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Rosing F, Meier M, Schroeder L, Laban S, Hoffmann T, Kaufmann A, Siefer O, Wuerdemann N, Klußmann JP, Rieckmann T, Alt Y, Faden DL, Waterboer T, Höfler D. Quantification of human papillomavirus cell-free DNA from low-volume blood plasma samples by digital PCR. Microbiol Spectr 2024; 12:e0002424. [PMID: 38829114 DOI: 10.1128/spectrum.00024-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/23/2024] [Indexed: 06/05/2024] Open
Abstract
The incidence rate of human papillomavirus-driven oropharyngeal cancer (HPV-OPC) is increasing in countries with high human development index. HPV cell-free DNA (cfDNA) isolated from 3 to 4 mL blood plasma has been successfully used for therapy surveillance. A highly discussed application of HPV-cfDNA is early detection of HPV-OPC. This requires sensitive and specific cfDNA detection as cfDNA levels can be very low. To study the predictive power of pre-diagnostic HPV-cfDNA, archived samples from epidemiological cohorts with limited plasma volume are an important source. To establish a cfDNA detection workflow for low plasma volumes, we compared cfDNA purification methods [MagNA Pure 96 (MP96) and QIAamp ccfDNA/RNA] and digital PCR systems (Biorad QX200 and QIAGEN QIAcuity One). Final assay validation included 65 low-volume plasma samples from oropharyngeal cancer (OPC) patients with defined HPV status stored for 2-9 years. MP96 yielded a 28% higher cfDNA isolation efficiency in comparison to QIAamp. Both digital PCR systems showed comparable analytical sensitivity (6-17 copies for HPV16 and HPV33), but QIAcuity detected both types in the same assay. In the validation set, the assay had 80% sensitivity (n = 28/35) for HPV16 and HPV33 and a specificity of 97% (n = 29/30). In samples with ≥750 µL plasma, the sensitivity was 85% (n = 17/20), while in samples with <750 µL plasma, it was 73% (n = 11/15). Despite the expected drop in sensitivity with decreased plasma volume, the assay is sensitive and highly specific even in low-volume samples and thus suited for studies exploring HPV-cfDNA as an early HPV-OPC detection marker in low-volume archival material.IMPORTANCEHPV-OPC has a favorable prognosis compared to HPV-negative OPC. However, the majority of tumors is diagnosed after regional spread, thus making intensive treatment necessary. This can cause lasting morbidity with a large impact on quality of life. One potential method to decrease treatment-related morbidity is early detection of the cancer. HPV cfDNA has been successfully used for therapy surveillance and has also been detected in pre-diagnostic samples of HPV-OPC patients. These pre-diagnostic samples are only commonly available from biobanks, which usually only have small volumes of blood plasma available. Hence, we have developed a workflow optimized for small-volume archival samples. With this method, a high sensitivity can be achieved despite sample limitations, making it suitable to conduct further large-scale biobank studies of HPV-cfDNA as a prognostic biomarker for HPV-OPC.
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Affiliation(s)
- Fabian Rosing
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Meier
- Department of Otorhinolaryngology and Head and Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center Ulm, University Medical Center Ulm, Ulm, Germany
| | - Lea Schroeder
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon Laban
- Department of Otorhinolaryngology and Head and Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center Ulm, University Medical Center Ulm, Ulm, Germany
| | - Thomas Hoffmann
- Department of Otorhinolaryngology and Head and Neck Surgery, Head and Neck Cancer Center of the Comprehensive Cancer Center Ulm, University Medical Center Ulm, Ulm, Germany
| | - Andreas Kaufmann
- Department of Gynecology, HPV Research Laboratory, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver Siefer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Nora Wuerdemann
- Department of Internal Medicine, Faculty of Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Thorsten Rieckmann
- Department of Radiobiology and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Otolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Alt
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniel L Faden
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
- Mass Eye and Ear, Boston, Massachusetts, USA
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniela Höfler
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Fonsêca TC, Jural LA, Marañón-Vásquez GA, Magno MB, Roza ALOC, Ferreira DMTP, Maia LC, Romañach MJ, Agostini M, Abrahão AC. Global prevalence of human papillomavirus-related oral and oropharyngeal squamous cell carcinomas: a systematic review and meta-analysis. Clin Oral Investig 2023; 28:62. [PMID: 38158517 DOI: 10.1007/s00784-023-05425-0] [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: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To conduct a systematic review to determine the global prevalence of HPV in oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS Literature was searched through October 2022 in main databases to address the question "What is the global prevalence of Human Papillomavirus in oral and oropharyngeal cancer?" Studies had to identify HPV by PCR, ISH, or p16 immunohistochemistry to be eligible. Quality was assessed using the JBI checklist for prevalence studies. Meta-analyses were performed, and reporting followed PRISMA guidelines. RESULTS Sixty-five studies were included, and most of them had methodological limitations related to sampling and the HPV detection tool. The pooled prevalence of HPV-positivity was 10% (event rate = 0.1; 95% CI: 0.07, 0.13; P < 0.01; I2 = 88%) in the oral cavity and 42% (event rate = 0.42; 95% CI: 0.36, 0.49; P = 0.02; I2 = 97%) in oropharynx. The highest HPV prevalence in OSCC was reached by Japan, meanwhile, in OPSCC, Finland and Sweden were the most prevalent. HPV16 is the genotype most frequent with 69% in OSCC and 89% in OPSCC, being the tonsils the intraoral location more affected by HPV (63%, p < 0.01, I2 76%). CONCLUSION The evidence points to an apparent burden in HPV-related OPSCC, mostly in North America, Northern Europe, and Oceania, especially due to the HPV16 infection suggesting different trends across continents. CLINICAL RELEVANCE This updated systematic review and meta-analysis provide sufficient evidence about the global HPV prevalence in OSCC and OPSCC and the most frequent HPV subtype worldwide.
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Affiliation(s)
- Thamyres Campos Fonsêca
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Guido Artemio Marañón-Vásquez
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil
| | - Aline Correa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Avenida Professor Rodolpho Paulo Rocco, 325, 1º Andar. Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, Brazil.
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Bussu F, Muresu N, Crescio C, Gallus R, Rizzo D, Cossu A, Sechi I, Fedeli M, Cossu A, Delogu G, Piana A. Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia. Cancers (Basel) 2022; 14:cancers14174205. [PMID: 36077741 PMCID: PMC9454854 DOI: 10.3390/cancers14174205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
HPV infection is a clear etiopathogenetic factor in oropharyngeal carcinogenesis and is associated with a markedly better prognosis than in smoking- and alcohol-associated cases, as specified by AJCC classification. The aim of the present work is to evaluate the prevalence of HPV-induced OPSCC in an insular area in the Mediterranean and to assess the reliability of p16 IHC (immunohistochemistry) alone, as accepted by AJCC, in the diagnosis of HPV-driven carcinogenesis in such a setting. All patients with OPSCC consecutively managed by the referral center in North Sardinia of head and neck tumor board of AOU Sassari, were recruited. Diagnosis of HPV-related OPCSS was carried out combining p16 IHC and DNA testing on FFPE samples and compared with the results of p16 IHC alone. Roughly 14% (9/62) of cases were positive for HPV-DNA and p16 IHC. Three more cases showed overexpression of p16, which has a 100% sensitivity, but only 75% specificity as standalone method for diagnosing HPV-driven carcinogenesis. The Cohen’s kappa coefficient of p16 IHC alone is 0.83 (excellent). However, if HPV-driven carcinogenesis diagnosed by p16 IHC alone was considered the criterion for treatment deintensification, 25% of p16 positive cases would have been wrongly submitted to deintensified treatment for tumors as aggressive as a p16 negative OPSCC. The currently accepted standard by AJCC (p16 IHC alone) harbors a high rate of false positive results, which appears risky for recommending treatment deintensification, and for this aim, in areas with a low prevalence of HPV-related OPSCC, it should be confirmed with HPV nucleic acid detection.
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Affiliation(s)
- Francesco Bussu
- Department of Medicine, Surgery and Pharmacy, University of Sassari-ENT Division, AOU Sassari, 07100 Sassari, Italy
| | - Narcisa Muresu
- Department of Humanities and Social Sciences, University of Sassari, 07100 Sassari, Italy
| | - Claudia Crescio
- Otolaryngology Division, Azienda Ospedaliera Universitaria, 07100 Sassari, Italy
- Correspondence: ; Tel.: +39-079-228-552
| | - Roberto Gallus
- Otolaryngology, Mater Olbia Hospital, 07026 Olbia, Italy
| | - Davide Rizzo
- Department of Medicine, Surgery and Pharmacy, University of Sassari-ENT Division, AOU Sassari, 07100 Sassari, Italy
| | - Andrea Cossu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Illari Sechi
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Mariantonietta Fedeli
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Antonio Cossu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giovanni Delogu
- Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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Therapeutic Vaccines for HPV-Associated Oropharyngeal and Cervical Cancer: The Next De-Intensification Strategy? Int J Mol Sci 2022; 23:ijms23158395. [PMID: 35955529 PMCID: PMC9368783 DOI: 10.3390/ijms23158395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
The rise in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) has prompted a quest for further understanding of the role of high-risk HPV in tumor initiation and progression. Patients with HPV-positive OPSCC (HPV+ OPSCC) have better prognoses than their HPV-negative counterparts; however, current therapeutic strategies for HPV+ OPSCC are overly aggressive and leave patients with life-long sequalae and poor quality of life. This highlights a need for customized treatment. Several clinical trials of treatment de-intensification to reduce acute and late toxicity without compromising efficacy have been conducted. This article reviews the differences and similarities in the pathogenesis and progression of HPV-related OPSCC compared to cervical cancer, with emphasis on the role of prophylactic and therapeutic vaccines as a potential de-intensification treatment strategy. Overall, the future development of novel and effective therapeutic agents for HPV-associated head and neck tumors promises to meet the challenges posed by this growing epidemic.
