1
|
Ezeh UC, Al-Awady A, Buitron I, Lee M, Forman G, Peifer S, Deo A, Sweeny L, Weed D, Kobetz EK, Reis IM, Franzmann E. Investigating Disparities in Hypopharyngeal/Laryngeal Cancer Survival in Florida With Geospatial Mapping Analysis. Cancer Control 2024; 31:10732748241246958. [PMID: 38623948 PMCID: PMC11022680 DOI: 10.1177/10732748241246958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/01/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE Identify predictors of overall survival (OS) after hypopharyngeal/laryngeal cancer in Florida. MATERIAL AND METHODS We conducted a retrospective cohort study using data from the Florida Cancer Data System (FCDS) on patients diagnosed with hypopharyngeal or laryngeal cancer from 2010-2017. Primary outcome was OS. Hazard ratios (HRs) were estimated from univariable and multivariable Cox regression models for OS. Data was analyzed from November 1, 2022, to June 30, 2023. RESULTS We analyzed 6771 patients, who were primarily male (81.2%), White non-Hispanic (WNH) (78.2%), publicly insured (70.1%), married (51.8%), and residents of urban counties (73.6%). Black patients were more likely to be younger at diagnosis (38.9%), single (43.4%), to have distant SEER stage disease (25.6%). Median OS were lowest among patients who were uninsured (34 months), with hypopharyngeal site disease (18 months), and a smoking history (current: 34 months, former: 46 months, no smoking: 63 months). Multivariable Cox regression analysis showed worse OS for single/unmarried vs married (HR 1.47 [95%CI: 1.36-1.59], P < .001), history of tobacco use (current: HR 1.62 [95%CI: 1.440-1.817], P < .001; former smokers: (HR 1.28 [95%CI: 1.139-1.437], P < .001) vs no history). Improved OS was observed among White Hispanics (WH) vs WNH (HR .73 [95%CI: .655-.817], P < .001) and women vs men (HR .88 [95%CI: .807-.954], P = .002). Geographical mapping showed that mortality rates were highest in census tracts with low income and education. CONCLUSION Our findings suggest that sociodemographic and clinical factors impact OS from hypopharyngeal/laryngeal cancer in Florida and vary geographically within the state. These results will help guide future public health interventions.
Collapse
Affiliation(s)
- Uche C. Ezeh
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abdurrahman Al-Awady
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Ming Lee
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Garrett Forman
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sophia Peifer
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alana Deo
- University of California Santa Barbara, Santa Barbara, CA, USA
| | - Larissa Sweeny
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Donald Weed
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Erin K. Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Division of Biostatistics, Department of Public Health Sciences, Sylvester Biostatistics and Bioinformatics Shared Resource, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Elizabeth Franzmann
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
2
|
Liberale C, Soloperto D, Marchioni A, Monzani D, Sacchetto L. Updates on Larynx Cancer: Risk Factors and Oncogenesis. Int J Mol Sci 2023; 24:12913. [PMID: 37629093 PMCID: PMC10454133 DOI: 10.3390/ijms241612913] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Laryngeal cancer is a very common tumor in the upper aero-digestive tract. Understanding its biological mechanisms has garnered significant interest in recent years. The development of laryngeal squamous cell carcinoma (LSCC) follows a multistep process starting from precursor lesions in the epithelium. Various risk factors have been associated with laryngeal tumors, including smoking, alcohol consumption, opium use, as well as infections with HPV and EBV viruses, among others. Cancer development involves multiple steps, and genetic alterations play a crucial role. Tumor suppressor genes can be inactivated, and proto-oncogenes may become activated through mechanisms like deletions, point mutations, promoter methylation, and gene amplification. Epigenetic modifications, driven by miRNAs, have been proven to contribute to LSCC development. Despite advances in molecular medicine, there are still aspects of laryngeal cancer that remain poorly understood, and the underlying biological mechanisms have not been fully elucidated. In this narrative review, we examined the literature to analyze and summarize the main steps of carcinogenesis and the risk factors associated with laryngeal cancer.
Collapse
Affiliation(s)
- Carlotta Liberale
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (C.L.); (D.M.); (L.S.)
| | - Davide Soloperto
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (C.L.); (D.M.); (L.S.)
| | | | - Daniele Monzani
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (C.L.); (D.M.); (L.S.)
| | - Luca Sacchetto
- Unit of Otorhinolaryngology, Head & Neck Department, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy; (C.L.); (D.M.); (L.S.)
| |
Collapse
|
3
|
Koyuncu CF, Nag R, Lu C, Corredor G, Viswanathan VS, Sandulache VC, Fu P, Yang K, Pan Q, Zhang Z, Xu J, Chute DJ, Thorstad WL, Faraji F, Bishop JA, Mehrad M, Castro PD, Sikora AG, Thompson LD, Chernock RD, Lang Kuhs KA, Wasman JK, Luo JR, Adelstein DJ, Koyfman SA, Lewis Jr JS, Madabhushi A. Image analysis reveals differences in tumor multinucleations in Black and White patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma. Cancer 2022; 128:3831-3842. [PMID: 36066461 PMCID: PMC9782693 DOI: 10.1002/cncr.34446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/17/2022] [Accepted: 06/28/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Understanding biological differences between different racial groups of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) patients, who have differences in terms of incidence, survival, and tumor morphology, can facilitate accurate prognostic biomarkers, which can help develop personalized treatment strategies. METHODS This study evaluated whether there were morphologic differences between HPV-associated tumors from Black and White patients in terms of multinucleation index (MuNI), an image analysis-derived metric that measures density of multinucleated tumor cells within epithelial regions on hematoxylin-eosin images and previously has been prognostic in HPV-associated OPSCC patients. In this study, the authors specifically evaluated whether the same MuNI cutoff that was prognostic of overall survival (OS) and disease-free survival in their previous study, TTR , is valid for Black and White patients, separately. We also evaluated population-specific cutoffs, TB for Blacks and TW for Whites, for risk stratification. RESULTS MuNI was statistically significantly different between Black (mean, 3.88e-4; median, 3.67e-04) and White patients (mean, 3.36e-04; median, 2.99e-04), with p = .0078. Using TTR , MuNI was prognostic of OS in the entire population with hazard ratio (HR) of 1.71 (p = .002; 95% confidence interval [CI], 1.21-2.43) and in White patients with HR of 1.72 (p = .005; 95% CI, 1.18-2.51). Population-specific cutoff, TW , yielded improved HR of 1.77 (p = .003; 95% CI, 1.21-2.58) for White patients, whereas TB did not improve risk-stratification in Black patients with HR of 0.6 (p = .3; HR, 0.6; 95% CI, 0.2-1.80). CONCLUSIONS Histological difference between White and Black patient tumors in terms of multinucleated tumor cells suggests the need for considering population-specific prognostic biomarkers for personalized risk stratification strategies for HPV-associated OPSCC patients.
