1
|
Lulić L, Jakovčević A, Kovačić I, Manojlović L, Dediol E, Skelin J, Tomaić V. HPV16 Impacts NHERF2 Expression in Oropharyngeal Cancers. Pathogens 2023; 12:1013. [PMID: 37623973 PMCID: PMC10459660 DOI: 10.3390/pathogens12081013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Infection with human papillomaviruses (HPVs), in particular with HPV type 16, is now considered to be a key risk factor for the development of a subset of oropharyngeal squamous cell carcinomas (OPSCC) that show different epidemiological, clinical, and prognostic characteristics from HPV-negative (HPV-) OPSCCs. So far, extensive research efforts aiming to distinguish these two distinct entities have not identified specific biomarkers, nor led to different therapies. Previous research has shown that HPV16 E6 oncoprotein binds NHERF2, inducing its proteasomal degradation, and consequently increasing cell proliferation; we therefore aimed to investigate how this might be reflected in human histological samples. We analyzed NHERF2 expression patterns in HPV16-positive (HPV16+) and HPV- OPSCC samples, to investigate any potential differences in NHERF2 pattern. Interestingly, we observed a statistically significant decrease in NHERF2 levels in HPV16+ and poorly differentiated HPV- OPSCCs, compared with healthy tissue. Furthermore, we observed a significant reduction in the percentage of NHERF2 immunoreactive cancer cells in HPV16+ tumors, compared with well and moderately differentiated HPV- OPSCCs, suggesting the importance of 16E6's targeting of NHERF2 in HPV-driven oncogenesis in the head and neck area.
Collapse
Affiliation(s)
- Lucija Lulić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Antonia Jakovčević
- Clinical Department of Pathology and Cytology, University Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Iva Kovačić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Luka Manojlović
- Department of Pathology and Cytology, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Josipa Skelin
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| | - Vjekoslav Tomaić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia
| |
Collapse
|
2
|
Yamada S, Itoh T, Ikegami T, Imai A, Mochizuki D, Nakanishi H, Ishikawa R, Kita J, Nakamura Y, Takizawa Y, Okamura J, Noda Y, Iwashita T, Hariyama T, Suzuki M, Misawa K, Kawasaki H. Association between human papillomavirus particle production and the severity of recurrent respiratory papillomatosis. Sci Rep 2023; 13:5514. [PMID: 37024540 PMCID: PMC10079853 DOI: 10.1038/s41598-023-32486-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
Recurrent respiratory papillomatosis (RRP) has a wide range of severity. We investigate the relationship between human papillomavirus (HPV) particle production and severity of RRP. From September 2005 to June 2021, 68 RRP samples (from 29 patients) were included. HPV type was determined. HPV viral load, physical status, and demographic and clinical characteristics were assessed. Immunohistochemistry (IHC) was performed for p16, Ki-67, L1, and E4. We used NanoSuit-CLEM (correlative light and electron microscopy) and transmission electron microscopy (TEM) to examine the samples. The total number of surgeries in HPV-positive and HPV-negative cases were 3.78 (n = 55/68, range: 1-16) and 1.30 (n = 13/68, range: 1-3), respectively (p = 0.02). IHC showed that L1 and E4 were correlated and expressed on the tumour surface. NanoSuit-CLEM and TEM revealed HPV particles in L1-positive nuclei. L1 IHC-positive cases had a shorter surgical interval (p < 0.01) and more frequent surgeries (p = 0.04). P16 IHC, viral load, and physical status were not associated with disease severity. This study visualised HPV particle production in RRP for the first time. Persistent HPV particle infection was associated with severity. We suggest L1 IHC for evaluating RRP severity in addition to the Derkay score.
Collapse
Affiliation(s)
- Satoshi Yamada
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Toshiya Itoh
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taro Ikegami
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Atsushi Imai
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Daiki Mochizuki
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Hiroshi Nakanishi
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Ryuji Ishikawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Junya Kita
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yuki Nakamura
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yoshinori Takizawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Jun Okamura
- Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Yoshihiro Noda
- Department of Otorhinolaryngology, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takahiko Hariyama
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kiyoshi Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Hideya Kawasaki
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| |
Collapse
|
3
|
刘 雅, 陈 怀. [New progress in diagnosis and treatment of HPV-positive oropharyngeal carcinoma]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:802-806. [PMID: 36217663 PMCID: PMC10128556 DOI: 10.13201/j.issn.2096-7993.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Indexed: 06/16/2023]
Abstract
In recent years, the incidence of oropharyngeal carcinoma (OPC) is increasing, while the better prognosis of patients with Human papillomavirus (HPV) positive oropharyngeal carcinoma has been confirmed in a number of studies. There are a variety of detection methods for HPV-associated oropharyngeal carcinoma. Including P16 immunohistochemistry, Polymerase Chain Reaction (PCR) or In situ hybridization (ISH) detection of HPV DNA, HPV RNA, Revers transcriptase Polymerase Chain Reaction (RT PCR) was used to detect HPV RNA. The better prognosis of patients with HPV-positive oropharyngeal carcinoma has led to the emergence of a large number of degraded treatment trials. The traditional P16 test has certain limitations in the diagnosis of patients with HPV-positive oropharyngeal carcinoma. It is necessary to combine with other detection methods to accurately screen out patients with HPV-positive oropharyngeal carcinoma and better apply to degraded therapy. In this article, we will briefly introduce the trend of HPV-associated oropharyngeal carcinoma, the detection methods and the new progress of degraded treatment trials.
Collapse
Affiliation(s)
- 雅岷 刘
- 南方医科大学南方医院耳鼻咽喉头颈外科(广州,510515)Department of Otolaryngology Head and Neck Surgery, Southern Hospital, Southern Medical University, Guangzhou, 510515, China
| | - 怀宏 陈
- 南方医科大学南方医院耳鼻咽喉头颈外科(广州,510515)Department of Otolaryngology Head and Neck Surgery, Southern Hospital, Southern Medical University, Guangzhou, 510515, China
| |
Collapse
|
4
|
Guarda V, Schroeder L, Pawlita M, Ikenberg K, Rupp NJ, Jochum W, Stoeckli SJ, Holzinger D, Broglie MA. Prevalence of Transcriptionally Active HPV Infection in Tumor-Free Oropharyngeal Tissue of OPSCC-Patients. Front Oncol 2022; 12:835814. [PMID: 35530340 PMCID: PMC9074725 DOI: 10.3389/fonc.2022.835814] [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: 12/14/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe natural history of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is still largely unknown. Since reports of second primary tumors (SPTs) in patients with HPV-related OPSCCs are increasing, a multifocal HPV infection, hinting a «virus-induced field effect», has been hypothesized. This study aimed to investigate the HPV-prevalence in normal appearing oropharyngeal tissue in patients with OPSCCs.Materials and Methods49 OPSCC patients undergoing panendoscopy were prospectively enrolled. Tumor specimens and biopsies of normal appearing oropharyngeal tissue adjacent to and distant from the index OPSCC underwent histopathological examination, p16INK4A immunohistochemical staining, HPV DNA and mRNA-detection. Patient characteristics and follow-up data on SPTs were obtained.Results26 of 49 (53%) OPSCC were positive for HPV DNA and p16INK4A. HPV mRNA was detected in 23 of 26 (88%) of these tumor samples. HPV DNA was detected in 36% adjacent mucosa and in 17% distant mucosa samples and only in patients with an HPV-related index OPSCC. HPV mRNA could not be detected in tumor-free distant and adjacent mucosa samples. No evidence of association between HPV detection in normal appearing mucosa and development of second primary tumors was found.ConclusionsHPV was detectable but not transcriptionally active in adjacent/distant tumor-free oropharyngeal tissue. This suggests that a multifocal HPV infection, hinting a «virus-induced fielcd cancerization», may not be pertaining to HPV-related OPSCC.
Collapse
Affiliation(s)
- Vittoria Guarda
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- *Correspondence: Vittoria Guarda,
| | - Lea Schroeder
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Niels J. Rupp
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Wolfram Jochum
- Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dana Holzinger
- Infections and Cancer Epidemiology, Infection Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
5
|
Quabius E, Heinrichs A, Kühnel A, Laudien M, Hoppe F, Mlynski R, Ambrosch P, Hoffmann M. Tonsillar swabs and sputum predict SLPI‑ and AnxA2 expression in tonsils: A prospective study on smoking dependent SLPI‑ and AnxA2‑expression, and tonsillar HPV infection. Oncol Lett 2022; 23:164. [DOI: 10.3892/ol.2022.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/10/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Elgar Quabius
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig‑Holstein, D‑24105 Kiel, Germany
| | - Alessa Heinrichs
- Department of Otorhinolaryngology, Head and Neck Surgery ‘Otto Koerner’, University of Rostock, D‑18057 Rostock, Germany
| | - André Kühnel
- Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios Hospital Harburg, D‑21075 Hamburg, Germany
| | - Martin Laudien
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig‑Holstein, D‑24105 Kiel, Germany
| | - Florian Hoppe
- Department of Otorhinolaryngology‑Head and Neck Surgery, Klinikum Oldenburg, D‑26133 Oldenburg, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery ‘Otto Koerner’, University of Rostock, D‑18057 Rostock, Germany
| | - Petra Ambrosch
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig‑Holstein, D‑24105 Kiel, Germany
| | - Markus Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig‑Holstein, D‑24105 Kiel, Germany
| |
Collapse
|
6
|
Rungraungrayabkul D, Panpradit N, Lapthanasupkul P, Kitkumthorn N, Klanrit P, Subarnbhesaj A, Sresumatchai V, Klongnoi B, Khovidhunkit SOP. Detection of Human Papillomavirus and p16 INK4a Expression in Thai Patients with Oral Squamous Cell Carcinoma. Head Neck Pathol 2021; 16:444-452. [PMID: 34590266 PMCID: PMC9187793 DOI: 10.1007/s12105-021-01381-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/15/2021] [Indexed: 11/26/2022]
Abstract
This study investigated the prevalence of human papillomavirus (HPV) infection in oral squamous cell carcinoma (OSCC) cases, as well as the association between HPV presence and p16INK4a expression, in Thai patients with OSCC. Eighty-one formalin-fixed paraffin-embedded specimens of OSCC were obtained. DNA extraction was performed; this was followed by nested polymerase chain reaction analysis to determine HPV DNA status, using consensus primers for the L1 region of HPV. HPV subtypes were determined by DNA sequencing. HPV-positive specimens and HPV-negative specimens from age- and sex-matched patients were subjected to immunohistochemical analysis to determine p16INK4a expression status. Of the 81 OSCC specimens, eight (9.9%) exhibited HPV DNA; DNA sequencing confirmed that the viral subtype was HPV-18 in all eight specimens. These eight HPV-positive specimens, as well as eight HPV-negative specimens from age- and sex-matched patients, were subjected to immunohistochemical analysis to determine p16INK4a expression status. Three of eight (37.8%) HPV-positive specimens and three of eight (37.8%) HPV-negative specimens showed positive p16INK4a expression findings. However, we did not find a significant association between HPV status and p16INK4a expression status in our OSCC samples. In conclusion, the prevalence of high-risk HPV was low in this group of OSCC patients; no association between HPV status and p16INK4a expression status was identified.
