] Open
Abstract
Vast amounts of clinically relevant text-based variables lie undiscovered and unexploited in electronic medical records (EMR). To exploit this untapped resource, and thus facilitate the discovery of informative covariates from unstructured clinical narratives, we have built a novel computational pipeline termed Text-based Exploratory Pattern Analyser for Prognosticator and Associator discovery (TEPAPA). This pipeline combines semantic-free natural language processing (NLP), regular expression induction, and statistical association testing to identify conserved text patterns associated with outcome variables of clinical interest. When we applied TEPAPA to a cohort of head and neck squamous cell carcinoma patients, plausible concepts known to be correlated with human papilloma virus (HPV) status were identified from the EMR text, including site of primary disease, tumour stage, pathologic characteristics, and treatment modalities. Similarly, correlates of other variables (including gender, nodal status, recurrent disease, smoking and alcohol status) were also reliably recovered. Using highly-associated patterns as covariates, a patient's HPV status was classifiable using a bootstrap analysis with a mean area under the ROC curve of 0.861, suggesting its predictive utility in supporting EMR-based phenotyping tasks. These data support using this integrative approach to efficiently identify disease-associated factors from unstructured EMR narratives, and thus to efficiently generate testable hypotheses.
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Affiliation(s)
- Frank Po-Yen Lin
- Department of Oncology, St Vincent's Hospital & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
| | - Adrian Pokorny
- Department of Oncology, St Vincent's Hospital & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia
| | - Christina Teng
- Department of Medical Oncology, Liverpool Hospital, Liverpool, Sydney, NSW, Australia
| | - Richard J Epstein
- Department of Oncology, St Vincent's Hospital & The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
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Jiang S, Dong Y. Human papillomavirus and oral squamous cell carcinoma: A review of HPV-positive oral squamous cell carcinoma and possible strategies for future. Curr Probl Cancer 2017; 41:323-327. [PMID: 28416242 DOI: 10.1016/j.currproblcancer.2017.02.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/24/2017] [Indexed: 11/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is a common cancer worldwide. Besides tobacco use and alcohol consumption, human papillomavirus (HPV) infection has also been identified as a risk factor for OSCC recently. The OSCC incidence has increased in recent years, especially among younger women. The purpose of this article is to review clinical and epidemiological studies on the association between HPV infection and OSCCs, and the efficacy of HPV vaccine, so as to provide possible policy implications for preventing HPV-positive OSCC. It is necessary to review the present related body of knowledge to determine whether the association between HPV infection and OSCC has been thoroughly studied. The study was based on literature review. Studies were identified using electronic databases including MEDLINE, PubMed, EMBASE, etc. The inclusion and exclusion criteria were based on consultation from a panel of experts in this area and carefully designed. Based on a systematic review of literatures, HPV infection is a possible cause for the incidence of HPV-positive OSCCs. The prevalence of HPV infection possibly contributed to the increasing trends of HPV-positive OSCCs. Oral HPV infection is a form of HPV transmission. Oral sex behaviors and open-mouthed kissing are probably reasons for oral HPV infection. We also have some epidemiological evidences proving that HPV vaccine provides a possible solution for preventing oral HPV infection. Increased awareness of HPV-positive OSCCs is essential due to the severity of this problem. Biological and epidemiological data regarding the link between sexual behavior and HPV-associated cancers indicate a probable connection, although definitive data are needed. Future studies are needed to investigate the mechanisms of how HPV infection causes HPV-positive OSCCs, whether HPV vaccine provides a prevention for OSCCs, and other important issues.