Collapse
Affiliation(s)
- Can F. Koyuncu
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA,Louis Stokes Cleveland Veterans Affairs Medical CenterClevelandOhioUSA
| | - Reetoja Nag
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA
| | - Cheng Lu
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA
| | - Germán Corredor
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA,Louis Stokes Cleveland Veterans Affairs Medical CenterClevelandOhioUSA
| | - Vidya S. Viswanathan
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA
| | - Vlad C. Sandulache
- Baylor College of MedicineHoustonTexasUSA,Otolaryngology‐Head and Neck SurgeryOperative Care Line, Michael E. DeBakey Veterans Affairs Medical CenterHoustonTexasUSA
| | - Pingfu Fu
- Department of Population and Quantitative Health SciencesCase Western Reserve UniversityClevelandOhioUSA
| | | | - Quintin Pan
- Case Comprehensive Cancer CenterCase Western Reserve UniversityClevelandOhioUSA
| | - Zelin Zhang
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA
| | - Jun Xu
- Nanjing University of Information Science and TechnologyNanjingChina
| | | | | | - Farhoud Faraji
- University of California San DiegoSan DiegoCaliforniaUSA
| | | | - Mitra Mehrad
- Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | | | | | | | | | | | - Jay K. Wasman
- School of MedicineCase Western Reserve UniversityClevelandOhioUSA
| | | | | | | | | | - Anant Madabhushi
- Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of Technology and Emory UniversityAtlantaGeorgiaUSA,Atlanta Veterans Administration Medical CenterAtlantaGeorgiaUSA,Louis Stokes Cleveland Veterans Affairs Medical CenterClevelandOhioUSA
| |
Collapse
|
4
|
Hoffmann M, Quabius ES. Relevance of Human Papillomaviruses in Head and Neck Cancer-What Remains in 2021 from a Clinician's Point of View? Viruses 2021; 13:v13061173. [PMID: 34207440 PMCID: PMC8235461 DOI: 10.3390/v13061173] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Human papillomaviruses (HPV) cause a subset of head and neck cancers (HNSCC). HPV16 predominantly signs responsible for approximately 10% of all HNSCC and over 50% of tonsillar (T)SCCs. Prevalence rates depend on several factors, such as the geographical region where patients live, possibly due to different social and sexual habits. Smoking plays an important role, with non-smoking patients being mostly HPV-positive and smokers being mostly HPV-negative. This is of unparalleled clinical relevance, as the outcome of (non-smoking) HPV-positive patients is significantly better, albeit with standard and not with de-escalated therapies. The results of the first prospective de-escalation studies have dampened hopes that similar superior survival can be achieved with de-escalated therapy. In this context, it is important to note that the inclusion of p16INK4A (a surrogate marker for HPV-positivity) in the 8th TMN-classification has only prognostic, not therapeutic, intent. To avoid misclassification, highest precision in determining HPV-status is of utmost importance. Whenever possible, PCR-based methods, still referred to as the "gold standard”, should be used. New diagnostic antibodies represent some hope, e.g., to detect primaries and recurrences early. Prophylactic HPV vaccination should lead to a decline in HPV-driven HNSCC as well. This review discusses the above aspects in detail.
Collapse
Affiliation(s)
- Markus Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, Christian-Albrechts-University Kiel, D24105 Kiel, Germany;
- Quincke-Forschungszentrum (QFZ), Medical Faculty, Christian-Albrechts-University Kiel, D24105 Kiel, Germany
- Correspondence: ; Tel.: +49-431-500-21701; Fax: +49-431-500-19028
| | - Elgar Susanne Quabius
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, Christian-Albrechts-University Kiel, D24105 Kiel, Germany;
- Quincke-Forschungszentrum (QFZ), Medical Faculty, Christian-Albrechts-University Kiel, D24105 Kiel, Germany
| |
Collapse
|
5
|
Feit NZ, Wang Z, Demetres MR, Drenis S, Andreadis K, Rameau A. Healthcare Disparities in Laryngology: A Scoping Review. Laryngoscope 2020; 132:375-390. [PMID: 33314122 DOI: 10.1002/lary.29325] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/06/2020] [Accepted: 12/01/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES/HYPOTHESIS This scoping review aims to map out existing disparities research within the subspecialty of laryngology in order to highlight gaps in knowledge and guide future research. STUDY DESIGN Scoping Review. METHODS We completed a scoping review of PubMed, Ovid Embase, and the Cochrane Library for primary research focused on evaluating the existence and impact of disparities in race/ethnicity, sex/gender, insurance status, education level, income, geography, and LGBTQ identity in the context of various laryngological conditions. Publications of any design and date, performed in the United States, and focusing on the adult population exclusively were included. RESULTS Of the 4,999 unique abstracts identified, 51 articles were ultimately included. The most frequently examined condition in relation to disparities was laryngeal cancer (27 of 51), followed by voice disorders (15 of 51), deglutitive disorders (eight of 51), and airway disorders (one of 51). Sources of inequity evaluated from most common to least common were race/ethnicity (43 of 51), sex/gender (39 of 51), insurance status (23 of 51), geography (23 of 51), income (21 of 51), and education level (16 of 51). No study examined the association of LGBTQ identity with inequity. CONCLUSIONS This scoping review highlights the limited extent of disparities research in laryngology and establishes the need for further scholarship on the impact of disparities in laryngology care. The pathologies studied were, in decreasing order of frequency: laryngeal cancer, voice disorders, deglutitive disorders, and airway disorders. Race/ethnicity and sex/gender were the most common disparities examined, with no evaluation of LGBTQ-related care inequity. LEVEL OF EVIDENCE NA Laryngoscope, 2020.