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5
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Morais E, Kothari S, Chen YT, Roberts CS, Gómez-Ulloa D, Fenoll R, Lara N, Pavón MÀ, Waterboer T, Mehanna H, Giuliano AR, Mirghani H, Alemany L. The BROADEN study: The design of an observational study to assess the absolute burden of HPV-related head and neck cancers. Contemp Clin Trials 2021; 115:106631. [PMID: 34838716 DOI: 10.1016/j.cct.2021.106631] [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] [Received: 06/24/2021] [Revised: 10/08/2021] [Accepted: 11/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Persistent human papillomavirus (HPV) infection is an important risk factor for a subset of head and neck cancers (HNCs). However, estimates of the HPV-attributable fraction of oropharyngeal cancers vary greatly, and the proportion is increasing. Growing evidence indicates smaller proportions of oral cavity and laryngeal cancers are also HPV-attributable, but this requires further investigation. The primary objective of the BROADEN study is to estimate the fraction of HNCs attributable to HPV in selected European and Asian countries by anatomic site. Secondary objectives are to determine HPV genotypes involved and to describe primary tumor and patient characteristics by HPV status. METHODS BROADEN is a non-interventional, cross-sectional study of patients with HNC in China, France, Germany, Italy, Japan, Portugal, and Spain. The HPV-attributable HNC fraction will be determined within pre-defined time-periods (2008-2009, 2013-2014 [China only], 2018-2019). Approximately 9000 patients from an estimated 90 hospitals with reference HNC diagnostic units and local reference pathology laboratories will participate. Sample size estimates were generated by grouped anatomic site (oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx) and country. HPV testing (HPV-DNA and p16 immunohistochemistry [IHC]) will be performed at a central laboratory on formalin-fixed paraffin-embedded tissue samples. All HPV-DNA-positive samples and HPV-DNA-negative/p16 IHC-positive samples, plus 10% of remaining HPV DNA-negative (control) samples will be tested for HPV mRNA. DISCUSSION BROADEN is a large global epidemiologic study to estimate current and recent past HPV burden in oropharyngeal and non-oropharyngeal HNCs. BROADEN is expected to provide robust estimates of HPV attributability by anatomic site in participating countries.
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Affiliation(s)
| | - Smita Kothari
- Merck & Co., Inc, 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Ya-Ting Chen
- Merck & Co., Inc, 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | - Craig S Roberts
- Merck & Co., Inc, 2000 Galloping Hill Road, 07033 Kenilworth, NJ, USA
| | | | - Raquel Fenoll
- IQVIA, Provença, 392, 3rd Floor, 08025 Barcelona, Spain
| | - Núria Lara
- IQVIA, Provença, 392, 3rd Floor, 08025 Barcelona, Spain.
| | - Miquel Àngel Pavón
- Cancer Epidemiology Research Program, Catalan Institute of Oncology - IDIBELL, Hospitalet de Llobregat; and CIBERESP, Granvia de l'Hospitalet, 199-203, 08908 Barcelona, Spain
| | - Tim Waterboer
- German Cancer Research Center (DKFZ), Im Neuenheimer Feld, 280, 69120 Heidelberg, Germany
| | - Hisham Mehanna
- Institute of Head & Neck Studies and Education (InHANSE), University of Birmingham, Robert Aitken Building, Vincent Drive, B15 2TT Birmingham, United Kingdom
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, 33612 Tampa, FL, USA
| | - Haïtham Mirghani
- Hôpital Européen Georges-Pompidou, 20 Rue Leblanc, 75015, Paris, France
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology - IDIBELL, Hospitalet de Llobregat; and CIBERESP, Granvia de l'Hospitalet, 199-203, 08908 Barcelona, Spain
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6
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Köksal MO, Yalçın BK, Keskin F, Çiftçi S, Yağcı I, Hasçiçek SÖ, Başaran B, Değer K, Ağaçfidan A, Quaas A, Akgül B. Genotype Distribution and Prevalence of Human Papillomavirus in Head and Neck Cancer Samples from Istanbul, Turkey. Pathogens 2021; 10:pathogens10121533. [PMID: 34959488 PMCID: PMC8706355 DOI: 10.3390/pathogens10121533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Human papillomavirus (HPV)-associated tumors account for a significant proportion of head and neck squamous cell carcinomas (HNSCC) in developed countries. In recent years, there has been a rise of HPV infections associated with HNSCC, especially HPV16, which is the most commonly detected type in oral and oropharyngeal cancers. To investigate the frequency of HPV-driven HNSCC among patients living in Turkey, HPV DNA positivity and p16INK4A expression were assessed in primary tumor biopsies (n = 106). Eighteen out of one hundred and six (19%) HNSCC tumors showed p16INK4A overexpression, and 26/106 cases (24.5%) were positive for HPV DNA. Sixteen out of twenty-six samples were positive for both HPV DNA and p16INK4A staining. HPV16 could be isolated from 22/26 samples (84.6%) and was found to be the most frequently detected HPV type. This study represents the largest cohort of Turkish patients with HNSCC characterized according to HPV status and p16INK4A expression. Our data suggest that HPV16 infection, along with smoking, contribute to the development of HNSCC.
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Affiliation(s)
- Muammer Osman Köksal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey; (M.O.K.); (A.A.)
| | - Başak Keskin Yalçın
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, 34116 Istanbul, Turkey;
| | - Fahriye Keskin
- Unit of Microbiology, Istanbul Faculty of Dentistry, Istanbul University, 34116 Istanbul, Turkey;
- Correspondence: ; Tel.: +90-5322059794
| | - Sevgi Çiftçi
- Unit of Microbiology, Istanbul Faculty of Dentistry, Istanbul University, 34116 Istanbul, Turkey;
| | - Ibrahim Yağcı
- Department of Otorhinolaryngology & Head and Neck Surgery, Sisli Hamidiye Training and Research Hospital, University of Health and Science, 34371 Istanbul, Turkey;
| | - Seyhan Özakkoyunlu Hasçiçek
- Department of Pathology, Sisli Hamidiye Training and Research Hospital, University of Health and Science, 34371 Istanbul, Turkey;
| | - Bora Başaran
- Department of Otorhinolaryngology & Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey; (B.B.); (K.D.)
| | - Kemal Değer
- Department of Otorhinolaryngology & Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey; (B.B.); (K.D.)
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey; (M.O.K.); (A.A.)
| | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, 50937 Cologne, Germany;
| | - Baki Akgül
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany;
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7
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Mohanty SK, Mishra SK, Bhardwaj N, Sardana R, Jaiswal S, Pattnaik N, Pradhan D, Sharma S, Kaushal S, Baisakh MR, Das S, Pradhan MR, Satapathy K, Pattnaik A, Sharma SK, Khadenga CR, Das S, Rath D, Nanda B, Parwani AV. p53 and p16 ink4a As Predictive and Prognostic Biomarkers for Nodal metastasis and Survival in A Contemporary Cohort of Penile Squamous Cell Carcinoma. Clin Genitourin Cancer 2021; 19:510-520. [PMID: 34348854 DOI: 10.1016/j.clgc.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/30/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human papilloma virus (HPV) infection is implicated in a proportion of invasive squamous cell carcinoma of the penis (PC). A subset of PC involves dysregulation of the p53 pathway. HPV in situ hybridization (ISH) and p16ink4a positivity are surrogate markers for HPV infection, and p53 immunohistochemistry (IHC) denotes abnormality in the p53 pathway. There remains an ambiguity with regard to the contribution of both the pathways in the prognosis of PC. We sought to analyze the clinicopathologic characteristics of a cohort of Indian PC patients with respect to p16 ink4a and p53 expression. PATIENTS AND METHODS A cohort of 123 PC patients was studied for p16ink4aand p53IHC and HPVISH. The results of these biomarkers were correlated with various clinicopathologic parameters. RESULTS p16ink4a and HPV ISH were positive in 47% and 53% of the tumors, respectively. The proportion of warty, basaloid, or mixed warty-basaloid tumor subtypes showed significant p16ink4apositivity (P < .0001) compared to other subtypes. Twenty-eight patients were dual negative (p53- /p16ink4a-), 32 were dual positive (p53+/p16ink4a+), 38 were p53+/p16ink4a-, and 25 were p53-/p16ink4a +. In patients where p16ink4a was negative, a p53-positive phenotype had a higher propensity for lymph node metastases (OR, 5.42; 95% CI, 1.75-16.80; P = .003). Similarly, p53 positivity dictates nodal involvement in the p16ink4a-positive subset of tumors (OR, 5.00; 95% CI, 1.23-20.17; P = .024). On multivariate analyses, pathologic subtypes (warty, warty-basaloid, and basaloid) (P < .0001), p16ink4aexpression (P < .0001), and absence of nodal metastasis (P < .0001) were significant predictors of improved overall (OS) and cancer specific survival (CSS). In Kaplan-Meier analysis, the OS was significantly longer in patients with p16ink4a + tumors (P < .0001), as was the CSS (P < .0001). Patients with dual positive tumors had a significantly higher OS (P < .001) and CSS (P = .012), in the entire cohort. In the node positive patients, dual positivity was associated with significantly higher OS (P < .0001); however, the median CSS for p53+/p16ink4a+tumors were not significantly different compared to p53- /p16ink4a- tumors (P = .064), although there was a trend towards improved CSS. CONCLUSIONS There is a strong concordance between p16ink4aIHC and HPV ISH results. p16ink4a status is an independent predictor of survival (OS and CSS) in our cohort of PCs. p53 is a predictor of nodal metastasis irrespective of p16 status. Dual positive tumors have a significantly better outcome in comparison to dual negative tumors.