Collapse
Affiliation(s)
| | - Naruemon Panpradit
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Puangwan Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nakarin Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Poramaporn Klanrit
- Department of Oral Biomedical Sciences, Division of Oral Diagnosis, Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases associated with Oral Health, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Ajiravudh Subarnbhesaj
- Department of Oral Biomedical Sciences, Division of Oral Diagnosis, Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases associated with Oral Health, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Vanvisa Sresumatchai
- Development of Disease Management Model for Oral Cancer with an Integration Network of Screening, Surveillance, and Treatment in Northeast Health District Project, Mahidol University, Bangkok, Thailand
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Boworn Klongnoi
- Development of Disease Management Model for Oral Cancer with an Integration Network of Screening, Surveillance, and Treatment in Northeast Health District Project, Mahidol University, Bangkok, Thailand
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Siribang-On Piboonniyom Khovidhunkit
- Development of Disease Management Model for Oral Cancer with an Integration Network of Screening, Surveillance, and Treatment in Northeast Health District Project, Mahidol University, Bangkok, Thailand.
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, 6 Yothi Rd. Rajthewee, Bangkok, 10400, Thailand.
| |
Collapse
|
7
|
Human DLG1 and SCRIB Are Distinctly Regulated Independently of HPV-16 during the Progression of Oropharyngeal Squamous Cell Carcinomas: A Preliminary Analysis. Cancers (Basel) 2021; 13:cancers13174461. [PMID: 34503271 PMCID: PMC8430552 DOI: 10.3390/cancers13174461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary The process of HPV-mediated oncogenesis in HNSCCs is not fully understood. DLG1 and SCRIB protein expression levels and localization changes were evaluated in a number of HPV16-positive and HPV-negative OPSCCs and seem to be associated with malignant transformation. Moreover, loss of SCRIB expression inversely correlates with higher grade tumors, and this is much more evident in the presence of HPV16 E6. This could serve as a potential marker in predicting development of OPSCCs. Abstract The major causative agents of head and neck squamous cell carcinomas (HNSCCs) are either environmental factors, such as tobacco and alcohol consumption, or infection with oncogenic human papillomaviruses (HPVs). An important aspect of HPV-induced oncogenesis is the targeting by the E6 oncoprotein of PDZ domain-containing substrates for proteasomal destruction. Tumor suppressors DLG1 and SCRIB are two of the principal PDZ domain-containing E6 targets. Both have been shown to play critical roles in the regulation of cell growth and polarity and in maintaining the structural integrity of the epithelia. We investigated how modifications in the cellular localization and protein expression of DLG1 and SCRIB in HPV16-positive and HPV-negative histologic oropharyngeal squamous cell carcinomas (OPSCC) might reflect disease progression. HPV presence was determined by p16 staining and HPV genotyping. Whilst DLG1 expression levels did not differ markedly between HPV-negative and HPV16-positive OPSCCs, it appeared to be relocated from cell–cell contacts to the cytoplasm in most samples, regardless of HPV16 positivity. This indicates that alterations in DLG1 distribution could contribute to malignant progression in OPSCCs. Interestingly, SCRIB was also relocated from cell–cell contacts to the cytoplasm in the tumor samples in comparison with normal tissue, regardless of HPV16 status, but in addition there was an obvious reduction in SCRIB expression in higher grade tumors. Strikingly, loss of SCRIB was even more pronounced in HPV16-positive OPSCCs. These alterations in SCRIB levels may contribute to transformation and loss of tissue architecture in the process of carcinogenesis and could potentially serve as markers in the development of OPSCCs.
Collapse
|
8
|
Budamagunta V, Foster TC, Zhou D. Cellular senescence in lymphoid organs and immunosenescence. Aging (Albany NY) 2021; 13:19920-19941. [PMID: 34382946 PMCID: PMC8386533 DOI: 10.18632/aging.203405] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023]
Abstract
Immunosenescence is a multi-faceted phenomenon at the root of age-associated immune dysfunction. It can lead to an array of pathological conditions, including but not limited to a decreased capability to surveil and clear senescent cells (SnCs) and cancerous cells, an increased autoimmune responses leading to tissue damage, a reduced ability to tackle pathogens, and a decreased competence to illicit a robust response to vaccination. Cellular senescence is a phenomenon by which oncogene-activated, stressed or damaged cells undergo a stable cell cycle arrest. Failure to efficiently clear SnCs results in their accumulation in an organism as it ages. SnCs actively secrete a myriad of molecules, collectively called senescence-associated secretory phenotype (SASP), which are factors that cause dysfunction in the neighboring tissue. Though both cellular senescence and immunosenescence have been studied extensively and implicated in various pathologies, their relationship has not been greatly explored. In the wake of an ongoing pandemic (COVID-19) that disproportionately affects the elderly, immunosenescence as a function of age has become a topic of great importance. The goal of this review is to explore the role of cellular senescence in age-associated lymphoid organ dysfunction and immunosenescence, and provide a framework to explore therapies to rejuvenate the aged immune system.
Collapse
Affiliation(s)
- Vivekananda Budamagunta
- Genetics and Genomics Graduate Program, Genetics Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Thomas C Foster
- Genetics and Genomics Graduate Program, Genetics Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Neuroscience, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Daohong Zhou
- Genetics and Genomics Graduate Program, Genetics Institute, College of Medicine, University of Florida, Gainesville, FL 32610, USA.,Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| |
Collapse
|
9
|
Weeramange CE, Liu Z, Hartel G, Li Y, Vasani S, Langton-Lockton J, Kenny L, Morris L, Frazer I, Tang KD, Punyadeera C. Salivary High-Risk Human Papillomavirus DNA as a Biomarker for Human Papillomavirus-Driven Head and Neck Cancers. J Mol Diagn 2021; 23:1334-1342. [PMID: 34325059 DOI: 10.1016/j.jmoldx.2021.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022] Open
Abstract
High-risk human papillomavirus (HR-HPV) infection is a major risk factor of head and neck cancers (HNCs). Despite the rising prevalence of HPV-driven HNC (HPV-HNC), biomarkers for detection, prognostication, and disease monitoring are lacking. To evaluate the capacity of salivary HR-HPV DNA as a biomarker of HPV-HNC, the salivary HR-HPV statuses of 491 and 10 patients with primary and recurrent HNC, respectively, were determined at diagnosis, using quantitative real-time PCR, with tumor cyclin-dependent kinase inhibitor 2A (p16) expression determined by IHC analysis. Patients with oropharyngeal cancer (OPC) (n = 215) were followed up for ≤5 years. Survival characteristics were evaluated in terms of event-free and cause-specific survival. Of the primary-HNC cohort, 43.2% were positive for salivary HR-HPV DNA, with most having OPC. Salivary HR-HPV DNA was detected in 81.4% of tumor p16-positive OPC patients at diagnosis. Prognosis in salivary HR-HPV-positive OPC patients was favorable compared with that in salivary HR-HPV-negative patients (event-free survival, hazard ratio = 0.42 [95% CI, 0.21-0.81, P = 0.010]; cause-specific survival, hazard ratio = 0.39 [95% CI, 0.18-0.86, P = 0.019]). In the recurrent-HNC cohort, salivary HR-HPV DNA was detected in 83.3% of those who previously had tumor p16-positive HNC. These findings indicate that this liquid biopsy-based, noninvasive biomarker could be essential in the detection and management of HPV-HNC.
Collapse
Affiliation(s)
- Chameera E Weeramange
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; Department of Medical Laboratory Sciences, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka
| | - Zhen Liu
- Department of Otolaryngology, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Gunter Hartel
- Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Yinan Li
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
| | - Sarju Vasani
- Department of Otolaryngology, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Julian Langton-Lockton
- Metro-North Sexual Health and HIV Service, Metro North Health, Brisbane, Queensland, Australia
| | - Lizbeth Kenny
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Central Integrated Regional Cancer Service, Queensland Health, Brisbane, Queensland, Australia
| | - Luc Morris
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ian Frazer
- Translational Research Institute, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kai D Tang
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia.
| | - Chamindie Punyadeera
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia.
| |
Collapse
|
10
|
Quabius ES, Tribius S, Heinrichs A, Haaser D, Kühnel A, Laudien M, Hoppe F, Mlynski R, Ambrosch P, Hoffmann M. HPV DNA/RNA detection in various oral and oropharyngeal biomaterials identifies active HPV infections also in non-neoplastic tonsils. Transl Oncol 2020; 14:101002. [PMID: 33352503 PMCID: PMC7772224 DOI: 10.1016/j.tranon.2020.101002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022] Open
Abstract
Previous studies describe a correlation between HPV-positivity and non-smoking in TSCC; p16INK4A-expression as surrogate-marker for HPV-DNA/RNA-positivity is discussed controversially. In the present study, these parameters are assessed prospectively. HPV-status of sputum and tonsillar-swabs was analyzed to determine their validity as surrogate-marker for tissue-HPV-status. TSCC- (n = 52) and non-neoplastic tonsillar tissue (n = 163) were analyzed. HPV-DNA- and HPV-RNA-status of total sputum, cellular fraction and supernatants, tonsillar-swabs and -tissue was determined by (RT)-PCR. Immunohistochemistry determined p16INK4A-expression. 23/163 (14.2%) non-neoplastic tonsils were HPV-DNA-positive; five patients (3 HPV16, 2 HPV11) had active HPV-infections (HPV-RNA-positive), in all biomaterials. 140/163 (85.9%) patients were either HPV-DNA-positive or HPV-DNA-negative in all samples. 21/52 (40.4%) TSCC-tonsils were HPV-DNA-positive; 17 patients were HPV-RNA-positive (14 HPV16; 4 HPV18). 40/52 (76.9%) TSCC-patients were congruent in all biomaterials. p16INK4A-expression alone would have misclassified the HPV-status of 14/52 (26.2%) TSCC-patients. This prospective study confirms the discrepancy between HPV-status and p16INK4A-expression and the significant correlation between non-smoking and HPV-DNA-positivity. HPV-sputum- and/or swab-results do not consistently match tissue-results, possibly having (detrimental) consequences if those were used to assess tissue-HPV-status. In the 5 patients with active HPV infection in the non-neoplasitic tonsils, tonsillectomy likely prevented subsequent development of TSCC.
Collapse
Affiliation(s)
- Elgar Susanne Quabius
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, Building 27, D24105 Kiel, Germany.
| | - Silke Tribius
- Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany.
| | - Alessa Heinrichs
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany.
| | - Dirk Haaser
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, Building 27, D24105 Kiel, Germany
| | - André Kühnel
- Department of Otorhinolaryngology, Head and Neck Surgery, Asklepios Hospital Harburg, Hamburg, Germany.
| | - Martin Laudien
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, Building 27, D24105 Kiel, Germany
| | - Florian Hoppe
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum Oldenburg, Hoppe, Germany.