Collapse
Affiliation(s)
- Noah Z Feit
- Otolaryngology Department, Weill Cornell Medical College, New York, New York, U.S.A
| | - Zhaorui Wang
- Otolaryngology Department, Weill Cornell Medical College, New York, New York, U.S.A
| | - Michelle R Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, U.S.A
| | - Sotirios Drenis
- Department of Otolaryngology, Head & Neck Surgery, Weill Cornell Medical College, New York, New York, U.S.A
| | - Katerina Andreadis
- Department of Otolaryngology, Head & Neck Surgery, Weill Cornell Medical College, New York, New York, U.S.A.,Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York, U.S.A
| | - Anaïs Rameau
- Department of Otolaryngology, Head & Neck Surgery, Weill Cornell Medical College, New York, New York, U.S.A.,Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York, U.S.A
| |
Collapse
|
6
|
Ben Elhadj M, Fourati A, El Amine O, Goucha A, El May A, El May MV, Mokni Baizig N. Prevalence and Prognostic Value of HPV among Tunisian Patients with Laryngeal Cancer and Relationship between DNA HPV and p16, IGF-1R, Survivin, p53 Expressions. Ann Otol Rhinol Laryngol 2020; 129:863-871. [PMID: 32364419 DOI: 10.1177/0003489420918280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Tobacco and alcohol are the main etiological factors common to laryngeal cancers. However, the Human Papilloma Virus (HPV) constitutes an alternative risk factor according to several studies. In Tunisia, despite the annual increasing incidence of laryngeal squamous cell carcinoma (LSCC), the prevalence and prognostic significance of HPV have never been explored.In this study, we sought to highlight HPV DNA in 70 biopsies of laryngeal cancer, and to analyze the status of HPV infection in association with p53, p16, survivin, and IGF-1R expressions. METHODS HPV high risk (HPV HR) DNA was detected in tumors by in situ hybridization. However, the expression of p53, p16, survivin and IGF-1R were stained by immunohistochemistry test. The correlations of HPV status with clinicopathological parameters, overall survival, disease-free survival and proteins expressions were statistically evaluated. RESULTS HPV HR DNA was detected in 39 out of 70 (55.71%) laryngeal tumors. HPV+ patients have a better overall survival (P = .081) and long disease-free-survival (P = .016) with a low rate of recurrence (P = .006) than HPV- patients. No significant correlations were found between HPV HR status and clinicopathological parameters (all P > .005). Moreover, HPV+ tumors were not associated with expression of p53, p16 and survivin. However, HPV HR status correlates with weak to moderate IGF-1R expression (P = .043). CONCLUSION The substantial detection of HPV HR in LSCC tumors suggest that this virus plays an important part in laryngeal cancer in Tunisia. It is a good prognostic factor. In addition, HPV infection could act to block the pathway of IGF-1R expression.
Collapse
Affiliation(s)
- Mariem Ben Elhadj
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Asma Fourati
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Olfa El Amine
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Aida Goucha
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Ahmed El May
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia
| | - Michèle-Veronique El May
- Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| | - Nehla Mokni Baizig
- Departement of Immuno-Histo-Cytology, Salah Azaiez Cancer Institute, Tunis, Tunisia.,Research unit 17/ES/13 Faculty of Medicine, Tunis, Tunisia, University of Tunis El Manar, Tunisia
| |
Collapse
|
7
|
Zhu Y, Xia X, Gao L, Zhu X, Diao W, Liang Z, Gao Z, Chen X. Prognostic implications of human papillomavirus type 16 status in non-oropharyngeal head and neck cancer: a propensity score matching analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:759. [PMID: 32042775 PMCID: PMC6989993 DOI: 10.21037/atm.2019.11.72] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/05/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the association between HPV 16 status and survival outcomes in patients with non-oropharyngeal squamous carcinoma (non-OPSCC). METHODS Patients with non-OPSCC diagnosed between 2006 and 2016 were included in this study. The presence of HPV 16 DNA was confirmed by quantitative real-time polymerase chain reaction. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching (PSM). RESULTS Overall, 1,539 patients with adequate specimens were identified, of whom 131 (8.51%) were positive for HPV 16. Compared to HPV 16-negative patients, the adjusted hazard ratios (aHR) for HPV 16-positive non-OPSCC patients were 0.77 and 0.81 for disease-specific survival (DSS) and overall survival (OS), respectively. Additionally, the larynx was the only subsite in which DSS was significantly improved. After PSM, cohorts consisted of 129 patients in the HPV 16-positive group and 129 in the HPV 16-negative group. HPV 16-positive non-OPSCC patients had favorable survival outcomes, however, these outcomes were not significantly different compared to HPV 16-negative patients. Stratified analysis performed according to primary site showed that only in the larynx was HPV 16-positive status a significant factor for predicting favorable DSS. CONCLUSIONS Our findings indicate that HPV 16-positive non-OPSCC patients did not have significantly better survival outcomes compared to HPV 16-negative patients.
Collapse
Affiliation(s)
- Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Liming Gao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xiaoli Zhu
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Wenwen Diao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Zhiqiang Gao
- Department of Otolaryngology-Head and Neck Surgery, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, China
| |
Collapse
|
8
|
Wang H, Wei J, Wang B, Meng L, Xin Y, Dong L, Jiang X. Role of human papillomavirus in laryngeal squamous cell carcinoma: A meta-analysis of cohort study. Cancer Med 2019; 9:204-214. [PMID: 31733044 PMCID: PMC6943161 DOI: 10.1002/cam4.2712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022] Open
Abstract
Objective To evaluate the association of human papilloma virus (HPV) infection with prognosis, specifically overall survival (OS) and disease‐free survival (DFS), in laryngeal squamous cell carcinoma (LSCC) patients. Method A systematic review and meta‐analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. LSCC was confirmed on the basis of histopathology, whereas HPV status was confirmed by polymerase chain reaction. Results A total of 6539 articles were initially searched from 8 databases, of which 11 studies were eligible for our review. A total of 1442 LSCC cases were included in this analysis. Eight studies examined 3‐year OS for LSCC. The pooled hazard ratio (HR) from the 8 studies was 0.29 (95% CI: 0.25‐0.33). There was a statistically significant difference in 3‐year OS between the HPV‐negative and ‐positive groups, with the latter having a better survival. There was no statistically significant differences in 5‐ and 10‐year OS. Five studies examined 3‐ and 5‐year DFS for LSCC, whereas only 3 studies examined 10‐year DFS. There was no statistically significant difference in 3‐, 5‐, and 10‐year DFS between the HPV groups. Conclusion This study evaluated the survival impact of HPV infection in LSCC patients. The OS of the HPV‐positive group was better than that of the HPV‐negative group in terms of short‐term survival. Compared with the HPV‐negative group, the HPV‐positive group had a better trend of DFS, suggesting that a larger sample size and further exploration of the pathology and local control of HPV‐positive tumors are needed.