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Affiliation(s)
- Shan Jiang
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Yong Dong
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Chen F, Yan L, Liu F, Huang J, Liu F, Wu J, Qiu Y, Zheng X, Cai L, Lin L, He B. Oral human papillomavirus infection, sexual behaviors and risk of oral squamous cell carcinoma in southeast of China: A case-control study. J Clin Virol 2016; 85:7-12. [PMID: 27788480 DOI: 10.1016/j.jcv.2016.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/14/2016] [Accepted: 10/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The causal association between human papillomavirus (HPV) and oral squamous cell carcinoma (OSCC) remains controversial. Most of previous studies did not consider the potential modification effect of sexual behaviors when evaluating the role of HPV infection in OSCC risk. OBJECTIVES To explore the independent and joint effects of oral HPV infection and sexual behaviors on OSCC in Chinese population. STUDY DESIGN A case-control study was conducted from September 2012 to September 2015 in Fujian, China. HPV DNA genotypes were detected in tumor tissues of 178 OSCC patients and oral exfoliated cells of 189 frequency-matched controls using flow-through hybridization and gene chip. Epidemiologic data were collected with a structured questionnaire by face-to-face interviews. Odds ratios (ORs) and 95% confidence interval (CI) were estimated with unconditional logistic regression models. RESULTS The overall HPV prevalence was 14.04% in OSCC patients and 3.17% in controls. HPV-18 was the most prevalent type in cases and controls (10.67% vs. 2.12%). Oral HPV infection was strongly associated with an increased risk of OSCC: the ORs were 7.21 (95% CI: 2.61-19.88) for HPV16/18 and 7.59 (95% CI: 2.34-24.64) for HPV-18. Moreover, the significant associations were only observed in females, young adults, married population, merchants, non-smokers, non-alcohol drinkers and non-tea drinkers. Additionally, the first intercourse below 22years of age and oral sex practice did not show an association with OSCC. But there was a significantly multiplicative interaction between HPV 16/18 and age at first intercourse for OSCC (Pinteraction<0.001). CONCLUSIONS Oral HPV infection (specifically type 18) is an independent risk factor for OSCC in Fujian area. Furthermore, there might be a combined effect of HPV 16/18 and age at first intercourse on OSCC.
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Affiliation(s)
- Fa Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Lingjun Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Fengqiong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Jiangfeng Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Fangping Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Junfeng Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Yu Qiu
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Xiaoyan Zheng
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Lin Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China
| | - Lisong Lin
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China.
| | - Baochang He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fujian, China.
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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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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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Fuentes-Pananá EM, Larios-Serrato V, Méndez-Tenorio A, Morales-Sánchez A, Arias CF, Torres J. Assessment of Epstein-Barr virus nucleic acids in gastric but not in breast cancer by next-generation sequencing of pooled Mexican samples. Mem Inst Oswaldo Cruz 2016; 111:200-8. [PMID: 26910355 PMCID: PMC4804503 DOI: 10.1590/0074-02760150405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/12/2016] [Indexed: 12/21/2022] Open
Abstract
Gastric (GC) and breast (BrC) cancer are two of the most common and deadly tumours.
Different lines of evidence suggest a possible causative role of viral infections for
both GC and BrC. Wide genome sequencing (WGS) technologies allow searching for viral
agents in tissues of patients with cancer. These technologies have already
contributed to establish virus-cancer associations as well as to discovery new tumour
viruses. The objective of this study was to document possible associations of viral
infection with GC and BrC in Mexican patients. In order to gain idea about cost
effective conditions of experimental sequencing, we first carried out an in
silico simulation of WGS. The next-generation-platform IlluminaGallx was
then used to sequence GC and BrC tumour samples. While we did not find viral
sequences in tissues from BrC patients, multiple reads matching Epstein-Barr virus
(EBV) sequences were found in GC tissues. An end-point polymerase chain reaction
confirmed an enrichment of EBV sequences in one of the GC samples sequenced,
validating the next-generation sequencing-bioinformatics pipeline.