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany.
| | - Petra Ambrosch
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, Building 27, D24105 Kiel, Germany
| | - Markus Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Str. 3, Building 27, D24105 Kiel, Germany.
| |
Collapse
|
11
|
Misawa K, Imai A, Kanazawa T, Mima M, Yamada S, Mochizuki D, Yamada T, Shinmura D, Ishikawa R, Kita J, Yamaguchi Y, Misawa Y, Mineta H. G Protein-Coupled Receptor Genes, PTGDR1, PTGDR2, and PTGIR, Are Candidate Epigenetic Biomarkers and Predictors for Treated Patients with HPV-Associated Oropharyngeal Cancer. Microorganisms 2020; 8:microorganisms8101504. [PMID: 33003642 PMCID: PMC7601742 DOI: 10.3390/microorganisms8101504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/26/2022] Open
Abstract
Differences in the biology of human papillomavirus (HPV)-associated oropharyngeal cancers (OPCs) and HPV-negative OPCs may have implications in patient management. Early detection is imperative to reduce HPV-associated OPC mortality. Circulating tumor DNA (ctDNA) can potentially serve as a biomarker for monitoring clinically relevant cancer-related genetic and epigenetic modifications. We analyzed the methylation status of 24 G protein-coupled receptor (GPCR) genes in verification (85 OPC primary samples) and validation (8 OPC ctDNA samples) studies using quantitative methylation-specific polymerase chain reaction (Q-MSP). The Q-MSP-based verification study with 85 OPC primary samples revealed the GPCR genes that were significantly associated with recurrence in high methylation groups (≥14 methylated genes) with OPC and HPV-associated OPC (p < 0.001). In the Kaplan–Meier estimate and multivariate Cox proportional hazard analyses, 13 GPCR genes were significantly related to increased recurrence in the methylation group. Furthermore, the validation study on ctDNA showed that three of these genes (Prostaglandin D2 receptor 1: PTGDR1, Prostaglandin D2 receptor 2: PTGDR2, and Prostaglandin I2 Receptor: PTGIR) had a prediction performance as emerging biomarkers. We characterized the relationship between the methylation status of GPCR genes and outcomes in HPV-associated OPC. Our results highlight the potential utility of ctDNA methylation-based detection for the clinical management of HPV-associated OPC.
Collapse
Affiliation(s)
- Kiyoshi Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
- Correspondence: ; Tel.: 81-53-435-2252; Fax: 81-53-435-2253
| | - Atsushi Imai
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Takeharu Kanazawa
- Department of Otorhinolaryngology/Head and Neck Surgery, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan;
| | - Masato Mima
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Satoshi Yamada
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Daiki Mochizuki
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Taiki Yamada
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Daichi Shinmura
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Ryuji Ishikawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Jyunya Kita
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Yuki Yamaguchi
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Yuki Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| | - Hiroyuki Mineta
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan; (A.I.); (M.M.); (S.Y.); (D.M.); (T.Y.); (D.S.); (R.I.); (J.K.); (Y.Y.); (Y.M.); (H.M.)
| |
Collapse
|
12
|
Gyawali BR, Acharya K, Sapkota R, Baskota DK, Sinha BK. Prevalence of p-16 Positive Laryngeal and Pharyngeal Tumors in Nepalese Population: A Hospital based Cross-sectional Study. ACTA ACUST UNITED AC 2020; 58:681-685. [PMID: 33068091 PMCID: PMC7580339 DOI: 10.31729/jnma.5132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 11/16/2022]
Abstract
Introduction: P16 overexpression is considered as a good prognostic marker for oropharyngeal squamous cell carcinoma. However, there are very few literatures on the prevalence and outcomes of p16 overexpression in non-oropharyngeal squamous cell carcinoma and benign head and neck tumors. The aim of our study was to estimate the hospital based prevalence of p16 positive laryngeal and pharyngeal tumors and to compare it with the prevalence of p16 expression in the non tumor tissue (tonsils). Methods: This was a descriptive cross-sectional study. Cases of all genders >15 years presenting with malignant or benign tumors of larynx and all the subsites of pharynx were included in the study for evaluation of p16 expression by immunohistochemistry. Tonsillar tissue of cases undergoing tonsillectomy for recurrent acute tonsillitis were taken as non-tumorous tissue to evaluate for p16 expression. Results: A total of 48 cases were included in our study with 24 cases having different tumors of head and neck region and 24 cases having recurrent acute tonsillitis who were kept under non-tumor group. Eight cases (33.3%) in the tumor group showed positive stain for p16 in IHC. In non tumor group, 7 cases (29.1%) showed positive IHC staining for p16. Conclusions: P16 expression can be present in both benign and malignant tumors of various subsites of head and neck region and also in tonsillar tissue affected by inflammation.
Collapse
Affiliation(s)
- Bigyan Raj Gyawali
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal, *Sikhar Biotech Company, Lalitpur, Nepal
| | - Kunjan Acharya
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal, *Sikhar Biotech Company, Lalitpur, Nepal
| | | | - Dharma Kanta Baskota
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal
| | | |
Collapse
|
13
|
Mehanna H, Bryant TS, Babrah J, Louie K, Bryant JL, Spruce RJ, Batis N, Olaleye O, Jones J, Struijk L, Molijn A, Vorsters A, Rosillon D, Taylor S, D'Souza G. Human Papillomavirus (HPV) Vaccine Effectiveness and Potential Herd Immunity for Reducing Oncogenic Oropharyngeal HPV-16 Prevalence in the United Kingdom: A Cross-sectional Study. Clin Infect Dis 2020; 69:1296-1302. [PMID: 30590469 PMCID: PMC6763631 DOI: 10.1093/cid/ciy1081] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 12/21/2018] [Indexed: 01/08/2023] Open
Abstract
Background Oropharyngeal cancer incidence is rapidly rising due to human papillomavirus (HPV) type 16 infection. The dearth of data on effectiveness of national female-only vaccination programs in preventing oral HPV infection and potential herd immunity in unvaccinated males has resulted in considerable controversy regarding the need to vaccinate males, especially in countries with high female vaccination coverage. Methods Subjects aged 0–65 years undergoing tonsillectomy for nonmalignant indications were recruited in 6 hospitals in the United Kingdom. Oral samples were collected as follows: oral rinse, tongue base, and pharyngeal wall brushes, then tonsil tissue (tonsillectomy). Vaccination data were obtained from regional health authorities. All samples were centrally tested for HPV DNA by polymerase chain reaction. Results Of 940 subjects, 243 females and 69 males were aged 12–24 years (median age, 18.6 years), with 189 (78%) females and no males vaccinated against HPV. Overall, oropharyngeal HPV-16 prevalence was significantly lower in vaccinated versus unvaccinated females (0.5% vs 5.6%, P = .04). In contrast, prevalence of any oropharyngeal HPV type was similar in vaccinated and unvaccinated females (19% vs 20%, P = .76). Oropharyngeal HPV-16 prevalence in unvaccinated males was similar to vaccinated females (0% vs 0.5%, P > .99), and lower than unvaccinated females (0% vs 5.6%, P = .08). Conclusions Our findings indicate that the UK female-only vaccination program is associated with significant reductions in oropharyngeal HPV-16 infections. These are also the first data to suggest potential herd immunity from female-only vaccination against oropharyngeal HPV infection in contemporaneously aged males.
Collapse
Affiliation(s)
- Hisham Mehanna
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Tyler S Bryant
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jaspreet Babrah
- Cancer Research UK Clinical Trials Unit, University of Birmingham, United Kingdom
| | - Karly Louie
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom
| | - Jennifer L Bryant
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Rachel J Spruce
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Nikolaos Batis
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Oladejo Olaleye
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - June Jones
- Institute of Head and Neck Studies and Education, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Linda Struijk
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Rijswijk, The Netherlands
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, GlaxoSmithKline, Wavre, Belgium
| | - Dominique Rosillon
- Clinical and Epidemiology Research Development, GlaxoSmithKline, Wavre, Belgium
| | - Sylvia Taylor
- Clinical and Epidemiology Research Development, GlaxoSmithKline, Wavre, Belgium
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
14
|
Tumban E. A Current Update on Human Papillomavirus-Associated Head and Neck Cancers. Viruses 2019; 11:v11100922. [PMID: 31600915 PMCID: PMC6833051 DOI: 10.3390/v11100922] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023] Open
Abstract
Human papillomavirus (HPV) infection is the cause of a growing percentage of head and neck cancers (HNC); primarily, a subset of oral squamous cell carcinoma, oropharyngeal squamous cell carcinoma, and laryngeal squamous cell carcinoma. The majority of HPV-associated head and neck cancers (HPV + HNC) are caused by HPV16; additionally, co-factors such as smoking and immunosuppression contribute to the progression of HPV + HNC by interfering with tumor suppressor miRNA and impairing mediators of the immune system. This review summarizes current studies on HPV + HNC, ranging from potential modes of oral transmission of HPV (sexual, self-inoculation, vertical and horizontal transmissions), discrepancy in the distribution of HPV + HNC between anatomical sites in the head and neck region, and to studies showing that HPV vaccines have the potential to protect against oral HPV infection (especially against the HPV types included in the vaccines). The review concludes with a discussion of major challenges in the field and prospects for the future: challenges in diagnosing HPV + HNC at early stages of the disease, measures to reduce discrepancy in the prevalence of HPV + HNC cases between anatomical sites, and suggestions to assess whether fomites/breast milk can transmit HPV to the oral cavity.
Collapse
Affiliation(s)
- Ebenezer Tumban
- Department of Biological Sciences, Michigan Technological University, 1400 Townsend Dr, Houghton, MI 49931, USA.
| |
Collapse
|
15
|
Holm A, Schindele A, Allard A, Eriksson I, Sandström K, Laurell G, Nylander K, Olofsson K. Mapping of human papilloma virus, p16, and epstein-barr virus in non-malignant tonsillar disease. Laryngoscope Investig Otolaryngol 2019; 4:285-291. [PMID: 31236460 PMCID: PMC6580074 DOI: 10.1002/lio2.260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 12/30/2022] Open
Abstract
Objectives Due to their location in the entrance of the aero-digestive tract, tonsils are steadily exposed to viruses. Human papilloma virus (HPV) and Epstein-Barr virus (EBV) are two potentially oncogenic viruses that tonsils encounter. The incidence of HPV positive tonsillar cancer is on the rise and it is unknown when infection with HPV occurs. Aim To investigate if tonsils are infected with HPV and EBV, to study the co-expression of HPV and its surrogate marker p16, and to evaluate the number of EBV positive cells in benign tonsillar disease. Materials and Methods Tonsils from 40 patients in a university hospital were removed due to hypertrophy, chronic or recurrent infection. These were analyzed for presence of HPV, its surrogate marker p16, and EBV. HPV was studied using PapilloCheck (a PCR method), while p16 was identified in epithelial and lymphoid tissue with immunohistochemistry and EBV using EBER-ISH (Epstein-Barr encoding region-in situ hybridization). Results HPV was not detected, and p16 was present at low numbers in all epithelial samples as well as in 92.5% of the lymphoid tonsillar samples. At least one EBER-positive cell was seen in 65% of cases. Larger numbers of EBER-expressing cells were only seen in two cases. Conclusion These findings demonstrate that EBV and HPV infect tonsils independently, but further studies are warranted to confirm their infectious relationship. Level of Evidence Cross-sectional study.
Collapse
Affiliation(s)
- Anna Holm
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden
| | - Alexandra Schindele
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden.,Department of Ear, Nose and Throat Östersunds hospital, Jämtland/Härjedalen County Council, Uppsala University Uppsala Sweden
| | - Annika Allard
- Division of Clinical Virology, Department of Clinical Microbiology Uppsala University Uppsala Sweden
| | - Irene Eriksson
- Division of Clinical Virology, Department of Clinical Microbiology Uppsala University Uppsala Sweden
| | - Karl Sandström
- Division of Otorhinolaryngology, Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - Göran Laurell
- Division of Otorhinolaryngology, Department of Surgical Sciences Uppsala University Uppsala Sweden
| | | | - Katarina Olofsson
- Division of Otorhinolaryngology, Department of Clinical Sciences Uppsala University Uppsala Sweden
| |
Collapse
|
16
|
Jaber L, Fatani H, Aldhahri SF. Absence of human papillomavirus in oral cavity squamous cell carcinomas among Saudi patients. Clin Exp Dent Res 2019; 5:38-43. [PMID: 30847231 PMCID: PMC6392823 DOI: 10.1002/cre2.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 12/24/2022] Open
Abstract
This study aimed to examine the possible association of human papillomavirus (HPV) with oral cavity squamous cell carcinomas (OCSCCs) in Saudi Arabia. Forty-five paraffin-embedded tumor blocks that represent different subsets of OCSCCs between 2010 and 2014 were retrieved and histologically evaluated. The presence of high-risk HPV (16, 18, 31, and 33) was assessed by p16-immunohistochemistry followed by DNA detection using in situ hybridization technique. Twenty-four patients were male with the mean age of 59.3 years, and 21 patients were female with the mean age of 61.2 years. Forty-one cases were positive for p16 immunostaining, and the remaining four cases were negative. However, none of the 45 cases showed DNA-expression for any HPV subtypes (16, 18, 31, and 33). High-risk HPV appears not to be involved in the etiology of OCSCCs in older Saudi patients, but further studies with cross section of a younger age group are still required.