Collapse
Affiliation(s)
- Huanhuan Wang
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| | - Jinlong Wei
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| | - Bin Wang
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| | - Lingbin Meng
- Department of Internal Medicine, Florida Hospital, Orlando, FL, USA
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
| | - Lihua Dong
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| |
Collapse
|
9
|
Zhu Y, Xia X, Gross N, Dahlstrom KR, Gao L, Liang Z, Gao Z, Wei P, Liu C, Li G, Li Y, Chen X. Prognostic implications of human papillomavirus status and p16 expression in laryngeal squamous cell carcinoma. Head Neck 2019; 41:4151-4163. [PMID: 31566825 DOI: 10.1002/hed.25961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/10/2019] [Accepted: 08/28/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate significance of HPV16 DNA/p16 for survival of patients with laryngeal squamous cell carcinoma (LSCC). METHODS HPV16 DNA and p16 status in 812 LSCC patients were determined. The survival was performed using Kaplan-Meier estimates and Cox model. RESULTS Compared with HPV negativity, adjusted HRs for HPV16 positivity were 0.57, 95% CI, 0.38 to 0.87; 0.60, 0.40 to 0.88; and 0.65, 0.46 to 0.94 for disease-specific survival (DSS), recurrence-free survival (RFS), and overall survival (OS), respectively. Additionally, for p16 expression, aHRs were 0.68, 95% CI, 0.48 to 0.96; 0.72, 0.52 to 0.98; and 0.73, 0.54 to 0.99 for DSS, RFS, and OS, respectively. Finally, for combined analysis, patients with both HPV16-positivity/p16-positivity had much better prognosis than those with either negativity. Such above survivals are more significantly better in never smokers. CONCLUSION Our findings suggest that HPV16/p16 may affect survival outcomes of LSCC patients, particularly in never smokers.
Collapse
Affiliation(s)
- Yingying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Neil Gross
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristina R Dahlstrom
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Liming Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhiqiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Peng Wei
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chuan Liu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guojun Li
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yuncheng Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
10
|
Ablanedo-Terrazas Y, Romero-Mora K, Gómez-Palacio M, Alvarado-de la Barrera C, Ruiz-Cruz M, Hernández-Juan R, Reyes-Terán G. Prevalence and risk factors for oral human papillomavirus infection in Mexican HIV-infected men. SALUD PUBLICA DE MEXICO 2019; 60:653-657. [PMID: 30699270 DOI: 10.21149/9834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/15/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infec- tion in human immunodeficiency virus(HIV)-infected men. MATERIALS AND METHODS Consecutive male outpatients with HIV-infection were enrolled. Demographic and behav- ioral risk data were obtained. Anal swabs and oral rinses were tested for HR-HPV DNA. Oral, pharyngeal and video laryngoscopy examinations were performed for detection of lesions. RESULTS The prevalence of HR-HPV oral infection was 9.3% (subtypes other than HR HPV 16/18 predominated). The prevalence of anal HR-HPV infection was 75.7%. The risk factors for oral infection with HR-HPV were tonsillectomy (OR=13.12) and years from HIV diagnosis (OR=1.17). CONCLUSIONS Tonsillectomy and years from HIV diagnosis were associated with oral HPV infection. No association was found between oral and anal HR-HPV infections. This is the first study reporting the prevalence and risk factors for oral HR-HPV infection in Mexican HIV-infected population.
Collapse
Affiliation(s)
- Yuria Ablanedo-Terrazas
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - Karla Romero-Mora
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - María Gómez-Palacio
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - Matilde Ruiz-Cruz
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - Ramón Hernández-Juan
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| | - Gustavo Reyes-Terán
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México
| |
Collapse
|
11
|
Shoffel-Havakuk H, O'Dell K, Johns MM, Reder L, Popova M, Halperin D, Feldberg E, Lahav Y. The rising rate of nonsmokers among laryngeal carcinoma patients: Are we facing a new disease? Laryngoscope 2019; 130:E108-E115. [PMID: 31090946 DOI: 10.1002/lary.28067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 03/29/2019] [Accepted: 04/23/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Laryngeal squamous cell carcinoma (SCC) is strongly associated with tobacco smoking. With the rising awareness of tobacco's adverse health effects, we have witnessed a global decrease in tobacco use. Nevertheless, laryngeal SCC remains prevalent and includes a subset of patients lacking the traditional risk factors. STUDY DESIGN A two-center retrospective cohort. METHODS Medical records of patients diagnosed with laryngeal SCC between 2009 and 2016 were reviewed. Data collected included demographics, smoking status, and tumor site. Patients who have never smoked were designated as nonsmokers. RESULTS The study included 330 patients with laryngeal SCC, of whom 75 (22.7%) were nonsmokers; this rate was relatively similar for each of the two institutions independently (21.9% and 25%). There were 285 patients with glottic SCC and 45 with supraglottic SCC. All nonsmoking patients in this cohort had glottic SCC, representing 26.3% (75/285) of the glottic SCC cases. The rate of female patients was significantly higher among nonsmokers. Of the patients with glottic SCC, females represented 25.3% (19/75) of the nonsmokers compared with 12.4% (26/210) of the smokers (P = .008). Mean age at diagnosis was 60.2 ± 17.5 years for nonsmoking glottic SCC patients and 63.6 ± 12.4 years for smokers (P = .280). However, nonsmokers demonstrated a distinct age distribution pattern. Nonsmoking females with glottic SCC demonstrated a bimodal age distribution pattern; 73.7% (14/19) were age <40 years or >75 years at diagnosis. CONCLUSIONS The rate of laryngeal SCC in nonsmokers is higher than what has previously been reported, representing a growing proportion, and may suggest a shift in etiology. Knowing that laryngeal SCC in nonsmokers predominantly affects the glottis, and that females and age extremities are more vulnerable, the traditional screening paradigm should be revised. LEVEL OF EVIDENCE 4 Laryngoscope, 130:E108-E115, 2020.