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Affiliation(s)
- Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India; Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Sourav K Mishra
- Department of Medical Oncology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Nitin Bhardwaj
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Ruhani Sardana
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Sunil Jaiswal
- Department of Surgical Oncology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Niharika Pattnaik
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | | | - Shivani Sharma
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Manas R Baisakh
- Department of Pathology and Laboratory Medicine, Prolife Diagnostics, Bhubaneswar, India
| | - Suren Das
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Manas R Pradhan
- Department of Urology, Advanced Medical Research Institute, Bhubaneswar, India
| | | | - Ashis Pattnaik
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Shailendra K Sharma
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Chira R Khadenga
- Department of Radiation Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Subodh Das
- Department of Urology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Debadarshi Rath
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Biswajit Nanda
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Anil V Parwani
- Department of Pathology, Wexner Medical Center, Columbus, OH.
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8
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[HPV-related oropharyngeal squamous cell carcinoma-Incidence steadily rising]. HNO 2021; 69:599-608. [PMID: 34143237 DOI: 10.1007/s00106-021-01087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
The incidence of human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is steadily increasing worldwide and has already exceeded cervical cancer rates in the USA. Due to their tumor biology, HPV-positive tumors of the oropharynx, which have been included in the eighth edition of the AJCC/UICC (American Joint Committee on Cancer/Union Internationale Contre le Cancer) Staging Manual since 2018, represent a separate entity. Following biopsy, diagnostic confirmation is performed by immunohistochemical detection of p16 expression, with p16 acting as a surrogate marker. Therapeutically, surgical and radiotherapeutic approaches are considered equivalent in terms of efficacy. With a 5-year overall survival of up to 80%, patients with HPV-positive OPSCC have a better prognosis compared to patients with HPV-negative OPSCC, where survival rates are between 40 and 50%.
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9
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Cherif S, Amine A, Thies S, Taube ET, Braicu EI, Sehouli J, Kaufmann AM. Prevalence of human papillomavirus detection in ovarian cancer: a meta-analysis. Eur J Clin Microbiol Infect Dis 2021; 40:1791-1802. [PMID: 34086102 PMCID: PMC8346400 DOI: 10.1007/s10096-021-04282-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
We conducted a meta-analysis of published data to update and estimate the prevalence of HPV in ovarian cancer. A comprehensive literature search was performed according to the PRISMA guidelines. Eligible articles published from 1989 until 2020 by searching Web of Sciences, Pubmed, Embase, and the Cochrane Library Central databases were gathered. A pooled estimation of HPV prevalence with a 95% confidence interval (CI) was calculated based on a random effect model. Quantitative assessment of heterogeneity was explored using Cochrane test and I2. Additionally, publication bias, sensitivity, meta-regression, and subgroup analyses were also performed. Twenty-nine studies involving 2280 patients with ovarian cancer were included. The statistical heterogeneity was high (I2 = 88%, P<0.0001). The pooled prevalence of HPV in ovarian cancer cases was 15.9% (95% CI, 11–22). In subgroup analyses, the highest prevalence of HPV was reported by studies from Asia (30.9%; 95% CI, 20–44) and Eastern Europe (29.3%; 95% CI, 4.4–78). Furthermore, the most frequently detected HPV genotype was HPV16 (54%; 95% CI, 27.9–55), followed by HPV18 (23.2%; 95% CI, 18.8–28.2). Our meta-analysis suggests a great difference in the prevalence of HPV detected in ovarian cancer by different studies, which is not seen in strongly HPV-associated cancers such as cervical cancer. However, the prevalence varied markedly by geographic region. Considering the substantial heterogeneity found, more studies with control groups and precise assays measuring HPV mRNA expression are needed to further evaluate the link and causative aetiology between HPV and ovarian cancer.
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Affiliation(s)
- Soumia Cherif
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany.,Laboratory of Biochemistry, Environment, and Agrifood, Faculty of Sciences and Techniques-Mohammedia, Hassan II University, 8 Casablanca, Morocco
| | - Abdessamad Amine
- Laboratory of Biochemistry, Environment, and Agrifood, Faculty of Sciences and Techniques-Mohammedia, Hassan II University, 8 Casablanca, Morocco
| | - Sarah Thies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eliane T Taube
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute for Pathology, Charitéplatz 1, 10117, Berlin, Germany
| | - Elena Ioana Braicu
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Jalid Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Andreas M Kaufmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology, Augustenburger Platz 1, 13353, Berlin, Germany.
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10
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Tagliabue M, Mena M, Maffini F, Gheit T, Quirós Blasco B, Holzinger D, Tous S, Scelsi D, Riva D, Grosso E, Chu F, Lucas E, Ridder R, Rrehm S, Bogers JP, Lepanto D, Lloveras Rubio B, Vijay Kumar R, Gangane N, Clavero O, Pawlita M, Anantharaman D, Radhakrishna Pillai M, Brennan P, Sankaranarayanan R, Arbyn M, Lombardi F, Taberna M, Gandini S, Chiesa F, Ansarin M, Alemany L, Tommasino M, Chiocca S. Role of Human Papillomavirus Infection in Head and Neck Cancer in Italy: The HPV-AHEAD Study. Cancers (Basel) 2020; 12:E3567. [PMID: 33260360 PMCID: PMC7760748 DOI: 10.3390/cancers12123567] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 02/07/2023] Open
Abstract
Literature on the role of human papillomavirus (HPV) in head and neck cancer (HNC) in Italy is limited, especially for non-oropharyngeal tumours. Within the context of the HPV-AHEAD study, we aimed to assess the prognostic value of different tests or test algorithms judging HPV carcinogenicity in HNC and factors related to HPV positivity at the European Institute of Oncology. We conducted a retrospective cohort study (2000-2010) on a total of 696 primary HNC patients. Formalin-fixed, paraffin-embedded cancer tissues were studied. All HPV-DNA-positive and a random sample of HPV-DNA-negative cases were subjected to HPV-E6*I mRNA detection and p16INK4a staining. Multivariate models were used to assess for factors associated with HPV positivity and proportional hazards for survival and recurrence. The percentage of HPV-driven cases (considering HPV-E6*I mRNA positivity) was 1.8, 2.2, and 40.4% for oral cavity (OC), laryngeal (LC), and oropharyngeal (OPC) cases, respectively. The estimates were similar for HPV-DNA/p16INK4a double positivity. Being a non-smoker or former smoker or diagnosed at more recent calendar periods were associated with HPV-E6*I mRNA positivity only in OPC. Being younger was associated with HPV-E6*I mRNA positivity in LC. HPV-driven OPC, but not HPV-driven OC and LC, showed better 5 year overall and disease-free survival. Our data show that HPV prevalence in OPC was much higher than in OC and LC and observed to increase in most recent years. Moreover, HPV positivity conferred better prognosis only in OPC. Novel insights on the role of HPV in HNC in Italy are provided, with possible implications in the clinical management of these patients.
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Affiliation(s)
- Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Marisa Mena
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fausto Maffini
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (F.M.); (D.L.)
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Beatriz Quirós Blasco
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Dana Holzinger
- Deutsches Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany; (D.H.); (M.P.)
| | - Sara Tous
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Daniele Scelsi
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Debora Riva
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Enrica Grosso
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Francesco Chu
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Eric Lucas
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Ruediger Ridder
- Roche mtm laboratories, 69117 Mannheim, Germany; (R.R.); (S.R.)
- Ventana Medical Systems Inc./Roche Tissue Diagnostics, Tucson, AZ 85755, USA
| | - Susanne Rrehm
- Roche mtm laboratories, 69117 Mannheim, Germany; (R.R.); (S.R.)
| | - Johannes Paul Bogers
- Laboratory for Cell Biology and Histology, University of Antwerp, 2610 Antwerp, Belgium;
| | - Daniela Lepanto
- Division of Pathology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (F.M.); (D.L.)
| | | | - Rekha Vijay Kumar
- Kidwai Memorial Institute of Oncology, Bangalore, Karnataka 560029, India;
| | - Nitin Gangane
- Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra State 442102, India;
| | - Omar Clavero
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Michael Pawlita
- Deutsches Krebsforschungszentrum (DKFZ), 69120 Heidelberg, Germany; (D.H.); (M.P.)
| | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala 695012, India; (D.A.); (M.R.P.)
| | | | - Paul Brennan
- Section of Genetics, International Agency for Research on Cancer (IARC), 69372 Lyon, France;
| | | | - Marc Arbyn
- Unit of Cancer Epidemiology/Belgian Cancer Centre, Sciensano, 1050 Brussels, Belgium;
| | - Francesca Lombardi
- Data Management, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Miren Taberna
- Medical Oncology Department, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L’Hospitalet de Llobregat, 08035 Barcelona, Spain;
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Fausto Chiesa
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Mohssen Ansarin
- Division of Otolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (M.T.); (D.S.); (D.R.); (E.G.); (F.C.); (F.C.); (M.A.)