Collapse
Affiliation(s)
- Louay Jaber
- College of DentistryImam Abdulrahman Bin Faisal UniversitySaudi Arabia
| | - Hanadi Fatani
- Department of PathologyKing Fahad Medical CitySaudi Arabia
| | | |
Collapse
|
17
|
Tachibana T, Orita Y, Gion Y, Miki K, Ikegami K, Marunaka H, Makino T, Akagi Y, Akisada N, Tsumura M, Ito T, Yoshino T, Nishizaki K, Sato Y. Young adult patients with squamous cell carcinoma of the tongue strongly express p16 without human papillomavirus infection. Acta Otolaryngol 2019; 139:80-84. [PMID: 30712427 DOI: 10.1080/00016489.2018.1541506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Long-term smoking and drinking are known to contribute to the onset of tongue cancer (TC). However, the increasing incidence of TC in younger adults has been suggested to be associated with other factors. OBJECTIVES The present study investigated the relationship between TC and human papillomavirus (HPV) infection. MATERIAL AND METHODS Clinical records and surgically resected specimens from 86 patients (<40-years-old, n = 12; ≥40-years-old, n = 74) with TC were analyzed. Strong nuclear and cytoplasmic p16 staining was considered positive. HPV DNA (high-risk subtypes: 16, 18, 31, 33, 35, 52b, and 58; low-risk subtypes: 6 and 11) was detected using consensus primer-mediated polymerase chain reaction. RESULTS Strong p16 expression was observed in 10 (11.6%) patients. HPV DNA was detected in 9 (10.5%) patients (high-risk subtypes, n = 2; low-risk subtypes, n = 7). Strong p16 expression was observed more frequently among younger adults than among older adults (33.3% vs. 8.1%; p = .045). p16 staining did not correlate with the detection of HPV DNA (correlation coefficient, 0.113; p = .300). CONCLUSIONS AND SIGNIFICANCE In TC, p16 expression was not associated with HPV infection, suggesting that it may be caused by a different mechanism.
Collapse
Affiliation(s)
- Tomoyasu Tachibana
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yorihisa Orita
- Department of Otolaryngology, Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Yuka Gion
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kentaro Miki
- Department of Otolaryngology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kana Ikegami
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Hidenori Marunaka
- Department of Otolaryngology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Takuma Makino
- Department of Otolaryngology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yusuke Akagi
- Department of Otolaryngology, Okayama Medical Center, Okayama, Japan
| | - Naoki Akisada
- Department of Otolaryngology, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Munechika Tsumura
- Department of Otolaryngology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Toshihiro Ito
- Department of Immunology, Nara Medical University, Kashihara, Japan
| | - Tadashi Yoshino
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yasuharu Sato
- Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| |
Collapse
|
18
|
Yakin M, Seo B, Hussaini H, Rich A, Hunter K. Human papillomavirus and oral and oropharyngeal carcinoma: the essentials. Aust Dent J 2018; 64:11-18. [PMID: 30238467 DOI: 10.1111/adj.12652] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2018] [Indexed: 01/14/2023]
Abstract
There is a global increase in the prevalence of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) in Australia and New Zealand. Risk factors for HPV-positive OPSCC are male gender, white race, age older than 40 but younger than 59 years old, having multiple lifetime sex partners, having oro-genital and oro-anal sex. High-risk HPV subtypes play a major role in the pathogenesis of OPSCC, however, they play a much lesser role in oral squamous cell carcinoma (OSCC). Among the laboratory tests used to detect oncogenic HPV infection, polymerase chain reaction is a sensitive method but does not reflect the role of HPV in oncogenesis. While widely used, p16 immunohistochemistry is both a sensitive and a specific surrogate marker for oncogenic HPV infection in OPSCC, but not in OSCC. However, it is a useful prognostic marker in OPSCC. The current gold standard to accurately detect oncogenic HPV infection is E6/E7 mRNAin situ hybridization. Because both HPV-positive and p16-positive OPSCC have better short-term prognoses there is current debate and trials on treatment de-escalation in HPV-positive OPSCC. Dental practitioners can play an important role in early diagnosis of HPV-positive OPSCC.
Collapse
Affiliation(s)
- M Yakin
- School of Dentistry & Health Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - B Seo
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - H Hussaini
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - A Rich
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - K Hunter
- School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| |
Collapse
|
19
|
Fakhry C, Ferris RL. P16 as a Prognostic Biomarker for Nonoropharyngeal Squamous Cell Cancers: Avatar or Mirage? J Natl Cancer Inst 2018; 110:1290-1291. [DOI: 10.1093/jnci/djy103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/01/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Carole Fakhry
- Department of Otolaryngology – Head and Neck Surgery and Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD
| | - Robert L Ferris
- Department of Immunology and Department of Otolaryngology, University of Pittsburgh, PA (RLF); Cancer Immunology Program, UPMC Hillman Cancer Center, Pittsburgh, PA
| |
Collapse
|
20
|
Lam EWH, Chan MMH, Wai CKC, Ngai CM, Chen Z, Wong MCS, Yeung ACM, Tong JHM, Chan ABW, To KF, Chan PKS. The role of human papillomavirus in laryngeal cancer in Southern China. J Med Virol 2018; 90:1150-1159. [PMID: 29446476 DOI: 10.1002/jmv.25058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 12/30/2022]
Abstract
To delineate the role of human papillomavirus (HPV) in laryngeal cancer in Southern Chinese, a retrospective cross-sectional study was conducted in a major otorhinolaryngology referral center in Hong Kong. Eighty-five Chinese patients with histology-confirmed laryngeal squamous cell carcinoma (LSCC) diagnosed between 2005 and 2010 were examined for the status of HPV by PCR, and the expression of p16 and p53 by immunohistochemistry. The HPV, p16 and p53 findings were correlated with clinicopathological features, recurrence and 5-year survival. HPV DNA was detected in one patient (1.2%, 95%CI: 0.2-6.4%) who had glottic cancer and harbored HPV-6. Overexpression of p16 and p53 were detected in 11 (12.9%) and 47 (55.3%) cases, respectively. Recurrence occurred in 22.4% of patients at a median of 13 months. The 5-year overall survival and disease-specific survival were 55.7% and 72.4%, respectively. Overexpression of p16 or p53 was not associated with clinicopathological features, recurrence or overall survival. HPV plays a limited role in laryngeal cancer in Hong Kong Southern Chinese. In contrast to oropharyngeal cancer, p16 cannot be used as a surrogate marker for oncogenic involvement of HPV and cannot predict survival in laryngeal cancer.
Collapse
Affiliation(s)
- Eddy W H Lam
- Department of Otorhinolaryngology, Head & Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Michael M H Chan
- Department of Otorhinolaryngology, Head & Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Cynthia K C Wai
- Department of Otorhinolaryngology, Head & Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Chi Man Ngai
- Department of Otorhinolaryngology, Head & Neck Surgery, Yan Chai Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Zigui Chen
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Apple C M Yeung
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Joanna H M Tong
- Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Amy B W Chan
- Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Ka-Fai To
- Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Paul K S Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| |
Collapse
|
21
|
Lafaurie GI, Perdomo SJ, Buenahora MR, Amaya S, Díaz-Báez D. Human papilloma virus: An etiological and prognostic factor for oral cancer? ACTA ACUST UNITED AC 2018; 9:e12313. [DOI: 10.1111/jicd.12313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/17/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Gloria I. Lafaurie
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University; Bogotá Colombia
| | - Sandra J. Perdomo
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University; Bogotá Colombia
| | - María R. Buenahora
- Unit of Oral Clinical Epidemiology; School of Dentistry, El Bosque University; Bogotá Colombia
| | - Sandra Amaya
- School of Dentistry, University of Valle; Cali Colombia
| | - David Díaz-Báez
- Unit of Basic Oral Investigation, School of Dentistry, El Bosque University; Bogotá Colombia
| |
Collapse
|
22
|
Prevalence of high-risk human papillomavirus infection and cancer gene mutations in nonmalignant tonsils. Oral Oncol 2017; 73:77-82. [PMID: 28939080 DOI: 10.1016/j.oraloncology.2017.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To analyze the prevalence of high-risk HPV (human papillomavirus) and genetic alterations in nonmalignant tonsils. METHODS We collected benign fresh tonsillar tissue specimens from 477 patients undergoing tonsillectomy because of chronic tonsillitis or tonsillar hypertrophy in 2012 (Group A, n=237) and in 2015 (Group B, n=240). Luminex xMAP technique served to detect E6/E7 DNA from 16 different high-risk HPV types. Tonsillar DNA and peripheral blood leukocyte DNA from the infected individuals were analyzed using Nimblegen SeqCap EZ Comprehensive Cancer Design panel. The panel targets 578 different genes that are relevant in carcinogenesis. HPV negative tonsillar specimens from age- and gender matched individuals were used as controls. All specimens harboring high-risk HPV were analyzed using fluorescence in situ hybridization (FISH). RESULTS Five of 477 (1.0%) patients tested positive for the following HPV types: HPV16 (two cases), HPV52 (one case), HPV66 (one case), HPV52 and HPV68 (coinfection, one case). FISH analyses showed that the appearance of HPV in specimens infected with HPV 16 was episomal. Benign tonsils infected with high-risk HPV harbored mutations in EP300, NF1, PIK3CA, and RB1 which are considered relevant in the development of HPV-associated head and neck squamous cell carcinoma (SCC). CONCLUSIONS The prevalence of high-risk HPV in nonmalignant tonsils is low. High-risk HPV positive tonsils harbored mutations in genes that are commonly altered in HPV-associated head and neck SCC. The role of these mutations in tonsillar carcinogenesis is an interesting target for future research.
Collapse
|
23
|
Quabius ES, Bögershausen B, Getzin L, Görögh T, Gebhard MP, Hoffmann AS, Hoffmann M. SLPI and AnxA2 expression in neoplasm-free palatine tonsils is associated with smoking habit of individuals. Mol Clin Oncol 2017; 7:427-434. [PMID: 28811900 DOI: 10.3892/mco.2017.1343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/06/2017] [Indexed: 12/28/2022] Open
Abstract
In order to confirm the inverse correlation between secretory leucocyte protease inhibitor (SLPI) expression, and human papillomavirus (HPV) infection previously observed in head and neck squamous-cell carcinoma, the present study retrospectively investigated the association between SLPI and Annexin A2 (AnxA2) expression, and HPV status in non-neoplastic chronic tonsillitis (n=118), and tonsillar hyperplasia (n=96) tissue. We hypothesised that smoking induces the upregulation of SLPI, resulting in reduced binding of HPV to AnxA2, a known modulator of HPV entry into the cell. SLPI and cyclin-dependent kinase inhibitor 2A (p16INK4A) protein expression was measured using immunohistochemistry in 214 specimens; SLPI and AnxA2 gene expression was measured using reverse transcription-quantitative polymerase chain reaction in 213 cases; and DNA was isolated from all the specimens to determine HPV status. The association between the results of the aforementioned analyses and the smoking habits of patients was analysed. The samples were HPV-negative. p16INK4A expression demonstrated moderate and strong staining in 38, and 0 cases, respectively. SLPI expression presented negative, weak and moderate signals in 163, 45, and 6 cases, respectively. A positive correlation was identified between smoking and SLPI (P=0.0001). Gene expression analysis (n=213) revealed that smoking (n=48) resulted in a significant increase in SLPI and AnxA2 expression. A significant positive correlation between AnxA2 and SLPI, indicating a surplus of AnxA2 in relation to SLPI, was exclusively identified in non-smokers. The data demonstrated that smoking results in increased SLPI and AnxA2 expression also in non-neoplastic tonsillar tissue. The observed surplus of AnxA2 in relation to SLPI identified exclusively in the tonsillar tissue of non-smokers indicates a higher possibility of a successful HPV infection of the tonsillar tissue of non-smokers, given the properties of AnxA2 to function as an infection modulator.