Collapse
Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karla O'Dell
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Michael M Johns
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Lindsay Reder
- Department of Otolaryngology, Head and Neck Surgery, Southern California Permanente Medical Group, Los Angeles, California
| | - Margarita Popova
- USC Voice Center, Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, California
| | - Doron Halperin
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, and the Hebrew University, Jerusalem, Israel
| | - Edit Feldberg
- Department of Pathology, Kaplan Medical Center, Rehovot, and the Hebrew University, Jerusalem, Israel
| | - Yonatan Lahav
- Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, and the Hebrew University, Jerusalem, Israel
| |
Collapse
|
12
|
Götz C, Bischof C, Wolff KD, Kolk A. Detection of HPV infection in head and neck cancers: Promise and pitfalls in the last ten years: A meta-analysis. Mol Clin Oncol 2019; 10:17-28. [PMID: 30655973 PMCID: PMC6313947 DOI: 10.3892/mco.2018.1749] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
The current controversial discussion on the disease-specific survival of patients with human papillomavirus (HPV)-positive (+) and -negative (-) squamous cell carcinoma (SCC) of the head neck region was the motivation for the present meta-analysis. Different detection methods for HPV are available, though these often lack sensitivity. As a consequence, there may be false interpretation of HPV positivity. A bias concerning HPV status and therefore also survival rates is serving a non-durable relevance in the discussion of tailored therapies. A literature search was performed via the online database PubMed/NCBI, and data extraction and statistical analysis were conducted. A total of 139 studies published between 2004 and 2014 were evaluated in the present meta-analysis. The HPV detection methods, patient characteristics, tumor localizations and stages, as well as (neo-) adjuvant therapies and survival times were analyzed. The average incidence rates of HPV+ patients with oropharyngeal tumors were higher than those of patients with cancers of other regions of the head and neck. Upon evaluating the results of different detection methods no significant differences were identified. We have compared the HPV incidence rates of each detection method, when studies have used more than one. Regarding overall survival, the pooled adjusted hazard ratio (HR) for oropharyngeal SCC was 0.31 [95% confidence interval (CI)=0.27-0.36]. Unfortunately, only 3 equivalent studies were available on nonoropharyngeal tumors, for which the pooled adjusted HR was 1 (95% CI=0.73-1.36). Overall, the evaluation demonstrated that the survival rates reported in numerous studies were not evaluated multifactorially and important confounders were excluded from the statistics. The HPV detection methods used were often not sufficient in representing HPV positivity. In addition, oropharyngeal and oral SCCs were assessed together in the localization. The widely differing number of HPV+ patients in each of the various studies may be explained by insufficient detection methods and by a lack of localization distinction. The considerations of a tailored therapy according to HPV status should be rejected based on the present information. The previously published studies should be read critically and do not represent a basis for therapeutic decisions.
Collapse
Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Clara Bischof
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| |
Collapse
|
13
|
Onerci Celebi O, Sener E, Hosal S, Cengiz M, Gullu I, Guler Tezel G. Human papillomavirus infection in patients with laryngeal carcinoma. BMC Cancer 2018; 18:1005. [PMID: 30342481 PMCID: PMC6195980 DOI: 10.1186/s12885-018-4890-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the HPV positivity rate in patients with laryngeal cancer, and to determine the effect of HPV positivity on survival. An additional aim was to determine if patients with HPV positive laryngeal cancer are more sensitive to chemotherapy and if such sensitivity differs according to chemotherapy protocol. METHODS The study included laryngeal specimens obtained from 82 laryngeal cancer patients and 11 laryngeal specimens with normal laryngeal mucosa that were obtained from our hospital's paraffin block archives between 1995 and 2013. HPV was detected via chromogenic in situ hybridization (cISH) and confirmed via genotyping. RESULTS HPV was not detected in any of the 82 laryngeal cancer patients' laryngeal specimens, nor in any of the 11 archived laryngeal specimens with normal laryngeal mucosa via cISH. Genotyping confirmed these findings; none of the HPV types studied were detected in any of the specimens. As none of the study samples were HPV positive, it was not possible to compare survival, recurrence, or chemotherapy sensitivity. CONCLUSIONS HPV infection is not a leading cause of laryngeal cancer; however, additional research on HPV positivity in patients with laryngeal cancer and its effect on recurrence, survival, and chemotherapy sensitivity is warranted.
Collapse
Affiliation(s)
- Ozlem Onerci Celebi
- Department of Otolarygology-Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Ebru Sener
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.,Department of Pathology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Sefik Hosal
- Department of Otolarygology-Head and Neck Surgery, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mustafa Cengiz
- Department of Radiation Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ibrahim Gullu
- Department of Medical Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Gaye Guler Tezel
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey
| |
Collapse
|
14
|
Lewis JS, Beadle B, Bishop JA, Chernock RD, Colasacco C, Lacchetti C, Moncur JT, Rocco JW, Schwartz MR, Seethala RR, Thomas NE, Westra WH, Faquin WC. Human Papillomavirus Testing in Head and Neck Carcinomas: Guideline From the College of American Pathologists. Arch Pathol Lab Med 2018; 142:559-597. [PMID: 29251996 DOI: 10.5858/arpa.2017-0286-cp] [Citation(s) in RCA: 348] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context Human papillomavirus (HPV) is a major cause of oropharyngeal squamous cell carcinomas, and HPV (and/or surrogate marker p16) status has emerged as a prognostic marker that significantly impacts clinical management. There is no current consensus on when to test oropharyngeal squamous cell carcinomas for HPV/p16 or on which tests to choose. Objective To develop evidence-based recommendations for the testing, application, interpretation, and reporting of HPV and surrogate marker tests in head and neck carcinomas. Design The College of American Pathologists convened a panel of experts in head and neck and molecular pathology, as well as surgical, medical, and radiation oncology, to develop recommendations. A systematic review of the literature was conducted to address 6 key questions. Final recommendations were derived from strength of evidence, open comment period feedback, and expert panel consensus. Results The major recommendations include (1) testing newly diagnosed oropharyngeal squamous cell carcinoma patients for high-risk HPV, either from the primary tumor or from cervical nodal metastases, using p16 immunohistochemistry with a 70% nuclear and cytoplasmic staining cutoff, and (2) not routinely testing nonsquamous oropharyngeal carcinomas or nonoropharyngeal carcinomas for HPV. Pathologists are to report tumors as HPV positive or p16 positive. Guidelines are provided for testing cytologic samples and handling of locoregional and distant recurrence specimens. Conclusions Based on the systematic review and on expert panel consensus, high-risk HPV testing is recommended for all new oropharyngeal squamous cell carcinoma patients, but not routinely recommended for other head and neck carcinomas.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - William C Faquin