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology-Bellvitge Biomedical Research Institute (ICO-IDIBELL), L’Hospitalet de Llobregat, 08908 Barcenola, Spain; (M.M.); (B.Q.B.); (S.T.); (O.C.); (L.A.)
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), 69372 Lyon, France; (T.G.); (E.L.)
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
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11
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Menegaldo A, Schroeder L, Holzinger D, Tirelli G, Dal Cin E, Tofanelli M, Rigo S, Mantovani M, Stellin M, Del Mistro A, Dei Tos AP, Guerriero A, Niero M, Borsetto D, Da Mosto MC, Polesel J, Pawlita M, Waterboer T, Boscolo-Rizzo P. Detection of HPV16/18 E6 Oncoproteins in Head and Neck Squamous Cell Carcinoma Using a Protein Immunochromatographic Assay. Laryngoscope 2020; 131:1042-1048. [PMID: 33103777 DOI: 10.1002/lary.29184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/24/2020] [Accepted: 09/25/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVES/HYPOTHESIS The accurate diagnostic assessment of clinically relevant human papillomavirus (HPV) infections in patients with head and neck squamous cell carcinoma represents an urgent unmet medical need. The aim of this study was to determine feasibility, accuracy, and clinical significance of HPV16/18 E6 oncoprotein detection on cytological specimens from oropharyngeal squamous cell carcinoma (OPSCC) and neck lymph node metastasis of SCC from unknown primary tumor (CUP) via a protein immunochromatographic assay. STUDY DESIGN Cross-sectional study. METHODS Cytological specimens from primary tumor and neck metastases were collected from 34 patients with OPSCC or CUP and applied to a lateral flow format test that detects HPV16 and HPV18 E6 oncoproteins. E6 oncoprotein positivity or negativity in these specimens was compared to the specimens' "HPV-driven" reference status, defined by presence of HPV-DNA in combination with p16INK4a overexpression and/or HPV E6 seropositivity. RESULTS Eighteen of 29 OPSCC (62%) and three of five CUP (60%) were HPV-driven according to our reference method. The E6 oncoprotein lateral flow test had a sensitivity of 94% (95% CI: 70%-100%) and a specificity of 100% (95% CI: 66%-100%) on primary tumor, and a sensitivity of 88% (95% CI: 64%-99%) and a specificity of 100% (95% CI: 74%-100%) on neck metastases. Test agreement between the E6 lateral flow test and the clinical reference method, HPV-DNA plus p16INK4a was excellent, both for primary lesion and neck metastases. CONCLUSIONS We found the detection of HPV16/18 E6 oncoproteins to be a feasible, highly reliable, and low-invasive method to assess "HPV-driven" status in OPSCC and CUP. LEVEL OF EVIDENCE II Laryngoscope, 131:1042-1048, 2021.
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Affiliation(s)
- Anna Menegaldo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Lea Schroeder
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dana Holzinger
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Giancarlo Tirelli
- Department of Otorhinolaryngology and Head and Neck Surgery, Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Trieste, Italy
| | - Elisa Dal Cin
- Department of Otorhinolaryngology and Head and Neck Surgery, Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Trieste, Italy
| | - Margherita Tofanelli
- Department of Otorhinolaryngology and Head and Neck Surgery, Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Trieste, Italy
| | - Stefania Rigo
- Department of Otorhinolaryngology and Head and Neck Surgery, Azienda Sanitaria Universitaria Integrata di Trieste-ASUITS, Trieste, Italy
| | - Monica Mantovani
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Marco Stellin
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | | | | | - Monia Niero
- Department of Pathology, University of Padova, Treviso, Italy
| | | | - Maria C Da Mosto
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
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12
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Fernández-Mateos J, Pérez-García J, Seijas-Tamayo R, Mesía R, Rubió-Casadevall J, García-Girón C, Iglesias L, Carral Maseda A, Adansa Klain JC, Taberna M, Vazquez S, Gómez MA, Del Barco E, Ocana A, González-Sarmiento R, Cruz-Hernández JJ. Oncogenic driver mutations predict outcome in a cohort of head and neck squamous cell carcinoma (HNSCC) patients within a clinical trial. Sci Rep 2020; 10:16634. [PMID: 33024167 PMCID: PMC7539152 DOI: 10.1038/s41598-020-72927-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/13/2020] [Indexed: 12/26/2022] Open
Abstract
234 diagnostic formalin-fixed paraffin-embedded (FFPE) blocks from homogeneously treated patients with locally advanced head and neck squamous cell carcinoma (HNSCC) within a multicentre phase III clinical trial were characterised. The mutational spectrum was examined by next generation sequencing in the 26 most frequent oncogenic drivers in cancer and correlated with treatment response and survival. Human papillomavirus (HPV) status was measured by p16INK4a immunohistochemistry in oropharyngeal tumours. Clinicopathological features and response to treatment were measured and compared with the sequencing results. The results indicated TP53 as the most mutated gene in locally advanced HNSCC. HPV-positive oropharyngeal tumours were less mutated than HPV-negative tumours in TP53 (p < 0.01). Mutational and HPV status influences patient survival, being mutated or HPV-negative tumours associated with poor overall survival (p < 0.05). No association was found between mutations and clinicopathological features. This study confirmed and expanded previously published genomic characterization data in HNSCC. Survival analysis showed that non-mutated HNSCC tumours associated with better prognosis and lack of mutations can be identified as an important biomarker in HNSCC. Frequent alterations in PI3K pathway in HPV-positive HNSCC could define a promising pathway for pharmacological intervention in this group of tumours.
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Affiliation(s)
- Javier Fernández-Mateos
- Medical Oncology Service, University Hospital of Salamanca-IBSAL, 37007, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain.,Molecular Medicine Unit-IBSAL, Department of Medicine, University of Salamanca, 37007, Salamanca, Spain.,Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, 37007, Salamanca, Spain
| | - Jéssica Pérez-García
- Molecular Medicine Unit-IBSAL, Department of Medicine, University of Salamanca, 37007, Salamanca, Spain.,Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, 37007, Salamanca, Spain
| | - Raquel Seijas-Tamayo
- Medical Oncology Service, University Hospital of Salamanca-IBSAL, 37007, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain
| | - Ricard Mesía
- Medical Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Universitat de Barcelona, IDIBELL, 08908, Barcelona, Spain
| | | | - Carlos García-Girón
- Medical Oncology Service, Hospital Universitario de Burgos, 09006, Burgos, Spain
| | - Lara Iglesias
- Medical Oncology Service, Hospital Universitario 12 de Octubre, 28041, Madrid, Spain
| | | | - Juan Carlos Adansa Klain
- Medical Oncology Service, University Hospital of Salamanca-IBSAL, 37007, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain
| | - Miren Taberna
- Medical Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Universitat de Barcelona, IDIBELL, 08908, Barcelona, Spain
| | - Silvia Vazquez
- Medical Oncology Department, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Universitat de Barcelona, IDIBELL, 08908, Barcelona, Spain
| | | | - Edel Del Barco
- Medical Oncology Service, University Hospital of Salamanca-IBSAL, 37007, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain
| | - Alberto Ocana
- Hospital Clínico San Carlos, IdISSC, CIBERONC, 28040, Madrid, Spain.,Centro Regional de Investigaciones Biomédicas, Universidad de Castilla La Mancha, 13071, Albacete, Spain
| | - Rogelio González-Sarmiento
- Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain. .,Molecular Medicine Unit-IBSAL, Department of Medicine, University of Salamanca, 37007, Salamanca, Spain. .,Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, 37007, Salamanca, Spain.
| | - Juan Jesús Cruz-Hernández
- Medical Oncology Service, University Hospital of Salamanca-IBSAL, 37007, Salamanca, Spain. .,Biomedical Research Institute of Salamanca (IBSAL), SACYL-University of Salamanca-CSIC, 37007, Salamanca, Spain. .,Molecular Medicine Unit-IBSAL, Department of Medicine, University of Salamanca, 37007, Salamanca, Spain. .,Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-CSIC, 37007, Salamanca, Spain.
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13
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Girardi FM, Wagner VP, Martins MD, Abentroth AL, Hauth LA. Prevalence of p16 expression in oropharyngeal squamous cell carcinoma in southern Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:681-691. [PMID: 32981865 DOI: 10.1016/j.oooo.2020.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/16/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Our aim was to evaluate the prevalence of human papillomavirus (HPV)-positive tumors in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) at a single center in southern Brazil and determine the short-term prognostic factors in this sample. STUDY DESIGN Ninety-one consecutive patients with newly diagnosed primary OPSCC between January 2017 and December 2019 were retrospectively included. Demographic, clinical, pathologic, and survival data were collected. HPV status was determined by using p16 immunohistochemistry. RESULTS The overall prevalence of HPV-positive (HPV+) OPSCC was 20.9%. Patients with HPV+ tumors presented a nodal metastasis as the first clinical sign (P = .02); reported less alcohol (P < .001) and tobacco use (P < .001); exhibited lower tumor stages (P < .001) and higher microscopic grades (P = .01); and had higher chances of having resectable tumors (P = .008). p16-negative status (P = .01); unresectable/inoperable tumors (P < .001); presence of nodal metastasis (P = .005); and higher American Joint Committee on Cancer (AJCC) stage (P = .002) were significantly associated with worse disease-specific survival. CONCLUSIONS The prevalence of HPV+ OPSCC in southern Brazil is relatively low, and p16-positive status was associated with Better prognosis. Higher AJCC stage, nodal metastasis, and unresectability/inoperability were associated with the highest hazard ratios for death resulting from OPSCC.