Collapse
Affiliation(s)
- Elgar S Quabius
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts University, D-24105 Kiel, Germany.,Institute of Immunology, Christian-Albrechts University, D-24105 Kiel, Germany
| | - Berit Bögershausen
- Department of Otorhinolaryngology, University of Schleswig-Holstein, D-23538 Lübeck, Germany
| | - Lukas Getzin
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts University, D-24105 Kiel, Germany
| | - Tibor Görögh
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts University, D-24105 Kiel, Germany
| | - Maximilian P Gebhard
- Department of Pathology, University of Schleswig-Holstein, D-23538 Lübeck, Germany
| | - Anna S Hoffmann
- Department of Pathology, University of Schleswig-Holstein, D-23538 Lübeck, Germany.,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Centre Hamburg-Eppendorf, D-20246 Hamburg, Germany
| | - Markus Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts University, D-24105 Kiel, Germany
| |
Collapse
|
24
|
Awan MS, Irfan B, Zahid I, Mirza Y, Ali SA. Comparison of Polymerase Chain Reaction and Immunohistochemistry Assays for Analysing Human Papillomavirus Infection in Oral Squamous Cell Carcinoma. J Clin Diagn Res 2017; 11:XC10-XC13. [PMID: 28764278 DOI: 10.7860/jcdr/2017/24742.10119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 12/30/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Polymerase Chain Reaction (PCR) and Immunohistochemistry (IHC) are two well-known techniques used for the diagnoses of genetic diseases, tumours and different pathogens. PCR basically amplify regions of DNA within a single molecule which may have etiologic significance, it is a method for in vitro amplification of specific DNA or RNA sequences, whereas IHC is used to verify tissue constituents (the antigens) with the utilization of specific antibodies that can be visualized through staining. AIM To compare and analyse PCR and IHC for their sensitivity to detect Human Papillomavirus (HPV) in Oral Squamous Cell Carcinoma (OSCC). MATERIALS AND METHODS This study was based on samples retrospectively collected from 47 patients with primary OSCC who were diagnosed and treated at The Aga Khan University Hospital, Karachi, Pakistan, during the period of January 2010 to December 2013. Inclusion criteria were complete clinicopathologic data, adequate clinical follow up and availability of sufficient paraffin- embedded tumour material. HPV general and type specific 16 and 18 were investigated by means of PCR. HPV immunoreactivity was further investigated by means of IHC. RESULTS Among the 47 evaluated patients, 32 (68.1%) were male and 15 (31.9%) were female, PCR detected the presence of HPV in 32 (68.1%) patients while IHC showed no positive test results. p53 was positive in 32 (68.1%) patients and negative in 15 (31.9%). HPV type 16 being most prevalent showing positivity in 27 (57.4%) patients whereas, type 18 was positive in only 1 (2.1%) patient. CONCLUSION We concluded that PCR is more sensitive and reliable when diagnosing and detecting HPV for OSCC rather than IHC as results from IHC were all negative and insignificant, hence PCR should be the first initial diagnostic test for detecting HPV due to its better sensitivity and successful detection of HPV.
Collapse
Affiliation(s)
- Muhammad Sohail Awan
- Associate Professor, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Babar Irfan
- Student, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Ibrahim Zahid
- Student, Dow University of Health Sciences, Karachi, Pakistan
| | - Yumna Mirza
- Research Associate, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Adnan Ali
- Assistant Professor, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
25
|
Abstract
Human papillomaviruses (HPVs) are a necessary cause of anogenital squamous cell carcinomas (SCC) and a subgroup of head and neck SCC, i.e., those originating in the oropharynx. The key events in high-risk HPV (HRHPV)-associated neoplastic progression include persistent infection, deregulated expression of virus early genes in basal epithelial cells, local immune suppression and the accumulation of chromosomal alterations. Evidence for these events particularly comes from studies of uterine cervical carcinogenesis; primary premalignant HRHPV-positive lesions of the head and neck mucosa are seldomly detected. Integration of virus DNA into host chromosomes is considered an important driver of carcinogenesis and observed in 40 up to 90 % of uterine cervical SCC (UCSCC) and oropharyngeal SCC (OPSCC), dependent on the integration detection method used and HRHPV type. In OPSCC, > 90 % HPV-positive tumors are infected with HPV16. Ten up to 60 % of HPV-positive tumors thus contain extrachromosomal (episomal) virus. In this chapter, causes and consequences of HPV integration are summarized from the literature, with special focus on the site of HPV integration in the cellular genome, and its effect on expression of viral oncogenes (particularly E6 and E7), on human (tumor) gene expression and on deregulation of cell proliferation, apoptosis and cell signaling pathways. Also data on DNA methylation, viral load and clinical outcome in relation to HPV integration are provided.
Collapse
Affiliation(s)
- Ernst Jan M Speel
- Unit Molecular Oncopathology & Diagnostics, Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
| |
Collapse
|
26
|
Black CC, Ogomo C. Does pTis exist in HPV-driven tonsillar carcinomas? An ultrastructural review and examination of two cases. Ultrastruct Pathol 2016; 41:55-61. [PMID: 27922337 DOI: 10.1080/01913123.2016.1258020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Many tonsillar tumors present clinically as cervical nodal metastases and the primary tumor is often difficult to find. HPV-driven tonsillar carcinoma begins in the reticulated crypt epithelium, possibly through viral integration. The basement membrane is not complete in the reticulated crypt epithelium, which may enhance the immune function. We examined the reticulated crypt epithelium in a normal case and five neoplastic tonsils with cervical metastasis as the presenting symptom to further investigate whether tonsil carcinoma in-situ exists. Our results suggest that in-situ carcinoma may need to be excluded from the future staging for human papilloma virus associated tonsillar tumors.
Collapse
Affiliation(s)
- Candice C Black
- a Department of Pathology , Dartmouth Hitchcock Medical Center , Lebanon , NH , USA
| | | |
Collapse
|
27
|
Morbini P, Benazzo M. Human papillomavirus and head and neck carcinomas: focus on evidence in the babel of published data. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2016; 36:249-258. [PMID: 27734976 PMCID: PMC5066459 DOI: 10.14639/0392-100x-853] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 03/19/2016] [Indexed: 02/08/2023]
Abstract
Human papillomavirus (HPV)-associated squamous cell carcinoma of the oropharynx is a well-defined entity mostly affecting young to middle-aged male non-smokers. It is generally associated with a favourable outcome, and for this reason a less intensive therapeutic approach has been proposed for this subset of patients. The incidence of HPV-associated oropharyngeal cancers is rapidly increasing in most Western countries, but detailed epidemiological data are not available for the Italian population. Furthermore, among other head and neck regions, a smaller proportion of oral high-grade dysplasia and cancers seems to depend on HPV infection, whereas its role in laryngeal cancer is recognised as less relevant. HPV-dependent neoplastic transformation depends on the expression of viral oncogenes in the infected host cell that can only be directly documented through viral oncogene mRNA identification. The consensus on how to classify these patients from clinical and laboratory diagnostic points of view is still limited, with different approaches based on one or more diagnostic techniques including p16 immunostaining, in situ hybridisation and polymerase chain reation (PCR) amplification of viral DNA. The possibility of early diagnosis relying on the identification of HPV infection in oral and oropharyngeal exfoliated cells has so far provided unsatisfactory results, although viral persistence after treatment has been associated with risk of recurrence. Presently, sufficient data are not available to document the natural history and progression from tonsillar HPV infection to oropharyngeal cancer development, and to clearly define the modality of transmission and risk exposure, among which sexual behaviours appear to play a relevant role. The diffusion of HPV vaccination and its administration to both genders will undoubtedly dramatically modify the epidemiology of HPV-related head and neck cancers in the coming years.
Collapse
Affiliation(s)
- P Morbini
- Department of Molecular Medicine, Unit of Pathology, and
| | - M Benazzo
- Department of Otolaryngology, University of Pavia and Foundation IRCCS Policlinico S. Matteo, Pavia, Italy
| |
Collapse
|
28
|
Betiol JC, Sichero L, Costa HODO, de Matos LL, Andreoli MA, Ferreira S, Faraj SF, de Mello ES, Sobrinho JS, Brandão LG, Cernea CR, Kulcsar MA, Pinto FR, Gonçalves AJ, Menezes MB, Silva L, Rossi LM, Nunes RAL, Termini L, Villa LL. Prevalence of human papillomavirus types and variants and p16(INK4a) expression in head and neck squamous cells carcinomas in São Paulo, Brazil. Infect Agent Cancer 2016; 11:20. [PMID: 27148398 PMCID: PMC4855326 DOI: 10.1186/s13027-016-0067-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 04/01/2016] [Indexed: 12/18/2022] Open
Abstract
Background Human papillomavirus (HPV) prevalence in head and neck squamous cell carcinomas (HNSCC) diverges geographically. The reliability of using p16INK4a expression as a marker of viral infection is controversial in HNSCC. We evaluated HPV types and HPV-16 variants prevalence, and p16INK4a expression in HNSCC specimens provided by two different Institutions in São Paulo. Methods HPV DNA from formalin-fixed specimens was accessed by Inno-LiPA, HPV-16 variants by PCR-sequencing, and p16INK4a protein levels by immunohistochemistry. Results Overall, HPV DNA was detected among 19.4 % of the specimens (36/186). Viral prevalence was higher in the oral cavity (25.0 %, 23/92) then in other anatomical sites (oropharynx 14,3 %, larynx 13.7 %) when samples from both Institutions were analyzed together. HPV prevalence was also higher in the oral cavity when samples from both Institutions were analyzed separately. HPV-16 was the most prevalent type identified in 69.5 % of the HPV positive smaples and specimens were assigned into Asian-American (57.2 %) or European (42.8 %) phylogenetic branches. High expression of p16INK4a was more common among HPV positive tumors. Conclusion Our results support a role for HPV-16 in a subset of HNSCC.