- From the Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Lewis); the Department of Radiation Oncology, Stanford University Medical Center, Palo Alto, California (Dr Beadle); the Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland (Drs Bishop and Westra); the Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri (Dr Chernock); Surveys, the College of American Pathologists, Northfield, Illinois (Mss Colasacco and Thomas); Policy and Advocacy, American Society of Clinical Oncology, Alexandria, Virginia (Ms Lacchetti); the Department of Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Moncur); the Department of Otolaryngology-Head and Neck Surgery, Ohio State University Wexler Medical Center, Columbus (Dr Rocco); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Schwartz); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Seethala); and the Department of Pathology, Massachusetts General Hospital, Boston (Dr Faquin)
| |
Collapse
|
15
|
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
|
16
|
Proportion of CD4 and CD8 tumor infiltrating lymphocytes predicts survival in persistent/recurrent laryngeal squamous cell carcinoma. Oral Oncol 2017; 77:83-89. [PMID: 29362129 DOI: 10.1016/j.oraloncology.2017.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/24/2017] [Accepted: 12/05/2017] [Indexed: 01/10/2023]
Abstract
Tumor infiltrating lymphocytes (TILs) have been shown to be an important prognostic factor in patients with previously untreated head and neck cancer. After organ preservation therapy for laryngeal cancer and subsequent persistence/recurrence, the prognostic value of TILs is unknown. Our goal was to determine if TILs have value as a prognostic biomarker in patients with surgically salvageable persistent/recurrent laryngeal squamous cell carcinoma. Levels of TILs were quantified on tissue microarrays from 183 patients undergoing salvage total laryngectomy for persistent/recurrent laryngeal cancer after radiation or chemoradiation between 1997 and 2014. Demographic and clinical data were abstracted. Immunohistology evaluation included CD4, CD8, PDL-1, p16, CD31, Vimentin, EGFR, and p53. Elevated levels of either CD8 or CD4 positive TILs were associated with improved disease specific survival (CD8: HR 0.46, 95% CI 0.24-0.88, CD4: HR 0.43; 95% CI 0.21-0.89) and disease free survival (CD8: HR 0.53, 95% CI 0.29-0.94, CD4: HR 0.52; 95% CI 0.27-0.99). Levels of CD8 (HR 0.74; 95% CI 0.47-1.17) or CD4 (HR 0.66; 95% CI 0.40-1.08) TILs were not significantly associated with overall survival. In bivariate analysis, patients with elevated CD4 and/or CD8 TILs had significantly improved disease specific survival (HR 0.42; 95% CI 0.21-0.83) and disease free survival (HR 0.45; 95% CI 0.24-0.84) compared to patients with low levels of CD4 and CD8. PDL-1, p16, CD31, Vimentin, EGFR, and p53 were not significant prognostic factors. On multivariate analysis, elevated CD8 TILs were associated with improved disease specific survival (HR 0.35; 95% CI 0.14-0.88, p = .02) and disease free survival (HR 0.41; 95% CI 0.17-0.96, p = .04). CD8, and possibly CD4, positive TILs are associated with favorable disease free and disease specific survival for recurrent/persistent laryngeal cancer.
Collapse
|
17
|
Hosseini SZ, Makvandi M, Samarbafzade A, Timori A, Ranjbar N, Saki N, Nisi N, Shahani T, Varnaseri M, Angali Ahmadi K. Frequency of Human Papillomavirus (HPV) 16 and 18 Detection
in Paraffin- Embedded Laryngeal Carcinoma Tissue. Asian Pac J Cancer Prev 2017; 18:889-893. [PMID: 28545184 PMCID: PMC5494237 DOI: 10.22034/apjcp.2017.18.4.889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background and Objective: Human papilloma virus (HPV) 16 and HPV18 have been detected in head and neck squamous cell carcinomas (HNSCC) and there is evidence that detection of HPVs would have better prognostic value than patients with HNSCC negative for HPVs. Thus, this study was conducted to evaluate frequency of HPV 16 and HPV 18 genotypes in patients with laryngeal carcinoma. Materials and methods: Fifty formalin-fixed, paraffin-embedded (FFPE) tissue blocks of laryngeal cancers were collected. Sections were prepared at 5 μm and DNA was extracted from each sample and subjected to the polymerase chain reaction (PCR) to detect HPV-16/18 DNA s. Results: All samples were squamous cell carcinomas (SCCs). Overall 14/50 (28%) were positive for HPVs, 8 (18%) with HPV-16 and 6 (12%) with HPV-18. Additionally, 2 (4%) mixed infections of HPV 16 and 18 genotypes were observed among these cases. Conclusions: Overall, 28% of HNSCC samples proved positive for HPV16 and HPV18 genotypes, two high-risk HPV types. It is important to further assess whether such viral infection, could be a risk factor in HNSCC progression.
Collapse
Affiliation(s)
- Seyed Zinab Hosseini
- Health Research Institute; Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Sánchez Barrueco A, González Galán F, Lora Pablos D, Villacampa Aubá JM, Ballestín Carcavilla C, Cenjor Español C, Almodóvar Álvarez C. HPV in Larynx Squamous Cell Carcinoma: New Serotypes and Survival Study within 10-Year Follow-up. Otolaryngol Head Neck Surg 2017; 156:677-682. [PMID: 28322111 DOI: 10.1177/0194599817695545] [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] [Indexed: 01/03/2023]
Abstract
Objective To determine the presence of human papillomavirus (HPV) in head and neck squamous cell carcinoma, specifically in the larynx without the bias of other sublocations, and to describe the different serotypes of HPV and their impact on overall and disease-free survival after 10-year follow-up. Study Design Retrospective case series with chart review of ear, nose, and throat oncologic database. Setting Academic tertiary care hospital. Subjects A total of 123 samples of larynx squamous cell carcinoma were included, only from the glottis and treated only with surgery between 1977 and 2005. Methods DNA extraction was carried out by polymerase chain reaction, and subsequent visualization was performed in low-density arrays. Results were compared with histologic, clinicopathologic, and survival parameters, with a 10-year follow-up. Results HPV DNA was detected in 22.76% (n = 28) of the samples. Eleven genotypes were detected, 2 of which had never been described in the larynx (HPV43 and HPV62). No increasing trend of HPV was observed over time. HPV presence did not correlate with better survival during the follow-up. Smoking was proven as an independent factor in relation to the presence of HPV. Conclusion HPV may represent a notable factor in the development of a subset of laryngeal squamous cell carcinoma without significant influence on overall and disease-free survival. More studies, including oncogene transcription proteins, would be necessary to draw more relevant conclusions about the relevance of HPV infection in the larynx.