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Affiliation(s)
- Ezequiel M Fuentes-Pananá
- Unidad de Investigación en Virología y Cáncer, Hospital Infantil de México Federico Gómez, México, DF, México
| | - Violeta Larios-Serrato
- Laboratorio de Biotecnología y Bioinformática Genómica, Unidad Profesional Lázaro Cárdenas, Escuela Nacional de Ciencias Biológicas, México, DF, México
| | - Alfonso Méndez-Tenorio
- Laboratorio de Biotecnología y Bioinformática Genómica, Unidad Profesional Lázaro Cárdenas, Escuela Nacional de Ciencias Biológicas, México, DF, México
| | - Abigail Morales-Sánchez
- Unidad de Investigación en Virología y Cáncer, Hospital Infantil de México Federico Gómez, México, DF, México
| | - Carlos F Arias
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de Mexico, Cuernavaca, Morelos, México
| | - Javier Torres
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, México, DF, México
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Marques MDPC, Bussoloti Filho I, Rossi LM, Andreoli MA, Cruz NO. Comparative study between biopsy and brushing sampling methods for detection of human papillomavirus in oral and oropharyngeal cavity lesions. Braz J Otorhinolaryngol 2015; 81:598-603. [PMID: 26475771 PMCID: PMC9442710 DOI: 10.1016/j.bjorl.2015.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 10/08/2014] [Indexed: 10/25/2022] Open
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Cáncer oral en un hospital general de zona del Instituto Mexicano del Seguro Social en México, (1988-2005). GACETA MEXICANA DE ONCOLOGÍA 2015. [DOI: 10.1016/j.gamo.2015.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sun Y, Zhang Y, Liu L, Song X, Li G. Genetic polymorphisms and HPV infection in oral squamous cell carcinomas. Curr Opin Virol 2015; 14:1-6. [DOI: 10.1016/j.coviro.2015.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/11/2015] [Accepted: 05/21/2015] [Indexed: 12/22/2022]
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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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Khyani IAM, Qureshi MA, Mirza T, Farooq MU. Salivary detection of human Papilloma virus 16 & 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos? Pak J Med Sci 2015; 31:1104-9. [PMID: 26648995 PMCID: PMC4641264 DOI: 10.12669/pjms.315.7093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 12/24/2014] [Accepted: 07/09/2015] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To evaluate salivary detection of HPV-16 & 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. METHODS This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' & 'C' having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions (PML). Group 'B' includes histologically proven oral squamous cell carcinoma (OSCC) and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples were centrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 & 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. RESULTS In group 'A', HPV-16 was detected in 3 (8.6%) cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 (20%) while HPV-18 was found in 06 (17.1%) cases. Mixed HPV-16 and HPV-18 were found in 02 (5.7%) cases. In group 'C', HPV-16 was detected in 03(8.6%) while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection (P= 0.002) while for HPV-16, no significant association was found (P= 0.245). CONCLUSION HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and difficult evaluation of the acquisition of viral load due to socio-cultural and religious restrictions could be the reason.
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Affiliation(s)
- Iqbal A. Muhammad Khyani
- Dr. Iqbal A. Muhammad Khyani, MBBS, DLO, FCPS, FRCS. Associate Professor, Department of E.N.T, Head & Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital, Karachi – Pakistan
| | - Masood A. Qureshi
- Prof. Masood A. Qureshi, M.Sc, PhD. Professor and Head, Department of Physiology, Dow University of Health Sciences, Dow International Medical College, Karachi – Pakistan
| | - Talat Mirza
- Prof. Talat Mirza, MBBS, M.Phil, PhD. Professor and Head, Department of Pathology, Dow University of Health Sciences, Dow International Medical College, Karachi – Pakistan
| | - M. Umar Farooq
- Prof. Dr. M. Umar Farooq, MBBS, DLO, FCPS, FICS, FRCS. Head of Department, ENT-Head & Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital, Karachi – Pakistan
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Gan LL, Zhang H, Guo JH, Fan MW. Prevalence of human papillomavirus infection in oral squamous cell carcinoma: a case-control study in Wuhan, China. Asian Pac J Cancer Prev 2015; 15:5861-5. [PMID: 25081714 DOI: 10.7314/apjcp.2014.15.14.5861] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
High risk forms of the human papilloma virus (HPV) are generally accepted as necessary causative agents for cervical cancer. Recently, a possible relation between HPV and oral squamous cell carcinoma (OSCC) has also been noticed. The present study was conducted to investigate the prevalence of HPV infection in OSCCs in Wuhan city. DNA samples were collected from fresh tissues in 200 patients with OSCC and 68 normal controls. The polymerase chain reaction and direct sequencing were used to identify the HPV types in the samples. The prevalence of HPV of all types in the OSCC group was higher than in the control group (55/200 vs 2/68, OR=11.5, 95% CI=2.6-50.2). HPV16 and HPV18 were the main types detected, with HPV6 was the only low-risk type identified. High-risk HPV types HPV16 and HPV18 are prevalent in OSCC patients and may participate in the development of OSCC with traditional risk factors, tobacco and alcohol, possibly exerting synergistic effects. The results of multinomial logistic regression showed that those who smoked, consumed alcohol and with HPV infection have the highest risk of developing oral cancer (OR=13.3, 95% CI=3.1-56.8). Adjusted for age, smoking and alcohol use, HPV infection was independently associated with oral squamous cell carcinoma.