Collapse
Affiliation(s)
- Julio C Betiol
- Molecular Biology Laboratory, Center of Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (ICESP), São Paulo, Brazil
| | - Laura Sichero
- Molecular Biology Laboratory, Center of Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (ICESP), São Paulo, Brazil.,Center of Translational Oncology - ICESP, Av. Dr. Arnaldo, 251, 8 andar, 01246-000, Cerqueira César, São Paulo, SP Brazil
| | | | - Leandro L de Matos
- Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria A Andreoli
- HPV Institute, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Silvaneide Ferreira
- Molecular Biology Laboratory, Center of Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (ICESP), São Paulo, Brazil
| | - Sheila F Faraj
- Department of Pathology, Cancer Institute of São Paulo (ICESP), São Paulo, Brazil
| | - Evandro S de Mello
- Department of Pathology, Cancer Institute of São Paulo (ICESP), São Paulo, Brazil
| | - João S Sobrinho
- Molecular Biology Laboratory, Center of Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (ICESP), São Paulo, Brazil
| | - Lenine G Brandão
- Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Claudio R Cernea
- Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marco A Kulcsar
- Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fabio R Pinto
- Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Antonio J Gonçalves
- Department of Surgery, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Marcelo B Menezes
- Department of Surgery, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Leonardo Silva
- Department of Otolaringology, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Lia M Rossi
- Department of Otolaringology, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Rafaella A Lima Nunes
- HPV Institute, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Lara Termini
- HPV Institute, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil
| | - Luisa L Villa
- Molecular Biology Laboratory, Center of Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (ICESP), São Paulo, Brazil.,HPV Institute, Santa Casa de Sao Paulo, School of Medicine (FCMSCSP), São Paulo, Brazil.,Department of Radiology and Oncology, School of Medicine, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
29
|
Abstract
We examined p16 expression in tumors from a population-based sample of laryngeal cancer cases diagnosed in the U.S. Samples had been previously genotyped for HPV DNA. Overall, p16 expression was observed in laryngeal tissue from 8 of 101 (7.9%) cases. p16 expression was observed in 2 of 16 (12.5%) cases previously determined to be HPV DNA positive. The two cases dually positive for p16 and HPV DNA were non-keratinizing SCC and papillary SCC tumors that were positive for genotypes 18 and 35/89, respectively. Positivity for p16 and/or HPV DNA was not associated with 5-year survival (log-rank p value=0.55). Our findings support a limited role of HPV in laryngeal carcinogenesis. p16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival.
Collapse
|
30
|
Franceschi S, Combes JD, Dalstein V, Caudroy S, Clifford G, Gheit T, Tommasino M, Clavel C, Lacau St Guily J, Birembaut P. Deep brush-based cytology in tonsils resected for benign diseases. Int J Cancer 2015; 137:2994-9. [PMID: 26111735 DOI: 10.1002/ijc.29660] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/22/2015] [Indexed: 03/25/2024]
Abstract
A fraction of oropharyngeal cancer (OPC), especially in the tonsil, is caused by human papillomavirus (HPV), mainly HPV16. Noninvasive diagnostic methods to detect precancerous lesions in the tonsil would be useful, e.g., liquid-based cytology (LBC). However, ill-characterized precancerous lesions may be hidden in the depth of the tonsillar crypts. We therefore conducted a study on HPV and tonsillar precancerous lesions to evaluate, among other things, the utility of LBC obtained by deep brushing of the resected tonsils. Two hundred non-paediatric patients (mean age: 30.3 years) who underwent tonsillectomy for infection-related conditions (69%) or other conditions (mainly obstructive sleep apnoea, 31%) were included. An ultra-sensitive Luminex bead-based platform was used to test for the DNA of 21 mucosal HPV types; 56% of slides were unsatisfactory due to low number of squamous epithelial cells or the masking effect of a large number of lymphocytes. Three patients (1.5%; 95% CI: 0.5-4.3) showed suspicious cytological findings (atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion, ASC-H) while 3 others were HPV-positive (2 for HPV16 and 1 for HPV39). None of the ASC-H patients and HPV-positive patients showed dysplasia at histological examination. The rarity of HPV infection in the tonsil conflicts with the relatively frequent detection of the virus in the mouth. In conclusion, aggressive deep brushing of tonsils, while hardly applicable in vivo, is unlikely to be a reliable method to detect precancerous lesions. The absence of OPC screening modalities places the priority on multi-purpose primary prevention strategies, i.e., HPV vaccination and reduction of smoking and drinking.
Collapse
Affiliation(s)
- Silvia Franceschi
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France
| | - Jean-Damien Combes
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France
| | - Véronique Dalstein
- CHU Reims, Hôpital Maison Blanche, Laboratoire Pol Bouin Histologie - Cytologie - Biologie Cellulaire, Reims, F-51092, France
- INSERM, UMR-S 903, Reims, F-51092 France, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, F-51095 France
| | - Stéphanie Caudroy
- CHU Reims, Hôpital Maison Blanche, Laboratoire Pol Bouin Histologie - Cytologie - Biologie Cellulaire, Reims, F-51092, France
- INSERM, UMR-S 903, Reims, F-51092 France, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, F-51095 France
| | - Gary Clifford
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France
| | - Tarik Gheit
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France
| | - Massimo Tommasino
- International Agency for Research on Cancer, 69372 Lyon cedex 08, France
| | - Christine Clavel
- CHU Reims, Hôpital Maison Blanche, Laboratoire Pol Bouin Histologie - Cytologie - Biologie Cellulaire, Reims, F-51092, France
- INSERM, UMR-S 903, Reims, F-51092 France, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, F-51095 France
| | - Jean Lacau St Guily
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine-Pierre Et Marie Curie University-Paris VI and Tenon Hospital, Assistance Publique Hôpitaux De Paris, France
| | - Philippe Birembaut
- CHU Reims, Hôpital Maison Blanche, Laboratoire Pol Bouin Histologie - Cytologie - Biologie Cellulaire, Reims, F-51092, France
- INSERM, UMR-S 903, Reims, F-51092 France, Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims, F-51095 France
| |
Collapse
|
31
|
Expression of pRb and p16INK4 in human thymic epithelial tumors in relation to the presence of human polyomavirus 7. Diagn Pathol 2015; 10:201. [PMID: 26537237 PMCID: PMC4634587 DOI: 10.1186/s13000-015-0418-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/01/2015] [Indexed: 01/24/2023] Open
Abstract
Background We have recently reported the presence of the Human polyomavirus 7 (HPyV7) in human thymic epithelial tumors as assessed by diverse molecular techniques. Here we report on the co-expression of p16, retinoblastoma protein (pRb) and phosphorylated retinoblastoma protein (phospho-Rb) in human thymic epithelial tumors in relation to HPyV7. Methods PRB, phospho-RB and p16 expression was assessed by immuno-histochemistry in 37 thymomas and 2 thymic carcinomas. 17 thymomas (46 %) and 1 thymic carcinoma (50 %) were recently tested positive for HPyV7. In addition, 20 follicular hyperplasias were tested. Results Expression of pRb was observed in 35 thymomas (94.6 %), in 16 thymomas (43.2 %) the expression was strong. Phospho-Rb was observed in 31 thymomas (83.8 %). 19 thymomas (51.4 %) showed immunoreactivity for p16 of which 8 thymomas revealed very strong p16 expression. No p16 expression was detected in thymic carcinomas. In addition, no significant correlation between the presence of HPyV7 and pRb-, phospho-Rb- and p16-expression could be established. No correlation between pRb, phospho-Rb, p16 and WHO staging, Masaoka-Koga staging or the presence of MG was found. All 20 follicular hyperplasias showed expression of pRb and less expression of phospho-Rb. Conclusions Although polyomaviruses have been shown to interact with cell cycle proteins no correlation between the presence of HPyV7 and the expression of pRb, phospho-Rb and p16 in human thymic epithelial tumors was observed. In as much HPyV7 contributes to human thymomagenesis remains to be established. Our data indicate pRb, phospho-Rb and p16 expression are rather unlikely to be involved in HPyV7 related thymomagenesis.
Collapse
|
32
|
Knör M, Tziridis K, Agaimy A, Zenk J, Wendler O. Human Papillomavirus (HPV) Prevalence in Nasal and Antrochoanal Polyps and Association with Clinical Data. PLoS One 2015; 10:e0141722. [PMID: 26509801 PMCID: PMC4624970 DOI: 10.1371/journal.pone.0141722] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/12/2015] [Indexed: 12/14/2022] Open
Abstract
Objectives The pathogenesis of sinonasal polyposis remains unclear, in spite of several investigative approaches. Antrochoanal polyps, a subgroup of sinonasal polyposis along with allergic- and chronic-inflammatory nasal polyps, mostly originate from the maxillary sinus and develop as a unilateral, pedunculated mass towards the nasopharynx. The human papillomavirus (HPV) is discussed as a possible causative and influencing factor in development and progression of sinonasal polyposis. This study aims to elucidate HPV frequency in nasal polyps and antrochoanal polyps. Materials and Methods Genomic DNA from 257 tissue specimens (166 nasal polyps, 39 antrochoanal polyps and 52 nasal turbinates) was subjected to three different established HPV- polymerase chain reaction assays, testing for 37 low- and high-risk HPV. In addition, immunohistochemical analyses for HPV16 were carried out, as well as immunohistochemistry and western blots of p16, a biomarker for HPV induced cancer. Results HPV-DNA was detected in 53.8% of antrochoanal polyps, 15.1% of nasal polyps, and 5.8% of nasal turbinates. HPV16 was the predominant type with a detection rate of 76% in nasal polyps and 62% in antrochoanal polyps. Immunohistochemically, HPV positive tissues stained positive for HPV16 antigens and p16 in epithelial cell layers. No significant p16 overexpression was traceable in antrochoanal polyps, nasal polyps and nasal turbinates by western blot. There was no correlation of HPV-status with sex, age, smoking, alcohol consumption or allergic background. Conclusion The present study shows a significant frequency of high-risk type HPV16 in antrochoanal polyps. Absence of oncogenic transformation or correlation of the HPV-status with clinical data suggests a latent superinfection, possibly because of anatomical proximity to the oropharynx.
Collapse
Affiliation(s)
- Mareike Knör
- Experimental Otorhinolaryngology, ENT-Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- * E-mail: (OW); (MK)
| | - Konstantin Tziridis
- Experimental Otorhinolaryngology, ENT-Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Johannes Zenk
- Experimental Otorhinolaryngology, ENT-Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Olaf Wendler
- Experimental Otorhinolaryngology, ENT-Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- * E-mail: (OW); (MK)
| |
Collapse
|
33
|
Saito Y, Yoshida M, Omura G, Kobayashi K, Fujimoto C, Ando M, Sakamoto T, Asakage T, Yamasoba T. Prognostic value of p16 expression irrespective of human papillomavirus status in patients with oropharyngeal carcinoma. Jpn J Clin Oncol 2015; 45:828-36. [DOI: 10.1093/jjco/hyv085] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 05/08/2015] [Indexed: 12/13/2022] Open
|
34
|
Mirghani H, Amen F, Moreau F, Lacau St Guily J. Do high-risk human papillomaviruses cause oral cavity squamous cell carcinoma? Oral Oncol 2015; 51:229-36. [DOI: 10.1016/j.oraloncology.2014.11.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/16/2014] [Accepted: 11/19/2014] [Indexed: 12/14/2022]
|
35
|
[HPV (Human Papilloma Virus) implication in other cancers than gynaecological]. Rev Med Interne 2015; 36:540-7. [PMID: 25661671 DOI: 10.1016/j.revmed.2015.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 01/26/2023]
Abstract
Worldwide, approximately 5 to 10% of the population is infected by a Human Papilloma Virus (HPV). Some of these viruses, with a high oncogenic risk (HPV HR), are responsible for about 5% of cancer. It is now accepted that almost all carcinomas of the cervix and the vulva are due to an HPV HR (HPV16 and 18) infection. However, these viruses are known to be involved in the carcinogenesis of many other cancers (head and neck [SCCHN], penis, anus). For head and neck cancer, HPV infection is considered as a good prognostic factor. The role of HPV HR in anal cancer is also extensively studied in high-risk patient's population. The role of HPV infection in the carcinogenesis of esophageal, bladder, lung, breast or skin cancers is still debated. Given the multiple possible locations of HPV HR infection, the question of optimizing the management of patients with a HPV+ cancer arises in the implementation of a comprehensive clinical and biological monitoring. It is the same in therapeutics with the existence of a preventive vaccination, for example.