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Affiliation(s)
| | - Vivian P Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Medicine, Porto Alegre Clinics Hospital (HCPA/UFRGS), Porto Alegre, RS, Brazil
| | | | - Luiz Alberto Hauth
- Integrated Oncology Center of Ana Nery Hospital, Santa Cruz do Sul, RS, Brazil
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14
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Del Mistro A, Frayle H, Menegaldo A, Favaretto N, Gori S, Nicolai P, Spinato G, Romeo S, Tirelli G, da Mosto MC, Polesel J, Boscolo Rizzo P. Age-independent increasing prevalence of Human Papillomavirus-driven oropharyngeal carcinomas in North-East Italy. Sci Rep 2020; 10:9320. [PMID: 32518378 PMCID: PMC7283341 DOI: 10.1038/s41598-020-66323-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/13/2020] [Indexed: 01/16/2023] Open
Abstract
HPV-driven oropharyngeal carcinomas (OPCs) show geographical variations with increasing temporal trends in several areas. We investigated their frequency and clinical outcomes within a prospective multicenter cohort study in North-East Italy. A tumor was defined as HPV-driven by using at least two different biomarkers, usually HPV-DNA positivity and p16INK4A overexpression. Different survival outcomes were compared among patients with HPV-driven and non-HPV-driven tumors. Overall, 42/130 (32.3%) patients with newly diagnosed OPC during the period 2000–2018 resulted HPV-driven; HPV16 was involved in 37 cases (88%), HPV33 in 3 cases (7%), HPV58 and HPV18 in 1 case each. Over time, HPV-driven cases raised from 16.7% (6/36) during 2000–2006 to 46.1% (24/52) during 2013–2018 (p < 0.001). The increase in HPV-driven OPCs was more marked in females than males (p = 0.010), and the frequency of HPV-driven cases was similar in the different age groups. In comparison to cases with non-HPV-driven tumors, a significantly (p < 0.001) better progression-free and overall survival were recorded among patients affected by HPV-driven OPC. The prevalence of HPV-driven OPC cases has been significantly increasing during the last two decades also in North-East Italy and was associated with favorable outcome. OPCs driven by non-HPV16 oncogenic types were restricted to patients older than 68-yrs.
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Affiliation(s)
- Annarosa Del Mistro
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy.
| | - Helena Frayle
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | - Anna Menegaldo
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, P.le Ospedale 1, 31100, Treviso, Italy
| | - Niccolò Favaretto
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Silvia Gori
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Via Gattamelata, 64, 35128, Padova, Italy
| | - Piero Nicolai
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Giacomo Spinato
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, P.le Ospedale 1, 31100, Treviso, Italy.,Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, Via Gattamelata, 64, 35128, Padova, Italy
| | - Salvatore Romeo
- Anatomical Pathology Unit, San Donà di Piave Hospital, Azienda ULSS 4 Veneto Orientale, Via Nazario Sauro 25, 30027, San Donà di Piave, VE, Italy
| | - Giancarlo Tirelli
- Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy
| | - Maria Cristina da Mosto
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, P.le Ospedale 1, 31100, Treviso, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Aviano National Cancer Institute, IRCCS, Via Franco Gallini, 2, 33081, Aviano, PN, Italy
| | - Paolo Boscolo Rizzo
- Department of Neurosciences DNS, Section of Otolaryngology, University of Padova, P.le Ospedale 1, 31100, Treviso, Italy
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15
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Morbini P, Alberizzi P, Ferrario G, Capello G, De Silvestri A, Pedrazzoli P, Tinelli C, Benazzo M. The evolving landscape of human papillomavirus-related oropharyngeal squamous cell carcinoma at a single institution in Northern Italy. ACTA ACUST UNITED AC 2019; 39:9-17. [PMID: 30936574 PMCID: PMC6444161 DOI: 10.14639/0392-100x-1905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022]
Abstract
The increasing incidence of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) observed in several developed countries has not yet been documented in Italy. To investigate changes in the epidemiology of HPV-related OPSCC we reviewed the HPV status of cases evaluated at our centre in northern Italy before and after 2010. The results were correlated with patient age, sex, oropharyngeal subsite (classified as palatine tonsil, tongue base, palatine arch/palate/uvula, posterior oropharyngeal wall, and oropharynx not otherwise specified), AJCC tumour stage, risk factor exposure (smoke, alcohol), disease history (recurrence, metastasis, second tumours), outcome and survival. Positivity for p16 and HR HPV DNA was required to classify HPV-related OPSCC. HPV-related tonsillar OPSCC increased significantly after 2010, while a non-significant reduction of HPV-related extra-tonsillar OPSCC was observed. Non-keratinising morphology was strongly associated with HPV positivity. HPV16 was the most common genotype; the frequency of other high-risk genotype infections decreased after 2010. At multivariate analysis, HPV status showed a significant association with better outcome. We documented an increase of HPV-related OPSCC in our Italian population, synchronous with the increase observed in several Western countries, which in recent years reached a prevalence similar to that reported in central European countries. Our results indicate that HPV infection in head and neck oncology is relevant in Italy and needs to be considered for accurate patient stratification.
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Affiliation(s)
- P Morbini
- Department of Molecular Medicine, Pathology Unit, University of Pavia, Italy.,Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - P Alberizzi
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - G Ferrario
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - G Capello
- Pathology Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - A De Silvestri
- Clinical Epidemiology and Biometrics Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - P Pedrazzoli
- Department of Oncology, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - C Tinelli
- Clinical Epidemiology and Biometrics Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| | - M Benazzo
- Department of Otolaryngology, University of Pavia and Foundation IRCCS Policlinico S. Matteo, Italy
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16
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Prevalence and characteristics of HPV-driven oropharyngeal cancer in France. Cancer Epidemiol 2019; 61:89-94. [PMID: 31158796 DOI: 10.1016/j.canep.2019.05.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/14/2019] [Accepted: 05/17/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND France has one of the highest incidence of head and neck cancers in Europe. Despite this, the epidemiological impact of high-risk human papilloma virus (HR-HPV) remains poorly investigated. METHODS We prospective assessed the proportion of oropharyngeal cancers due to HR-HPV in 15 hospitals throughout France. HPV-status was determined by p16-immunohistochemistry, and by detection of HPV-DNA using in situ hybridization. Cancers were classified as HPV-driven if both p16-immunohistochemistry and HPV-DNA assays were positive. Demographical and clinical features were recorded. RESULTS 291 patients with palatine-tonsil or tongue-base cancers were recruited from March-2011 to July-2012. Of these, 43.1% of samples were p16-positive and 37.7% were positive for both p16 and HPV-DNA. Prognosis was significantly better in patients with HPV-driven cancers, with smoking negatively impacting patients' oncological outcomes. CONCLUSION In France, more than a third of tonsillar and tongue base cancers are HPV-driven. More research concerning the evolution of HPV-driven cancers over time is needed.
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17
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Wittekindt C, Wagner S, Bushnak A, Prigge ES, von Knebel Doeberitz M, Würdemann N, Bernhardt K, Pons-Kühnemann J, Maulbecker-Armstrong C, Klussmann JP. Increasing Incidence rates of Oropharyngeal Squamous Cell Carcinoma in Germany and Significance of Disease Burden Attributed to Human Papillomavirus. Cancer Prev Res (Phila) 2019; 12:375-382. [PMID: 31003993 DOI: 10.1158/1940-6207.capr-19-0098] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/19/2019] [Accepted: 04/08/2019] [Indexed: 11/16/2022]
Abstract
Increasing incidences of head and neck cancers and rising proportions of these associated with human papillomavirus (HPV), especially in the oropharynx, have been reported in international studies. So far, the trends and contribution of HPV to the number of newly diagnosed cases of oropharyngeal squamous cell carcinomas (OPSCC) in Germany are uncertain. We investigated HPV association and incidence rates in a cohort of consecutively included patients with OPSCC in Giessen 2000-2017, and compared our results with regional (Giessen and the federal state of Hesse), national (Germany), and international (United States) databases. Regional data show a significant increase in the overall incidence rates of oropharyngeal cancers and in the incidence of HPV-associated cancers of the subsites tonsils and oropharynx, whereas other oropharyngeal subsites show no significant change. Analysis of national databases shows a significant incidence increase in Germany and in the United States. The rise in incidence is predominantly attributable to male patients in the US population, whereas in Germany rising OPSCC incidence is more associated with females. There is a significant elevation of OPSCC incidence rates in Germany, which corresponds to the recognized incidence increase of HPV-related oropharyngeal cancers based on experimental data from consecutively included patients of our cohort. Our investigation shows different patterns of this increase in Germany and in the United States, which demonstrates spatial heterogeneity and the need for population-based investigations regarding the role of HPV in oropharyngeal cancer.