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Affiliation(s)
- Li-Li Gan
- Hubei-MOST KLOS and KLOBME, School and Hospital of Stomatology, Wuhan University, Wuhan, China E-mail :
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Human papillomavirus status and p16INK4A expression in patients with mucosal squamous cell carcinoma of the head and neck in Queensland, Australia. Cancer Epidemiol 2015; 39:174-81. [DOI: 10.1016/j.canep.2015.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/19/2015] [Accepted: 01/21/2015] [Indexed: 12/20/2022]
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Gonzalez-Losa MDR, Barrera ES, Herrera-Pech V, Conde-Ferráez L, Puerto-Solís M, Ayora-Talavera G. Epidemiology of oral HPV in the oral mucosa in women without signs of oral disease from Yucatan, Mexico. Braz J Microbiol 2015. [PMID: 26221121 PMCID: PMC4512083 DOI: 10.1590/s1517-838246120130976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
High-risk human papillomaviruses (HR-HPV) are considered necessary for the development of cervical cancer. Furthermore, there is no doubt that some types of oral squamous cell carcinoma are associated with HR-HPV. The epidemiology of oral HPV infections in healthy subjects remains unclear due to a lack of knowledge. The objective of this study was to investigate the epidemiology of human papillomavirus infections of the oral mucosa without pathology. A cross-sectional study was performed; samples from 390 women seeking prenatal care, Pap smears, family planning or gynecological diseases were studied. Oral cells were collected by direct swab sampling. Information regarding sociodemographic status, sexual behavior, infectious diseases, contraceptive history and tobacco and alcohol consumption were obtained through direct interviews. HPV and genotypes were detected by type-specific polymerase chain reaction. Our results revealed that 14% of the women studied had an oral HPV infection. Women ≤ 20 years of age had the highest HPV prevalence (24.5%). In total, seven genotypes were identified, including the high-risk genotypes 16, 18, 58 and 59 and the low-risk genotypes 6, 81 and 13, the latter of which is a type exclusive to oral mucosa. Sexual behavior was not associated with the presence of genital HPV types in the oral mucosa. Genital HPV types were present in the oral mucosa of women without associated clinical manifestations; however, sexual behavior was not associated with infection, and therefore others routes of transmission should be explored.
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Affiliation(s)
- María Del Refugio Gonzalez-Losa
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | | | - Verónica Herrera-Pech
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Laura Conde-Ferráez
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Marylin Puerto-Solís
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
| | - Guadalupe Ayora-Talavera
- Laboratorio de Virología, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Universidad Autónoma de Yucatán, Yucatán, México
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Ramqvist T, Grün N, Dalianis T. Human papillomavirus and tonsillar and base of tongue cancer. Viruses 2015; 7:1332-43. [PMID: 25803099 PMCID: PMC4379573 DOI: 10.3390/v7031332] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/13/2015] [Accepted: 03/17/2015] [Indexed: 12/11/2022] Open
Abstract
In 2007, human papillomavirus (HPV) type 16 was recognized as a risk factor by the International Agency for Research on Cancer, for oropharyngeal squamous cell carcinoma (OSCC), where tonsillar and base of tongue cancer (TSCC and BOTSCC) dominate. Furthermore, patients with HPV-positive TSCC and BOTSCC, had a much better clinical outcome than those with corresponding HPV-negative cancer and other head and neck cancer. More specifically, survival was around 80% for HPV-positive TSCC and BOTSCC vs. 40% five-year disease free survival, for the corresponding HPV-negative tumors with conventional radiotherapy and surgery, while this could not be observed for HPV-positive OSCC at other sites. In addition, the past 20-40 years in many Western Countries, the incidence of HPV-positive TSCC and BOTSCC has risen, and >70% are men. This has resulted in a relative increase of patients with HPV-positive TSCC and BOTSCC that may not need the intensified chemo-radiotherapy (with many more severe debilitating side effects) often given today to patients with head and neck cancer. However, before tapering therapy, one needs to enable selection of patients for such treatment, by identifying clinical and molecular markers that together with HPV-positive status will better predict patient prognosis and response to therapy. To conclude, there is a new increasing group of patients with HPV-positive TSCC and BOTSCC with good clinical outcome, where options for better-tailored therapy are needed. For prevention, it would be of benefit to vaccinate both girls and boys against HPV16 infection. For potential future screening the ways to do so need optimizing.