Collapse
|
36
|
Berta E, Atallah I, Reyt E, Boyer E, Karkas A, Righini CA. The role of tonsillectomy in the initial diagnostic work-up of head and neck squamous cell carcinoma of unknown primary. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:305-8. [DOI: 10.1016/j.anorl.2014.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 01/21/2014] [Accepted: 03/04/2014] [Indexed: 10/24/2022]
|
37
|
Masterson L, Moualed D, Liu ZW, Howard JEF, Dwivedi RC, Tysome JR, Benson R, Sterling JC, Sudhoff H, Jani P, Goon PKC. De-escalation treatment protocols for human papillomavirus-associated oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis of current clinical trials. Eur J Cancer 2014; 50:2636-48. [PMID: 25091798 DOI: 10.1016/j.ejca.2014.07.001] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 06/27/2014] [Accepted: 07/01/2014] [Indexed: 11/26/2022]
Abstract
Iatrogenic complications associated with current treatment protocols for oropharyngeal squamous cell carcinoma are noted to cause high rates of acute and chronic morbidity. The aims of this study are to provide an overview of the current de-escalation trials for human papillomavirus positive (HPV+) oropharyngeal carcinoma and to evaluate the evidence supporting improved response to treatment of patients within this viral cohort. This study reviewed all completed or in progress randomised controlled trials (RCTs) assessing clinical interventions for human papillomavirus-associated locally advanced oropharyngeal squamous cell carcinoma. We utilised a validated 'risk of bias' tool to assess study quality. We identified nine RCTs that met the full inclusion criteria for this review (all of which are currently on-going and will report from 2015 onwards). Five RCTs performed a post hoc analysis by HPV status, which allowed meta-analysis of 1130 patients. The data reveal a significant difference in overall survival (hazard ratio (HR) 0.49 [95% confidence interval (CI) 0.35-0.69]), loco-regional failure (HR 0.43 [95% CI 0.17-1.11]) and disease specific survival (0.41 [95% 0.3-0.56]) in favour of the HPV+ category. In considering de-escalation treatment protocols, nine studies are currently ongoing. Our meta-analysis provides strong evidence for an improved prognosis in the viral associated cohort when treated by platinum based chemotherapy in combination with radiotherapy or primary radiotherapy. So far, one trial (with moderate to high risk of bias) suggests a reduced survival outcome for the HPV+ population when using the epidermal growth factor receptor (EGFR) inhibitor cetuximab.
Collapse
Affiliation(s)
- Liam Masterson
- ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Pathology, University of Cambridge, UK.
| | - Daniel Moualed
- ENT Department, Milton Keynes Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Zi Wei Liu
- ENT Department, Barts Health NHS Trust, London, UK
| | - James E F Howard
- Oncology Centre, University College Hospital NHS Trust, London, UK
| | - Raghav C Dwivedi
- ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - James R Tysome
- ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Holger Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
| | - Piyush Jani
- ENT Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | |
Collapse
|
38
|
Prigge ES, Toth C, Dyckhoff G, Wagner S, Müller F, Wittekindt C, Freier K, Plinkert P, Hoffmann J, Vinokurova S, Klussmann JP, von Knebel Doeberitz M, Reuschenbach M. p16INK4a/Ki-67 co-expression specifically identifies transformed cells in the head and neck region. Int J Cancer 2014; 136:1589-99. [DOI: 10.1002/ijc.29130] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/15/2014] [Accepted: 07/22/2014] [Indexed: 01/07/2023]
Affiliation(s)
- Elena-Sophie Prigge
- Department of Applied Tumor Biology; Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Csaba Toth
- Institute of Pathology, University of Heidelberg, and National Center for Tumor Diseases (NCT) Tissue Bank; Heidelberg Germany
| | - Gerhard Dyckhoff
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Heidelberg; Heidelberg Germany
| | - Steffen Wagner
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Giessen; Giessen Germany
| | - Franziska Müller
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Giessen; Giessen Germany
| | - Claus Wittekindt
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Giessen; Giessen Germany
| | - Kolja Freier
- Department of Oral and Maxillofacial Surgery; University of Heidelberg; Heidelberg Germany
| | - Peter Plinkert
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Heidelberg; Heidelberg Germany
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery; University of Heidelberg; Heidelberg Germany
| | - Svetlana Vinokurova
- Department of Applied Tumor Biology; Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology; Head and Neck Surgery, University of Giessen; Giessen Germany
| | - Magnus von Knebel Doeberitz
- Department of Applied Tumor Biology; Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ); Heidelberg Germany
| | - Miriam Reuschenbach
- Department of Applied Tumor Biology; Institute of Pathology, University of Heidelberg, and Clinical Cooperation Unit Applied Tumor Biology, German Cancer Research Center (DKFZ); Heidelberg Germany
| |
Collapse
|
39
|
Woods RSR, O’Regan EM, Kennedy S, Martin C, O’Leary JJ, Timon C. Role of human papillomavirus in oropharyngeal squamous cell carcinoma: A review. World J Clin Cases 2014; 2:172-193. [PMID: 24945004 PMCID: PMC4061306 DOI: 10.12998/wjcc.v2.i6.172] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 04/21/2014] [Accepted: 05/19/2014] [Indexed: 02/05/2023] Open
Abstract
Human papillomavirus (HPV) has been implicated in the pathogenesis of a subset of oropharyngeal squamous cell carcinoma. As a result, traditional paradigms in relation to the management of head and neck squamous cell carcinoma have been changing. Research into HPV-related oropharyngeal squamous cell carcinoma is rapidly expanding, however many molecular pathological and clinical aspects of the role of HPV remain uncertain and are the subject of ongoing investigation. A detailed search of the literature pertaining to HPV-related oropharyngeal squamous cell carcinoma was performed and information on the topic was gathered. In this article, we present an extensive review of the current literature on the role of HPV in oropharyngeal squamous cell carcinoma, particularly in relation to epidemiology, risk factors, carcinogenesis, biomarkers and clinical implications. HPV has been established as a causative agent in oropharyngeal squamous cell carcinoma and biologically active HPV can act as a prognosticator with better overall survival than HPV-negative tumours. A distinct group of younger patients with limited tobacco and alcohol exposure have emerged as characteristic of this HPV-related subset of squamous cell carcinoma of the head and neck. However, the exact molecular mechanisms of carcinogenesis are not completely understood and further studies are needed to assist development of optimal prevention and treatment modalities.
Collapse
|
40
|
Deng Z, Hasegawa M, Aoki K, Matayoshi S, Kiyuna A, Yamashita Y, Uehara T, Agena S, Maeda H, Xie M, Suzuki M. A comprehensive evaluation of human papillomavirus positive status and p16INK4a overexpression as a prognostic biomarker in head and neck squamous cell carcinoma. Int J Oncol 2014; 45:67-76. [PMID: 24820457 PMCID: PMC4079160 DOI: 10.3892/ijo.2014.2440] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 04/28/2014] [Indexed: 11/25/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) patients with human papillomavirus (HPV) infection have better prognosis than those without HPV infection. Although p16INK4a expression is used as a surrogate marker for HPV infection, there is controversy as to whether p16INK4a reliably indicates HPV infection. Here, to evaluate the accuracy of p16INK4a expression for determining HPV infection and the prognostic value of HPV infection and p16INK4a expression for HNSCC survival, especially oropharyngeal squamous cell carcinoma (OPSCC) survival, 150 fresh-frozen HNSCC samples were analyzed for HPV DNA, E6/E7 mRNA and p16INK4a expression by polymerase chain reaction and immunohistochemistry. p16INK4a expression was scored from 0 to 4 according to the percentage of p16INK4a-positive cells, with overexpression defined as >40% positive cells. Of the 150 tumor samples tested, 10 tumors were nasopharyngeal, 53 oropharyngeal, 39 hypopharyngeal, 24 laryngeal and 24 were located in the oral cavity. HPV DNA was detected in 47 (31.3%) samples, but only 21 also exhibited HPV mRNA expression. Inter-rater agreement was low between p16INK4a expression and HPV DNA presence and between p16INK4a expression and HPV mRNA expression, but was good between the combination of HPV DNA status and p16INK4a overexpression and HPV mRNA expression. Three-year recurrence-free survival was significantly higher for OPSCC patients who were HPV DNA-positive than for OPSCC patients who were HPV DNA-negative (P=0.008) and for OPSCC patients over-expressing p16INK4a than for without overexpressing p16INK4a (P=0.034). Multivariate analysis revealed that T1-3 stage and the combination of HPV DNA positivity and p16INK4a overexpression predicted significantly better recurrence-free survival. This combination is a more accurate marker for active HPV infection in HNSCC than HPV DNA status or general p16INK4a-positive status alone and offers a useful and reliable method for detecting and determining the prognosis of HPV-related HNSCC.
Collapse
Affiliation(s)
- Zeyi Deng
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masahiro Hasegawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kazuo Aoki
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Sen Matayoshi
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Asanori Kiyuna
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yukashi Yamashita
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takayuki Uehara
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shinya Agena
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroyuki Maeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Minqiang Xie
- Department of Otorhinolaryngology, Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
41
|
Role of human papillomavirus in non-oropharyngeal head and neck cancers. Oral Oncol 2014; 50:370-9. [DOI: 10.1016/j.oraloncology.2013.11.004] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/23/2013] [Accepted: 11/12/2013] [Indexed: 11/18/2022]
|
42
|
Gheit T, Abedi-Ardekani B, Carreira C, Missad CG, Tommasino M, Torrente MC. Comprehensive analysis of HPV expression in laryngeal squamous cell carcinoma. J Med Virol 2014; 86:642-6. [PMID: 24374907 DOI: 10.1002/jmv.23866] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 01/08/2023]
Abstract
Role of human papillomavirus (HPV) in laryngeal carcinoma remains controversial. The aim of this study is to evaluate the role of HPV in laryngeal squamous cell carcinoma by determining presence of markers of viral infection. HPV DNA and E6*I mRNA status was determined by type-specific E7 PCR bead-based multiplex genotyping and RT-PCR assays in laryngeal squamous cell carcinoma biopsy samples. p16(INK4a) and COX-2 expression was determined by immunohistochemistry. Four cases out of 32 (13%) were HPV DNA+: HPV 11 (n = 1), HPV 31 (n = 3), HPV 59 (n = 1). One double infection: HPV 11 and HPV 31. p16(INK4a) was overexpressed in three cases (9%) and COX-2 in 17 cases (53%). Two of four HPV DNA+ samples had E6*I mRNA for HPV 31 and overexpressed p16(INK4a) and COX-2. HPV appears to play an active role in a small subset of laryngeal squamous cell carcinoma. p16(INK4a) can be used as a surrogate marker of transcriptionally active HPV infection; COX-2 expression had no correlation with HPV DNA and/or RNA positivity.