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Affiliation(s)
- Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Steffen Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.
| | - Ayman Bushnak
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Elena-Sophie Prigge
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Magnus von Knebel Doeberitz
- Department of Applied Tumor Biology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Nora Würdemann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Katharina Bernhardt
- Hesse Cancer Registry, Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Frankfurt/Main, Germany
| | - Jörn Pons-Kühnemann
- Medical Statistics, Institute of Medical Informatics, University of Giessen, Giessen, Germany
| | | | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
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18
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HPV-driven oropharyngeal squamous cell cancer in Croatia - Demography and survival. PLoS One 2019; 14:e0211577. [PMID: 30707715 PMCID: PMC6358070 DOI: 10.1371/journal.pone.0211577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Main HNSCC risk factors are tobacco, alcohol, and high-risk human papillomavirus (HPV). HPV+ oropharyngeal squamous cell cancer (OPSCC) usually have different etiology, increasing incidence and often show an improved survival when compared to HPV-negative cases. The objective of the current study was to retrospectively examine the influence of HPV on the survival of OPSCC patients in a non-Western population setting. Materials and methods We determined the presence of HPV DNA and/or RNA in 99 formalin-fixed paraffin embedded (FFPE) tissue samples of OPSCC patients treated between 2002 and 2015. Patients were compared based on laboratory, demographic, clinical, life style characteristics and survival. Results HPV RNA was found in 29.3% cases. However, groups based on HPV data (either RNA, DNA or retrospectively collected p16 staining) did not show significant differences. Overall, 5-year survival was 30% with minimal influence of the HPV positivity. Conclusions The HPV influence on survival of OPSCC patients is not identical between populations probably due to other factors overshadowing the HPV effect. This should be taken into account when treatment or policy decisions are made in each particular setting.
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19
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Broccolo F, Ciccarese G, Rossi A, Anselmi L, Drago F, Toniolo A. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) in keratinizing versus non- keratinizing squamous cell carcinoma of the oropharynx. Infect Agent Cancer 2018; 13:32. [PMID: 30455727 PMCID: PMC6230228 DOI: 10.1186/s13027-018-0205-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/23/2018] [Indexed: 12/11/2022] Open
Abstract
Background Oral and oropharyngeal squamous cell carcinomas (OSCC and OPSCC) represent the majority of head and neck squamous cell carcinomas (HNSCC). Human papillomavirus (HPV) is an important etiologic factor together with Epstein-Barr virus (EBV). Little is known on the prevalence of major herpesviruses [EBV, cytomegalovirus (CMV) and HHV-6, − 7 and − 8] in HNSCCs. Methods Fifty-one formalin-fixed paraffin-embedded (FFPE) tissue samples taken at surgery (40 oropharyngeal, 11 oral) were analyzed for 40 HPV genotypes (20 high-risk types), EBV, CMV, HHV-6, − 7 and − 8 by quantitative PCR. Expression of the HPV-induced p16INK4A protein was also investigated by immunohistochemistry (IHC). Results In SCC, the prevalence of EBV was significantly higher compared to that of HPV (EBV 51% vs. HPV 19.5%; P = 0.005). HPV infection was found in 25% of OPSCC and in none of the OSCC; conversely, higher prevalence of EBV was found in OSCC (72.7%). HPV and EBV co-infection was detected only in 4 (10%) OPSCC. CMV was detected in only two cases, whereas HHV-6, − 7 and − 8 resulted negative. The prevalence of HPV but no EBV was associated with the non-keratinizing SCC type (NKSCC) compared to the keratinizing SCC type (KSCC)(HPV-DNA P < 0.005; EBV = 0.054). Conclusions Single HPV or EBV positivity was higher in OSCC than in OPSCC. Other potentially oncogenic herpesvirus types were minimally or not represented.
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Affiliation(s)
- Francesco Broccolo
- 1Department of Medicine and Surgery (School of Medicine), University of Milano-Bicocca, Monza, Italy.,5Laboratory of Medical Microbiology, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Giulia Ciccarese
- 2DISSAL Department of Dermatology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Agostino Rossi
- 3Laboratory of Medical Microbiology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Luca Anselmi
- Department of Pathology, ASL 3 Genovese, Genoa, Sampierdarena Italy
| | - Francesco Drago
- 2DISSAL Department of Dermatology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Antonio Toniolo
- 3Laboratory of Medical Microbiology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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20
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Ursu RG, Danciu M, Spiridon IA, Ridder R, Rehm S, Maffini F, McKay-Chopin S, Carreira C, Lucas E, Costan VV, Popescu E, Cobzeanu B, Ghetu N, Iancu LS, Tommasino M, Pawlita M, Holzinger D, Gheit T. Role of mucosal high-risk human papillomavirus types in head and neck cancers in Romania. PLoS One 2018; 13:e0199663. [PMID: 29940024 PMCID: PMC6016945 DOI: 10.1371/journal.pone.0199663] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/12/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Limited information is available about the involvement of human papillomavirus (HPV) in head and neck squamous cell carcinomas (HNSCCs) in Romanian patients. OBJECTIVE To evaluate the HPV-attributable fraction in HNSCCs collected in Northeastern Romania. MATERIALS AND METHODS In total, 189 formalin-fixed paraffin-embedded tissue samples (99 oral cavity tumors, 28 oropharynx, 48 pharynx, and 14 larynx/hypopharynx) were analyzed for HPV DNA and RNA using Luminex-based assays, and for overexpression of p16INK4a (p16) by immunohistochemistry. RESULTS Of the 189 cases, 23 (12.2%) were HPV DNA-positive, comprising half of the oropharyngeal cases (14/28, 50.0%) and 9/161 (5.6%) of the non-oropharyngeal cases. HPV16 was the most prevalent HPV type (20/23, 86.9%), followed by HPV18 (5/23, 21.7%) and HPV39 (1/23, 4.3%). Only two (2/189, 1.1%) HNSCC cases were HPV-driven, i.e. positive for both HPV DNA and RNA. CONCLUSION A very small subset of HNSCC cases within this cohort from Northeastern Romania appeared to be HPV-driven.
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Affiliation(s)
- Ramona Gabriela Ursu
- University of Medicine and Pharmacy “Grigore T. Popa”, Discipline of Microbiology, Iași, Romania
| | - Mihai Danciu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Pathology, Iași, Romania
| | | | - Ruediger Ridder
- Roche MTM Laboratories, Mannheim, Germany
- Ventana Medical Systems, Inc., Tucson, Arizona, United States of America
| | - Susanne Rehm
- Roche MTM Laboratories, Mannheim, Germany
- Ventana Medical Systems, Inc., Tucson, Arizona, United States of America
| | - Fausto Maffini
- Department of Pathology, European Institute of Oncology, Milan, Italy
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Christine Carreira
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Eric Lucas
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Victor-Vlad Costan
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Oral and Maxillofacial Surgery, Iași, Romania
| | - Eugenia Popescu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Oral and Maxillofacial Surgery, Iași, Romania
| | - Bogdan Cobzeanu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Otorhinolaryngology, Iași, Romania
| | - Nicolae Ghetu
- University of Medicine and Pharmacy “Grigore T. Popa”, Department of Plastic surgery, Iași, Romania
| | - Luminita Smaranda Iancu
- University of Medicine and Pharmacy “Grigore T. Popa”, Discipline of Microbiology, Iași, Romania
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Michael Pawlita
- German Cancer Research Center (DKFZ), Division of Molecular Diagnostics of Oncogenic Infections, Heidelberg, Germany
| | - Dana Holzinger
- German Cancer Research Center (DKFZ), Division of Molecular Diagnostics of Oncogenic Infections, Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
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21
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HPV E6 oncoproteins and nucleic acids in neck lymph node fine needle aspirates and oral samples from patients with oropharyngeal squamous cell carcinoma. PAPILLOMAVIRUS RESEARCH 2018; 6:1-5. [PMID: 29842928 PMCID: PMC5986165 DOI: 10.1016/j.pvr.2018.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/26/2018] [Accepted: 05/25/2018] [Indexed: 11/23/2022]
Abstract
Commercial assays measuring HPV E6 viral oncoproteins, E6/E7 mRNA or DNA were used to test neck lymph node fine needle aspirates (FNA) and oropharyngeal samples (saliva and oral swabs) from 59 Canadian patients with oropharyngeal squamous cell carcinomas (OPSCC). Overall agreements of p16 antigen staining of tumors to FNA tested for OncoE6™, Aptima HPV E6/E7 mRNA and cobas HPV DNA were 81.4% (k 0.53), 94.9% (k 0.83) and 91.1% (k 0.73) respectively. Using HPV presence in a subset of 25 tumors as the comparator, overall agreement was 64.0% (k 0.08) with OncoE6™, 88.0% (k 0.65) with Aptima HPV E6/E7 mRNA and 91.7% (k 0.70) with cobas HPV DNA. HPV testing of oropharyngeal samples yielded lower agreements with tumor markers; 23.7-24.0% (k 0.02), 55.9-68.0% (k 0.24-0.37) and 78.9-86.9% (k 0.49-0.58) in the 3 respective tests. HPV 16 was present in 93.7-100% of the samples tested and showed 100% genotype agreement between FNA and tumors. The high rates for HPV E6 oncoproteins and E6/E7 mRNA suggests most patients were experiencing transcriptionally active HPV-related OPSCC. Results from these commercial assays performed on FNA but not oropharyngeal samples showed moderate to very good agreements with p16 and HPV testing of tumors.