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Affiliation(s)
- Torbjörn Ramqvist
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden.
| | - Nathalie Grün
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden.
| | - Tina Dalianis
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska R8:01, Karolinska University Hospital, 171 76 Stockholm, Sweden.
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46
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Dalianis T. Human papillomavirus (HPV) and oropharyngeal squamous cell carcinoma. Presse Med 2014; 43:e429-34. [PMID: 25455638 DOI: 10.1016/j.lpm.2014.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022] Open
Abstract
Numerous reports in recent decades have shown that, in addition to smoking and alcohol, human papillomavirus (HPV) is also associated with the development of oropharyngeal squamous cell carcinoma (OPSCC), predominantly in the tonsils and base of the tongue. In 2007, the International Agency on Research against Cancer (IARC) therefore declared HPV to be a risk factor for OPSCC and noted that 80% of those affected are men. In addition, patients with HPV-positive OPSCC, in particular never-smokers, have a much better clinical response to therapy than patients with HPV-negative OPSCC and other head and neck cancers. Most patients with HPV-positive OPSCC may thus not need the increasingly intensive chemo-radiotherapy currently administered today to most patients with head neck cancers and associated with many adverse effects. Furthermore, an increase in the incidence of OPSCC has been observed in many western countries, accompanied by a rise in the proportion of HPV-positive tumors. Patients with HPV-positive OPSCC, like those with cervical cancer, more often have an earlier sexual debut and have more sexual partners. It has therefore been proposed that the increased incidence of OPSCC observed might be due to an epidemic of sexually transmitted HPV. The important issues today regarding this growing cohort of patients with HPV-positive OPSCC are therefore individualized treatment and prevention. More specifically, selected HPV-positive OPSCC patients with biomarkers of good prognosis might be included in randomized trials with less intensive treatment. HPV vaccination should also be considered for boys, in addition to the current recommendations for immunization of girls.
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Affiliation(s)
- Tina Dalianis
- Karolinska Institutet, Department of Oncology-Pathology, Cancer Center Karolinska, Karolinska University Hospital, 17176 Stockholm, Sweden.
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47
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DALIANIS TINA. Human papillomavirus and oropharyngeal cancer, the epidemics, and significance of additional clinical biomarkers for prediction of response to therapy (Review). Int J Oncol 2014; 44:1799-805. [PMID: 24676623 PMCID: PMC4063535 DOI: 10.3892/ijo.2014.2355] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 02/05/2014] [Indexed: 12/19/2022] Open
Abstract
In 2007, the International Agency for Research against Cancer (IARC) recognized human papillomavirus (HPV), especially HPV16, besides smoking and alcohol, as a risk factor for oropharyngeal squamous cell carcinoma (OPSCC), where tonsillar and base of tongue cancer dominate. Moreover, during the past decade, in many Western countries, a sharp rise in the incidence of OPSCC, more specifically of HPV-positive OPSCC has been observed. Notably, patients with HPV-positive OPSCC, where the majority are men, particularly never-smokers have a better clinical outcome than patients with HPV-negative OPSCC and other head neck cancer (roughly 80 vs. 40% disease-free survival with conventional radiotherapy and surgery). This suggests that many patients with HPV-positive OPSCC may not require the more aggressive intensified chemo-radiotherapy given to head neck cancer patients today, and could with somewhat tapered treatment maintain excellent survival, avoiding some of the severe side effects along with intensified treatment. However, before de-intensified treatment is administered additional biomarkers are necessary in combination with HPV-positive status in order to predict and select patients that will respond favorably to therapy. In conclusion, noteworthy issues within this field with an increasing cohort of patients with HPV-positive OPSCC are better-tailored therapy and prevention. Patients with HPV-positive OPSCC, with biomarkers for good response to therapy e.g., low MHC class I, or CD44 expression or high numbers of CD8+ tumor infiltrating lymphocytes, could be included in randomized trials with less severe therapy. Furthermore, possibilities to screen for HPV-positive OPSCC and to vaccinate boys against HPV infection should be further investigated.