Collapse
Affiliation(s)
- Alvaro Sánchez Barrueco
- 1 ENT and Head and Neck Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Fernando González Galán
- 1 ENT and Head and Neck Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - David Lora Pablos
- 2 Clinical Research Unit (imas12-CIBERESP), Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Carlos Cenjor Español
- 1 ENT and Head and Neck Surgery Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | |
Collapse
|
19
|
Meshman J, Wang PC, Chin R, John MS, Abemayor E, Bhuta S, Chen AM. Prognostic significance of p16 in squamous cell carcinoma of the larynx and hypopharynx. Am J Otolaryngol 2017; 38:31-37. [PMID: 27751621 DOI: 10.1016/j.amjoto.2016.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the prognostic significance of p16 expression among patients with squamous cell carcinoma of the larynx (LSCC) and hypopharynx (HSCC). METHODS The medical records of all patients with locally advanced, non-metastatic LSCC/HSCC were reviewed. p16INK4A (p16) protein expression was evaluated on pathological specimens by immunohistochemistry (IHC), and the Kaplan-Meier method was used to estimate overall survival (OS) and locoregional control (LRC). In select cases, p16 expression was correlated to high-risk and low-risk HPV genotypes using in situ hybridization (ISH). RESULTS Thirty-one patients (23 LSCC; 8 HSCC) were identified. Seventeen (54.8%) patients were p16 negative; 14 (45.2%) were p16-positive. The primary treatment modality was radiation therapy for 22 (71.0%) patients and surgery for 9 (29.0%). Nineteen (61.3%) patients were evaluated for high-risk HPV and low-risk HPV genotypes by IHC, of whom 2 (10.5%) patients were positive for high-risk HPV and 1 (5.3%) was positive for low-risk HPV. For high-risk HPV, the positive predictive value (PPV), sensitivity, and specificity of p16 was 20.0%, 100%, and 52.9%. There was no significant difference in the 2-year actuarial rates of OS (91% vs. 64%, p=0.34) or LRC (51% vs. 46%, p=0.69) between the p16-positive and p-16 negative patients. CONCLUSION In this small cohort of 31 LSCC and HSCC patients, p16 was not a significant predictive of either LRC or OS. Furthermore, p16 was poorly correlated with HPV genotyping as identified by ISH.
Collapse
|
20
|
Ragin C, Liu JC, Jones G, Shoyele O, Sowunmi B, Kennett R, Groen HJM, Gibbs D, Blackman E, Esan M, Brandwein MS, Devarajan K, Bussu F, Chernock R, Chien CY, Cohen MA, Samir EM, Mikio S, D'Souza G, Funchain P, Eng C, Gollin SM, Hong A, Jung YS, Krüger M, Lewis J, Morbini P, Landolfo S, Rittà M, Straetmans J, Szarka K, Tachezy R, Worden FP, Nelson D, Gathere S, Taioli E. Prevalence of HPV Infection in Racial-Ethnic Subgroups of Head and Neck Cancer Patients. Carcinogenesis 2016; 38:218-229. [PMID: 28025390 DOI: 10.1093/carcin/bgw203] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Indexed: 12/13/2022] Open
Abstract
The landscape of HPV infection in racial/ethnic subgroups of head and neck cancer (HNC) patients has not been evaluated carefully. In this study, a meta-analysis examined the prevalence of HPV in HNC patients of African ancestry. Additionally, a pooled analysis of subject-level data was also performed to investigate HPV prevalence and patterns of p16 (CDNK2A) expression amongst different racial groups. Eighteen publications (N = 798 Black HNC patients) were examined in the meta-analysis, and the pooled analysis included 29 datasets comprised of 3,129 HNC patients of diverse racial/ethnic background. The meta-analysis revealed that the prevalence of HPV16 was higher among Blacks with oropharyngeal cancer than Blacks with non-oropharyngeal cancer. However, there was great heterogeneity observed among studies (Q test P<0.0001). In the pooled analysis, after adjusting for each study, year of diagnosis, age, gender and smoking status, the prevalence of HPV16/18 in oropharyngeal cancer patients was highest in Whites (61.1%), followed by 58.0% in Blacks and 25.2% in Asians (P<0.0001). There was no statistically significant difference in HPV16/18 prevalence in non-oropharyngeal cancer by race (P=0.682). With regard to the pattern of HPV16/18 status and p16 expression, White patients had the highest proportion of HPV16/18+/p16+ oropharyngeal cancer (52.3%), while Asians and Blacks had significantly lower proportions (23.0% and 22.6%, respectively) [P <0.0001]. Our findings suggest that the pattern of HPV16/18 status and p16 expression in oropharyngeal cancer appears to differ by race and this may contribute to survival disparities.
Collapse
Affiliation(s)
- Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Jeffrey C Liu
- Department of Otolaryngology, Temple University; and Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Gieira Jones
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Olubunmi Shoyele
- Department of Pathology and Laboratory Medicine, Western Connecticut Health Network, Danbury Hospital, Danbury, CT, USA
| | - Bukola Sowunmi
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Rachel Kennett
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Harry J M Groen
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Denise Gibbs
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Elizabeth Blackman
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Michael Esan
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Margaret S Brandwein
- Department of Pathology and Anatomical Sciences, SUNY at the University at Buffalo, Buffalo, NY, USA
| | - Karthik Devarajan
- Department of Biostatistics, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Francesco Bussu
- Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - Rebecca Chernock
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - El-Mofty Samir
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Suzuki Mikio
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pauline Funchain
- Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Charis Eng
- Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Susanne M Gollin
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Angela Hong
- Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuh-S Jung
- Department of Otolaryngology, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea
| | - Maximilian Krüger
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - James Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Patrizia Morbini
- Department of Molecular Medicine, Unit of Pathology, University of Pavia, and à IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Santo Landolfo
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Massimo Rittà
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Jos Straetmans
- Department of Otorhinolaryngology-Head and Neck Surgery, GROW Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Krisztina Szarka
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary
| | - Ruth Tachezy
- Department of Immunology, Institute of Hematology and Blood Transfusion National Reference Laboratory for Papillomaviruses, Prague, Czech Republic
| | - Francis P Worden
- Department of Internal Medicine, Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Deborah Nelson
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Samuel Gathere
- Non Communicable Diseases Research Programme, Kenya Medical Research Institute, Nairobi, Kenya
| | - Emanuela Taioli
- Departments of Population Health Science and Policy, of Thoracic Surgery, and Institute For Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
21
|
Worsham MJ, Chen KM, Datta I, Stephen JK, Chitale D, Gothard A, Divine G. The biological significance of methylome differences in human papilloma virus associated head and neck cancer. Oncol Lett 2016; 12:4949-4956. [PMID: 28101231 PMCID: PMC5228097 DOI: 10.3892/ol.2016.5303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/26/2016] [Indexed: 01/02/2023] Open
Abstract
In recent years, studies have suggested that promoter methylation in human papilloma virus (HPV) positive head and neck squamous cell carcinoma (HNSCC) has a mechanistic role and has the potential to improve patient survival. The present study aimed to replicate key molecular findings from previous analyses of the methylomes of HPV positive and HPV negative HNSCC in an independent cohort, to assess the reliability of differentially methylated markers in HPV-associated tumors. HPV was measured using real-time quantitative PCR and the biological significance of methylation differences was assessed by Ingenuity Pathway Analysis (IPA). Using an identical experimental design of a 450K methylation platform, 7 of the 11 genes were detected to be significantly differentially methylated and all 11 genes were either hypo- or hypermethylated, which was in agreement with the results of a previous study. IPA's enriched networks analysis identified one network with msh homeobox 2 (MSX2) as a central node. Locally dense interactions between genes in networks tend to reflect significant biology; therefore MSX2 was selected as an important gene. Sequestration in the top four canonical pathways was noted for 5-hydroxytryptamine receptor 1E (serotonin signaling), collapsin response mediator protein 1 (semaphorin signaling) and paired like homeodomain 2 (bone morphogenic protein and transforming growth factor-β signaling). Placement of 9 of the 11 genes in highly ranked pathways and bionetworks identified key biological processes to further emphasize differences between HNSCC HPV positive and negative pathogenesis.