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22
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Boscolo-Rizzo P, Zorzi M, Del Mistro A, Da Mosto MC, Tirelli G, Buzzoni C, Rugge M, Polesel J, Guzzinati S. The evolution of the epidemiological landscape of head and neck cancer in Italy: Is there evidence for an increase in the incidence of potentially HPV-related carcinomas? PLoS One 2018; 13:e0192621. [PMID: 29415020 PMCID: PMC5802923 DOI: 10.1371/journal.pone.0192621] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/26/2018] [Indexed: 01/28/2023] Open
Abstract
The current study aimed to investigate the incidence and survival patterns of HNSCCs arising from different anatomic sites, potentially related (the oropharynx) or unrelated (the oral cavity, the larynx/hypopharynx) to HPV, to provide clues on possible growing impact of HPV in the epidemiology of HNSCC in Italy. Epidemiological data were retrieved from ten long-term Cancer Registries covering a population of 7.8 million inhabitants. Trends were described by means of the estimated annual percent change (APC) stratified by age and gender, and compared between HPV-related and HPV-unrelated anatomical sites. The data regarding 28,295 HNSCCs diagnosed in Italy between 1988 and 2012 were analyzed. In males, the incidence rate (IR) of cancers arising from sites unrelated to HPV infection significantly decreased in all age groups (APC:-3.31 for larynx/hypopharynx; APC:-1.77 for oral cavity), whereas stable IR were observed for cancers arising from sites related to HPV infection. In females, IR for cancers from HPV-related sites increased significantly over the observed period; the largest increment was noted in those over 60 (APC:2.92%) who also showed a significantly lower number of HNSCCs from the larynx/hypopharynx (APC:- 0.84) and a significantly higher number of oral cavity tumors (APC = 2.15). The five-year relative survival remained largely unchanged in the patients with laryngeal/hypopharyngeal SCC and, conversely, significantly improved in the patients with SCC at HPV-related sites. The trends observed suggest a potential increasing impact of HPV infection on the epidemiology of HNSCC in Italy, but to a lesser extent and with a different pattern from that observed in other Western countries.
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Affiliation(s)
- Paolo Boscolo-Rizzo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Veneto Region, Padova, Italy
| | | | - Maria Cristina Da Mosto
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padova, Treviso, Italy
| | - Giancarlo Tirelli
- Head and Neck Department, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - Carlotta Buzzoni
- AIRTUM Database, Firenze, Italy
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Firenze, Italy
| | - Massimo Rugge
- Veneto Tumor Registry, Veneto Region, Padova, Italy
- Department of Medicine, Surgical Pathology Unit, University of Padova, Padova, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Italy
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23
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Spinato G, Stellin M, Azzarello G, Bonazza D, Zanconati F, Politi D, Cocuzza S, Di Mauro P, Ausoni S, Tonoli G, Costantini G, Maiolino L, Spinato R, Da Mosto MC, Baboci L, Del Mistro A, Serra A, Tirelli G. Multicenter research into the quality of life of patients with advanced oropharyngeal carcinoma with long-term survival associated with human papilloma virus. Oncol Lett 2017; 14:185-193. [PMID: 28693152 PMCID: PMC5494809 DOI: 10.3892/ol.2017.6152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/28/2016] [Indexed: 01/22/2023] Open
Abstract
The treatment of advanced-stage oropharyngeal squamous cell carcinoma may utilize various modes, including combining surgery with chemoradiotherapy (CTRT), or primary CTRT followed by rescue surgery. In previous literature it has been revealed how patients treated with combined modes report a low quality of life (QoL) and severe consequences following surgery, radiotherapy and chemotherapy, in the short and in the long-term. The decrease in the QoL of patients treated with high-intensity multi-modal strategies highlights the necessity of modifying treatments, particularly for young HPV-positive patients, where an increased survival rate has already been reported. The modified treatment for HPV-positive tumors in the tonsils and at the base of the tongue is based on the deintensification of therapies aiming to reduce toxicity and thereby improve QoL in the long term, whilst still maintaining therapeutic effectiveness. The aim of the present study was to evaluate the QoL in patients with a long-term survival, who were treated with combined therapy for squamous cell tumors in the tonsils and at the base of the tongue, and to compare the results observed in HPV-positive and HPV-negative patients. According to statistical analysis, differences in the general QoL and in the single scales of the European Organization for the Research and Treatment of Cancer questionnaires were not correlated with the type of therapy selected for the particular patient. QoL considered the presence of HPV, the type of treatment, the subregion of the tonsils vs. the base of the tongue and the disease stage at the time of diagnosis, and was determined to be non-influential with regard to these specific variables.
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Affiliation(s)
- Giacomo Spinato
- Ear, Nose and Throat Department, Rovigo Provincial Hospital, I-45100 Rovigo, Italy
| | - Marco Stellin
- Department of Neurosciences, Ear, Nose and Throat Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Provincial Hospital, I-35122 Padua, Italy
| | | | - Deborah Bonazza
- Pathology Department, Cattinara Hospital, University of Trieste, I-34149 Trieste, Italy
| | - Fabrizio Zanconati
- Pathology Department, Cattinara Hospital, University of Trieste, I-34149 Trieste, Italy
| | - Doriano Politi
- Provincial Ear, Nose and Throat Department of Venice, Mestre Hospital, I-30174 Venice, Italy
| | - Salvatore Cocuzza
- Ear, Nose and Throat Department, University of Catania, I-95125 Catania, Italy
| | - Paola Di Mauro
- Ear, Nose and Throat Department, University of Catania, I-95125 Catania, Italy
| | - Simonetta Ausoni
- Department of Biomedical Sciences, University of Padua, I-35122 Padua, Italy
| | - Giovanni Tonoli
- Ear, Nose and Throat Department, Rovigo Provincial Hospital, I-45100 Rovigo, Italy
| | - Giulio Costantini
- Psychology Department, University of Milano-Bicocca, I-20126 Milan, Italy
| | - Luigi Maiolino
- Ear, Nose and Throat Department, University of Catania, I-95125 Catania, Italy
| | - Roberto Spinato
- Provincial Ear, Nose and Throat Department of Venice, Mestre Hospital, I-30174 Venice, Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Ear, Nose and Throat Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso Provincial Hospital, I-35122 Padua, Italy
| | - Lorena Baboci
- Veneto Institute of Oncology IOV-IRCCS, Immunology and Molecular Oncology Unit, Padua, I-35128 Padova, Italy
| | - Annarosa Del Mistro
- Veneto Institute of Oncology IOV-IRCCS, Immunology and Molecular Oncology Unit, Padua, I-35128 Padova, Italy
| | - Agostino Serra
- Ear, Nose and Throat Department, University of Catania, I-95125 Catania, Italy
| | - Giancarlo Tirelli
- Ear, Nose and Throat Department, Cattinara Hospital, University of Trieste, I-34149 Trieste, Italy
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24
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Holzinger D, Wichmann G, Baboci L, Michel A, Höfler D, Wiesenfarth M, Schroeder L, Boscolo‐Rizzo P, Herold‐Mende C, Dyckhoff G, Boehm A, Del Mistro A, Bosch FX, Dietz A, Pawlita M, Waterboer T. Sensitivity and specificity of antibodies against HPV16 E6 and other early proteins for the detection of HPV16‐driven oropharyngeal squamous cell carcinoma. Int J Cancer 2017; 140:2748-2757. [DOI: 10.1002/ijc.30697] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/21/2017] [Accepted: 02/27/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
| | - Gunnar Wichmann
- Department of OtorhinolaryngologyUniversity Hospital LeipzigLeipzig Germany
| | - Lorena Baboci
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
- Department of Oncology and Surgical SciencesUniversity of PaduaPadua Italy
| | - Angelika Michel
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
| | - Daniela Höfler
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
| | - Manuel Wiesenfarth
- Division of BiostatisticsGerman Cancer Research CenterHeidelberg Germany
| | - Lea Schroeder
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
| | - Paolo Boscolo‐Rizzo
- Department of NeurosciencesENT Clinic and Regional Center for Head and Neck Cancer, University of PaduaTreviso Italy
| | - Christel Herold‐Mende
- Department of Otorhinolaryngology, Head and Neck SurgeryHeidelberg UniversityHeidelberg Germany
- Department of Neurosurgery, Division of Experimental NeurosurgeryHeidelberg UniversityHeidelberg Germany
| | - Gerhard Dyckhoff
- Department of Otorhinolaryngology, Head and Neck SurgeryHeidelberg UniversityHeidelberg Germany
| | - Andreas Boehm
- Department of OtorhinolaryngologyUniversity Hospital LeipzigLeipzig Germany
| | - Annarosa Del Mistro
- Department of Immunology and Molecular OncologyIRCCS Veneto Institute of Oncology (IOV)Padua Italy
| | - Franz X. Bosch
- Department of Otorhinolaryngology, Head and Neck SurgeryHeidelberg UniversityHeidelberg Germany
| | - Andreas Dietz
- Department of OtorhinolaryngologyUniversity Hospital LeipzigLeipzig Germany
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer ProgramGerman Cancer Research Center (DKFZ)Heidelberg Germany
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25
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Albano PM, Holzinger D, Salvador C, Orosa J, Racelis S, Leaño M, Sanchez D, Angeles LM, Halec G, Schmitt M, Ramos JD, Pawlita M. Low prevalence of human papillomavirus in head and neck squamous cell carcinoma in the northwest region of the Philippines. PLoS One 2017; 12:e0172240. [PMID: 28199413 PMCID: PMC5310881 DOI: 10.1371/journal.pone.0172240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/01/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Geographic heterogeneity of human papillomavirus (HPV) involvement in head and neck squamous cell carcinoma (HNSCC) has been observed over the last few years. This trend has not been evaluated in the Philippines. Hence, this study aims to provide for the first time a data on the prevalence of HPV in HNSCC in the northwestern region of the Philippines. METHODS Two hundred one (201) biopsy samples (179 formalin fixed paraffin embedded and 22 fresh frozen) from 163 Filipino HNSCC cases (oral cavity = 88; larynx = 60; oropharynx = 15) diagnosed between 2003 to 2013 were initially included in this study. HPV DNA was detected by two methods: (1) BSGP5+/6+-PCR/ multiplex human papillomavirus genotyping and (2) TaqMan probes-based real-time qPCR. Presence of HPV type-specific transcripts were also analyzed by reverse transcription-PCR with subsequent hybridization to oligonucleotide probes coupled to Luminex beads. Co-amplification of the β-globin and ubiquitin C genes served as internal positive controls for DNA and RNA analyses, respectively. RESULTS AND CONCLUSIONS Of the 163, 82 (50.3%) cases had at least one tissue sample that was valid for molecular analysis. Only two of the DNA valid cases (2.4%) were HPV DNA-positive (HPV11 and HPV33). All HPV mRNA assays rendered negative results except for HPV11 transcripts. Results of this study may indicate that there is probably very low prevalence of HPV-associated HNSCC among Filipino adults living in a rural region of the Philippines. This study could serve as a benchmark for designing follow-up studies that would assess possible changes in trends of HNSCC among Filipinos in different ethnic regions of the country, especially urban areas in which the population is expected to adapt Western style sexual behavior. A prospective sampling of fresh frozen tissue is also highly recommended to ensure better molecular analyses.