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Affiliation(s)
- TINA DALIANIS
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska, Karolinska University Hospital, 171 76 Stockholm,
Sweden
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48
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HPV positive tonsillar cancer in two laser surgeons: case reports. J Otolaryngol Head Neck Surg 2013; 42:54. [PMID: 24246045 PMCID: PMC3843579 DOI: 10.1186/1916-0216-42-54] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 11/14/2013] [Indexed: 01/09/2023] Open
Abstract
A 53 year-old male gynecologist presented with human papillomavirus (HPV) 16 positive tonsillar squamous cell carcinoma. He had no identifiable risk factors with the exception of long term occupational exposure to laser plumes, having performed laser ablations and loop electrosurgical excision procedures (LEEP) on greater than 3000 dysplastic cervical and vulvar lesions over 20 years of practice. The second patient is a 62 year old male gynecologist with a 30 year history of laser ablation and LEEP who subsequently developed HPV 16 positive base of tongue cancer. He also had very few other risk factors for oropharyngeal cancer or HPV infection. HPV is a probable causative agent for oropharyngeal squamous cell carcinoma and has been reported as being transmittable through laser plume. This paper suggests that HPV transmitted through laser plume can result in subsequent squamous cell carcinoma.
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49
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Lee LA, Huang CG, Tsao KC, Liao CT, Kang CJ, Chang KP, Huang SF, Chen IH, Fang TJ, Li HY, Yang SL, Lee LY, Hsueh C, Chen TC, Lin CY, Fan KH, Wang HM, Ng SH, Chang YL, Lai CH, Shih SR, Yen TC. Increasing rates of low-risk human papillomavirus infections in patients with oral cavity squamous cell carcinoma: Association with clinical outcomes. J Clin Virol 2013; 57:331-7. [DOI: 10.1016/j.jcv.2013.04.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 03/18/2013] [Accepted: 04/16/2013] [Indexed: 02/08/2023]
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50
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Lee SM, Park JS, Norwitz ER, Koo JN, Oh IH, Park JW, Kim SM, Kim YH, Park CW, Song YS. Risk of vertical transmission of human papillomavirus throughout pregnancy: a prospective study. PLoS One 2013; 8:e66368. [PMID: 23785495 PMCID: PMC3681772 DOI: 10.1371/journal.pone.0066368] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 05/05/2013] [Indexed: 11/19/2022] Open
Abstract
Objective Much controversy still exists about maternal-to-infant transmission of human papillomavirus (HPV) infection, specifically about the magnitude of the risk and the route and timing of such vertical transmission. This prospective cohort study examines the risk of vertical transmission of maternal HPV in each trimester of pregnancy. Study design One hundred fifty three healthy pregnant women were followed longitudinally throughout pregnancy and cervical swabs obtained in each trimester and postpartum for HPV detection. Cord blood, neonatal nasopharyngeal aspirates, and placental biopsies were collected at delivery. DNA isolation, polymerase chain reaction, and hybridization were performed using the GG HPV Genotyping Chip Kit (Goodgene Inc., Seoul, Korea). Detection of HPV in neonates was defined as the presence of HPV DNA in either cord blood or neonatal nasopharyngeal aspirate. Results HPV DNA was detected in 14%(22/153) of healthy women in the first trimester, 18%(22/124) in the second trimester, and 10%(15/153) in the third trimester; 24%(37/153) were positive for HPV DNA on at least one occasion in pregnancy. At birth, 5.2%(8/153) of neonates were HPV DNA positive. Seven of these eight infants were born to HPV-positive mothers. Placental HPV DNA was positive in 3.3%(5/152) of cases, and all five cases were from mothers with at least one HPV-positive test. Detection of HPV DNA in neonates was associated with detection of HPV in mothers during any of the three trimesters of pregnancy. Conclusion HPV DNA was detected at birth in 5.2%(8/153) of neonates born to healthy women, and was associated with the detection of HPV in mothers during any of the three trimesters of pregnancy.
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Affiliation(s)
- Seung Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
| | - Errol R. Norwitz
- Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | | | | | - Jeong Woo Park
- Department of Obstetrics and Gynecology, Inje University College of Medicine, Ilsan-Paik Hospital, Gyeonggi, Korea
| | - Sun Min Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Hwan Kim
- Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea
| | - Chan-Wook Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Sang Song
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Major in Biomodulation, World Class University, Seoul National University, Seoul, Korea
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