Collapse
Affiliation(s)
- Tarik Gheit
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | | | | |
Collapse
|
43
|
Schache A, Croud J, Robinson M, Thavaraj S. Human Papillomavirus Testing in Head and Neck Squamous Cell Carcinoma: Best Practice for Diagnosis. Histopathology 2014; 1180:237-55. [DOI: 10.1007/978-1-4939-1050-2_13] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
44
|
Melkane AE, Mirghani H, Aupérin A, Saulnier P, Lacroix L, Vielh P, Casiraghi O, Griscelli F, Temam S. HPV-related oropharyngeal squamous cell carcinomas: a comparison between three diagnostic approaches. Am J Otolaryngol 2014; 35:25-32. [PMID: 24112760 DOI: 10.1016/j.amjoto.2013.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 08/03/2013] [Indexed: 01/28/2023]
Abstract
PURPOSE HPV-related oropharyngeal squamous cell carcinomas clearly represent a growing entity in the head and neck with distinct carcinogenesis, clinico-pathological presentation and survival profile. We aimed to compare the HPV prevalence rates and clinico-pathological correlations obtained with three distinct commonly used HPV detection methods. MATERIALS AND METHODS p16-immunohistochemistry (IHC), HPV DNA viral load by real-time PCR (qPCR), and HPV genotyping by a reverse hybridization-based line probe assay (INNO-LiPA) were performed on pretreatment formalin-fixed paraffin-embedded tumor samples from 46 patients treated for single primary oropharyngeal carcinomas. RESULTS Twenty-eight patients (61%) had a p16 overexpression in IHC. Twenty-nine patients (63%) harbored HPV DNA on qPCR. Thirty-four patients (74%) harbored HPV DNA on INNO-LiPA. The concordance analysis revealed a good agreement between both HPV DNA detection methods (κ=0.65); when both tests were positive, the depicted HPV subtypes were always concordant (HPV16 in 27 cases, HPV18 in 1 case). Agreement was moderate between IHC and qPCR (κ=0.59) and fair between IHC and INNO-LiPA (κ=0.22). CONCLUSIONS Certain highly sensitive methods are able to detect the mere presence of HPV without any carcinogenetic involvement while other more specific tests provide proof of viral transcriptional activity and thus evidence of clinically relevant infections. The use of a stepwise approach allows reducing false positives; p16-immunostaining seems to be an excellent screening test and in situ hybridization may overcome some of the PCR limitations.
Collapse
|
45
|
Wang H, Sun R, Lin H, Hu WH. P16INK4A as a surrogate biomarker for human papillomavirus-associated oropharyngeal carcinoma: consideration of some aspects. Cancer Sci 2013; 104:1553-9. [PMID: 24344719 DOI: 10.1111/cas.12287] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/03/2013] [Accepted: 09/11/2013] [Indexed: 12/21/2022] Open
Abstract
Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinomas (OPSCCs) frequently show different clinical and pathological features, which tend to be younger age, better performance status, less tobacco and alcohol consumption, more poorly differentiated histopathology, but usually with better treatment response and prognosis compared with HPV-negative OPSCCs. In tumor tissue, HPV infection is closely correlated with p16(INK4A) expression, which has been suggested to be a surrogate biomarker of HPV infection. However, there is diversity of sensitivity and specificity about p16(INK4A) in surrogate detection of HPV status. Herein, we summarize the current knowledge and note some aspects for consideration concerning p16(INK4A) as a surrogate biomarker for HPV-associated OPSCC.
Collapse
Affiliation(s)
- Hongzhi Wang
- Sun Yat-sen University Cancer Center, Guangdong, China; State Key Laboratory of Oncology in South China, Guangdong, China; Collaborative Innovation Center for Cancer Medicine, Guangdong, China
| | | | | | | |
Collapse
|
46
|
Mirghani H, Amen F, Moreau F, Guigay J, Ferchiou M, Melkane AE, Hartl DM, Lacau St Guily J. Human papilloma virus testing in oropharyngeal squamous cell carcinoma: what the clinician should know. Oral Oncol 2013; 50:1-9. [PMID: 24169585 DOI: 10.1016/j.oraloncology.2013.10.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022]
Abstract
High risk Human Papilloma virus (HR-HPV) associated oropharyngeal cancers are on the increase. Although, the scientific community is aware of the importance of Human Papilloma Virus (HPV) testing, there is no consensus on the assays that are required to reliably identify HR-HPV related tumors. A wide range of methods have been developed. The most widely used techniques include viral DNA detection, with polymerase chain reaction (PCR) or In Situ Hybridization, and p16 detected by immunohistochemistry. However, these tests provide different information and have their own specific limitations. In this review, we summarize these different techniques, in light of the recent literature. p16 Overexpression, which is an indirect marker of HPV infection, is considered by many head and neck oncologists to be the most important marker for patient stratification. We describe the frequent lack of concordance of this marker with other assays and the possible reasons for this. The latest developments in HPV testing are also reported, such as the RNAscope™ HPV test, and how they fit into the existing framework of techniques. HPV testing must not be considered in isolation, as there are important interactions with other parameters, such as tobacco exposure. This is an important and rapidly evolving field and is likely to become pivotal to staging and choice of treatment of oropharyngeal carcinoma in the future.
Collapse
Affiliation(s)
- Haïtham Mirghani
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Furrat Amen
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Frederique Moreau
- Department of Virology, Faculty of Medicine, University Pierre et Marie Curie Paris VI and Hospital Tenon Assistance Publique Hôpitaux de Paris, France.
| | - Joel Guigay
- Department of Medical Oncology, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Malek Ferchiou
- Department of Pathology, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Antoine E Melkane
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Dana M Hartl
- Department of Head and Neck Surgery, Institut de Cancérologie Gustave Roussy, Villejuif, France.
| | - Jean Lacau St Guily
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University Pierre et Marie Curie Paris VI and Hospital Tenon Assistance Publique Hôpitaux de Paris, France.
| |
Collapse
|
47
|
Mooren JJ, Gültekin SE, Straetmans JMJAA, Haesevoets A, Peutz-Kootstra CJ, Huebbers CU, Dienes HP, Wieland U, Ramaekers FCS, Kremer B, Speel EJM, Klussmann JP. P16(INK4A) immunostaining is a strong indicator for high-risk-HPV-associated oropharyngeal carcinomas and dysplasias, but is unreliable to predict low-risk-HPV-infection in head and neck papillomas and laryngeal dysplasias. Int J Cancer 2013; 134:2108-17. [PMID: 24127203 DOI: 10.1002/ijc.28534] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 09/12/2013] [Indexed: 01/08/2023]
Abstract
Human papillomavirus (HPV) is a risk factor for the development of benign and malignant mucosal head and neck lesions. P16(INK4A) is often used as a surrogate marker for HPV-infection, although there is still controversy with respect its reliability. Our aim was to determine if p16(INK4A) overexpression can accurately predict both high-risk and low-risk-HPV-presence in (pre)malignant and benign head and neck lesions. P16(INK4A) immunohistochemistry was performed on paraffin-embedded tissue sections of 162 oropharyngeal squamous cell carcinomas (OPSCC), 14 tonsillar and 23 laryngeal dysplasias, and 20 tonsillar and 27 laryngeal papillomas. PCR, enzyme-immunoassay and FISH analysis were used to assess HPV-presence and type. Of the 162 OPSCC and 14 tonsillar dysplasias, 51 (31%) and 10 (71%) were HPV16-positive, respectively. All tonsillar papillomas were HPV-negative and four laryngeal dysplasias and 26 laryngeal papillomas were positive for HPV6 or -11. P16(INK4A) immunohistochemistry revealed a strong nuclear and cytoplasmic staining in 50 out of 51 HPV16-positive and 5 out of 111 HPV-negative OPSCC (p < 0.0001) and in all HPV16-positive tonsillar dysplasias, whereas highly variable staining patterns were detected in the papillomas and laryngeal dysplasias, irrespective of the HPV-status. In addition, the latter lesions generally showed a higher nuclear than cytoplasmic p16(INK4A) immunostaining intensity. In conclusion, our data show that strong nuclear and cytoplasmic p16(INK4A) overexpression is a reliable surrogate indicator for HPV16 in OPSCC and (adjacent) dysplasias. For HPV6 or -11-positive and HPV-negative benign and premalignant lesions of the tonsil and larynx, however, p16(INK4A) immunostaining is highly variable and cannot be recommended to predict HPV-presence.
Collapse
Affiliation(s)
- Jeroen J Mooren
- Department of Otorhinolaryngology, Head and Neck Surgery, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Wendt M, Romanitan M, Näsman A, Dalianis T, Hammarstedt L, Marklund L, Ramqvist T, Munck-Wikland E. Presence of human papillomaviruses and p16 expression in hypopharyngeal cancer. Head Neck 2013; 36:107-12. [DOI: 10.1002/hed.23394] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 03/24/2013] [Accepted: 05/21/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Malin Wendt
- Department of Clinical Science, Intervention and Technology, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Mircea Romanitan
- Department of Oncology-Pathology, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Anders Näsman
- Department of Oncology-Pathology, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Tina Dalianis
- Department of Oncology-Pathology, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Lalle Hammarstedt
- Department of Clinical Science, Intervention and Technology, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Linda Marklund
- Department of Clinical Science, Intervention and Technology, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Torbjörn Ramqvist
- Department of Oncology-Pathology, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Eva Munck-Wikland
- Department of Clinical Science, Intervention and Technology, Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| |
Collapse
|
49
|
Melkane AE, Auperin A, Saulnier P, Lacroix L, Vielh P, Casiraghi O, Msakni I, Drusch F, Temam S. Human papillomavirus prevalence and prognostic implication in oropharyngeal squamous cell carcinomas. Head Neck 2013; 36:257-65. [PMID: 23728782 DOI: 10.1002/hed.23302] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) is associated with favorable survival. The purpose of this study was to evaluate the prevalence and prognostic significance of the HPV infection through both the p16 expression status and the oncogenic HPV DNA viral load. METHODS A retrospective chart review was conducted on all patients treated for oropharyngeal SCC between January 2007 and June 2009. P16 expression status by immunohistochemistry and HPV DNA viral load by quantitative polymerase chain reaction (qPCR) were evaluated on routine pretreatment tumor samples. RESULTS One hundred thirty-three patients (94 men and 39 women) were included in the study. Mean age was 59 years. One hundred twenty-two lesions (92%) were localized to lymphoid areas. Sixty-seven patients (50%) were p16+, and 87 patients (65%) harbored HPV DNA. The p16+/HPV DNA+ profile (48%) was associated with the most favorable prognosis. HPV16 was responsible for the majority of the infections (89%). CONCLUSION HPV is common among oropharyngeal SCC in France, and acts as an independent prognostic factor.
Collapse
Affiliation(s)
- Antoine E Melkane
- Department of Otolaryngology - Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Badoual C, Péré H, Roussel H, Si Mohamed A, Tartour É. [Cancers of the upper aerodigestive tract associated with human papillomavirus]. Med Sci (Paris) 2013; 29:83-8. [PMID: 23351698 DOI: 10.1051/medsci/2013291017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Carcinomas of the aerodigestive tract are most often secondary to alcohol and tobacco intoxication. However, it is shown that the oncogenic human papillomavirus (HPV) have an increasing role in the carcinogenesis of these cancers. Patients with HPV+ carcinoma are generally younger and not alcohol and tobacco users. These carcinomas are mainly localized in the oropharynx and in particular at the tonsil. HPV is found in 40 to 90 % of the cancers in the oropharynx, depending on the country. These HPV+ carcinomas have a better prognosis with better radio or chemosensitivity. To date, no change of treatment is recommended, however, several trials are underway. Preventive vaccination of boys is a real public health issue, especially since it is recommended in some countries. Moreover, a better understanding of the tumor microenvironment will ultimately offer therapeutic vaccination.
Collapse
Affiliation(s)
- Cécile Badoual
- Service d'anatomie pathologique, hôpital européen Georges Pompidou, 20-40, rue Leblanc, 75015 Paris, France.
| | | | | | | | | |
Collapse
|