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Affiliation(s)
- Pia Marie Albano
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Biology, College of Science, University of Santo Tomas, Manila, Philippines
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines
| | - Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christianne Salvador
- Deparment of ENT Head and Neck Surgery, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Jose Orosa
- Deparment of ENT Head and Neck Surgery, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Sheryl Racelis
- Department of Pathology and Laboratories, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Modesty Leaño
- Department of Pathology and Laboratories, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Danilo Sanchez
- Deparment of ENT Head and Neck Surgery, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines
| | - Lara Mae Angeles
- Department of Clinical Pathology, University of Santo Tomas Hospital, Manila, Philippines
| | - Gordana Halec
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Markus Schmitt
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - John Donnie Ramos
- Department of Biology, College of Science, University of Santo Tomas, Manila, Philippines
- Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
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26
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Lupato V, Holzinger D, Höfler D, Menegaldo A, Giorgi Rossi P, Del Mistro A, Da Mosto MC, Pawlita M, Boscolo-Rizzo P. Prevalence and Determinants of Oral Human Papillomavirus Infection in 500 Young Adults from Italy. PLoS One 2017; 12:e0170091. [PMID: 28103272 PMCID: PMC5245874 DOI: 10.1371/journal.pone.0170091] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 01/05/2023] Open
Abstract
Although the prevalence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is increasing in developed countries and becoming a relevant health issue, the natural history of oral HPV infection is still unclear. Estimating the infection's prevalence in specific populations and identifying risk factors can widen our understanding of its natural history and help to delineate appropriate prevention strategies. This study sought to (i) determine oral HPV prevalence and genotype distribution in a large series of young Italian adults, (ii) validate an oral rinse sampling/storage protocol, and (iii) pinpoint factors associated with oral HPV infection. Five hundred students, nurses, and technicians (19-35 years-old) studying and working at/for the University of Padua were recruited. Each participant was provided with an oral rinse sampling kit and instructions for use. They were also asked to complete an anonymous questionnaire concerning their demographic characteristics and behaviors. The questionnaires and oral rinse containers were labeled with the same identification code number. The oral rinse samples were tested using a bead-based multiplex BSGP5+/6+-MPG genotyping assay which amplifies the L1 region of 51 mucosal HPV types. The prevalence of oral HPV infection was 4.0% (95% confidence interval (CI), 2.5%-6.1%); those of 14 high-risk HPV types and of HPV-type 16 (HPV16) infection were 2.2% (95% CI, 1.1%-3.9%) and 1.6% (95% CI, 0.6%-3.1%), respectively. HPV16 was the most frequent genotype (40.0% of oral HPV infections). No association was found between oral infection and the co-variables studied (gender, tobacco, alcohol and illegal drug use, number of sex and oral sex partners, HPV vaccination status, history of HPV and sexually transmitted infections, abnormal pap smears, recurrent tonsillitis and tonsillectomy). The oral rinse sampling protocol outlined here proved to be simple, efficient and well tolerated, and the prevalence rate can be considered reliable and thus useful to guide future research. Determinants of oral HPV infection are still unclear and further studies are certainly warranted.
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Affiliation(s)
- Valentina Lupato
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- Unit of Otolaryngology, Azienda Ospedaliera “S. Maria degli Angeli”, Pordenone, Italy
| | - Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniela Höfler
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna Menegaldo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia, Italy
- Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto—IRCCS, Padova, Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- * E-mail:
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27
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Boscolo-Rizzo P, Da Mosto MC, Rampazzo E, Giunco S, Del Mistro A, Menegaldo A, Baboci L, Mantovani M, Tirelli G, De Rossi A. Telomeres and telomerase in head and neck squamous cell carcinoma: from pathogenesis to clinical implications. Cancer Metastasis Rev 2017; 35:457-74. [PMID: 27501725 PMCID: PMC5035656 DOI: 10.1007/s10555-016-9633-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Strongly associated with tobacco use, heavy alcohol consumption, and with high-risk human papillomavirus (HPV) infection, head and neck squamous cell carcinoma (HNSCC) is a frequently lethal, heterogeneous disease whose pathogenesis is a multistep and multifactorial process involving genetic and epigenetic events. The majority of HNSCC patients present with locoregional advanced stage disease and are treated with combined modality strategies that can markedly impair quality of life and elicit unpredictable results. A large fraction of those who undergo locoregional treatment and achieve a complete response later develop locoregional recurrences or second field tumors. Biomarkers that are thus able to stratify risk and enable clinicians to tailor treatment plans and to personalize post-therapeutic surveillance strategies are highly desirable. To date, only HPV status is considered a reliable independent predictor of treatment response and survival in patients with HNSCC arising from the oropharyngeal site. Recent studies suggest that telomere attrition, which may be an early event in human carcinogenesis, and telomerase activation, which is detected in up to 90 % of malignancies, could be potential markers of cancer risk and disease outcome. This review examines the current state of knowledge on and discusses the implications linked to telomere dysfunction and telomerase activation in the development and clinical outcome of HNSCC.
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MESH Headings
- Animals
- Biomarkers, Tumor
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Gene Expression Regulation, Neoplastic
- Genetic Predisposition to Disease
- Genetic Variation
- Genomic Instability
- Head and Neck Neoplasms/genetics
- Head and Neck Neoplasms/metabolism
- Head and Neck Neoplasms/mortality
- Head and Neck Neoplasms/pathology
- Humans
- Leukocytes, Mononuclear/metabolism
- Leukocytes, Mononuclear/pathology
- Mice
- Prognosis
- Squamous Cell Carcinoma of Head and Neck
- Telomerase/metabolism
- Telomere/genetics
- Telomere Homeostasis
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Affiliation(s)
- Paolo Boscolo-Rizzo
- Section of Otolaryngology and Regional Centre for Head and Neck Cancer, Department of Neurosciences, University of Padova, Treviso, Italy
| | - Maria Cristina Da Mosto
- Section of Otolaryngology and Regional Centre for Head and Neck Cancer, Department of Neurosciences, University of Padova, Treviso, Italy
| | - Enrica Rampazzo
- Section of Oncology and Immunology, Department of Surgical Sciences, Oncology and Gastroenterology, University of Padova, via Gattamelata 64, 35128, Padova, Italy
| | - Silvia Giunco
- Section of Oncology and Immunology, Department of Surgical Sciences, Oncology and Gastroenterology, University of Padova, via Gattamelata 64, 35128, Padova, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Anna Menegaldo
- Section of Otolaryngology and Regional Centre for Head and Neck Cancer, Department of Neurosciences, University of Padova, Treviso, Italy
| | - Lorena Baboci
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Monica Mantovani
- Section of Otolaryngology and Regional Centre for Head and Neck Cancer, Department of Neurosciences, University of Padova, Treviso, Italy
| | - Giancarlo Tirelli
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Trieste, Trieste, Italy
| | - Anita De Rossi
- Section of Oncology and Immunology, Department of Surgical Sciences, Oncology and Gastroenterology, University of Padova, via Gattamelata 64, 35128, Padova, Italy.
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto-IRCCS, Padova, Italy.
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