Collapse
Affiliation(s)
- Maria J Worsham
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Kang Mei Chen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Indrani Datta
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Josena K Stephen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Dhananjay Chitale
- Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA
| | | | - George Divine
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA
| |
Collapse
|
22
|
Baldwin BJ, Chitale D, Chen KM, Worsham MJ, Yaremchuk K. Investigation into the presence of human papillomavirus in patients with obstructive sleep apnea. Laryngoscope 2016; 127:1231-1234. [PMID: 27412085 DOI: 10.1002/lary.26175] [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] [Received: 02/17/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES/HYPOTHESIS The human papillomavirus (HPV) is known to infect the tissues of the oropharynx as demonstrated in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). HPV has also been shown to induce benign lymphoid hypertrophy. We sought to investigate an association between obstructive sleep apnea (OSA) and the presence of HPV in palatine and lingual tonsillar oropharyngeal tissue. STUDY DESIGN Case series with chart review. METHODS This retrospective laboratory-based study of oropharyngeal tissue from patients with OSA included patients >18 years old who underwent surgical treatment for OSA at a single institution between January 2012 and May 2014. Surgical specimens of adequate size were analyzed for HPV6, 11, and 16 using real-time quantitative polymerase chain reaction from DNA extracted from formalin-fixed paraffin-embedded tissue blocks. Student t test, Pearson χ2 test, and linear logistic regression were used to assess comparisons of body mass index (BMI), apnea-hypopnea index (AHI), age, and gender between HPV-positive and HPV-negative groups. RESULTS Of 99 cases included in the study, six were positive for HPV: two with HPV16 and four with HPV6. BMI, AHI, age, and gender showed no significant differences between the HPV-positive and HPV-negative groups. Logistic regression to predict HPV positivity accounting for each variable and multivariate analysis were not statistically significant. CONCLUSIONS Our study did not show HPV to have a statistically significant association with OSA. None of the covariates analyzed (BMI, AHI, gender, age) predicted HPV positivity in surgically resected oropharyngeal tissue from OSA patients. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1231-1234, 2017.
Collapse
Affiliation(s)
- Brett J Baldwin
- Otolaryngology/Head and Neck Surgery, Henry Ford Macomb Hospital, Clinton Township, Michigan, U.S.A
| | - Dhananjay Chitale
- Department of Pathology, Henry Ford Hospital, Detroit, Michigan, U.S.A
| | - Kang Mei Chen
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Maria J Worsham
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| | - Kathleen Yaremchuk
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, U.S.A
| |
Collapse
|
23
|
Shaikh MH, McMillan NAJ, Johnson NW. HPV-associated head and neck cancers in the Asia Pacific: A critical literature review & meta-analysis. Cancer Epidemiol 2015; 39:923-38. [PMID: 26523982 DOI: 10.1016/j.canep.2015.09.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/14/2015] [Accepted: 09/28/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Malignancies of the upper aero-digestive tract are a major public health problem, especially in the Asia Pacific. Certain Human papillomaviruses (HPVs) are well-established risk factors for carcinoma of the uterine cervix and for a subset of head and neck carcinomata: however their true importance in different populations and anatomical subsites remains unclear. The major risk factors in Asia Pacific remain smoked/smokeless tobacco, areca nut, alcohol abuse and poor diet, with limited evidence for HPVs. We review published studies of association of HPV with anatomical site-specific Head & Neck Squamous Cell Carcinoma (HNSCC) in these populations and attempt a meta-analysis. MATERIALS AND METHODS From MEDLINE/PubMed/WEB-of SCIENCE/EMBASE/Scopus databases we found 67 relevant studies with a total of 7280 cases: 15 case-control studies met our inclusion criteria for meta-analysis, totaling 1106 cases & 638 controls. HPV detection rates, sample site and size, and methods of tissue preservation and HPV detection were tabulated for each study. RESULTS Studies were heterogeneous in terms of sample selection and method of detection of HPVs. Most were of limited quality. Averaging data from 67 studies of HNSCC, the prevalence of HPV of any subtype is approximately 36%. PCR (polymerase chain reaction) was the most used detection method and HPV16 the most common genotype reported. Meta-analyses of case-control studies from this region reveal significant heterogeneity but suggest higher HPV prevalence in oropharyngeal cancer (OR: 14.66; 95%CI: 6.09-35.26) compared to oral cavity cancer and laryngeal cancer; (OR: 4.06; 95%CI: 3.05-5.39 & OR: 3.23; 95%CI: 1.37-7.61) respectively. CONCLUSION In view of the significant association of HPV with HNSCC, studies with accurate subsite classification and more sensitive detection methods are necessary. Accurate data from this geographical region are essential to inform public health policies and treatment decisions, especially as studies from Europe and North America reveal HPV-driven cancers to be less aggressive, permitting treatment de-intensification.
Collapse
Affiliation(s)
- Mushfiq Hassan Shaikh
- School of Dentistry & Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia; School of Medical Science, Griffith University, Gold Coast Campus, Queensland, Australia; Cancer Research Centre, Molecular Basis of Disease program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| | - Nigel A J McMillan
- School of Medical Science, Griffith University, Gold Coast Campus, Queensland, Australia; Cancer Research Centre, Molecular Basis of Disease program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| | - Newell W Johnson
- Cancer Research Centre, Molecular Basis of Disease program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Population & Social Health Research program, Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| |
Collapse
|
24
|
Gama RR, Carvalho AL, Filho AL, Scorsato AP, López RVM, Rautava J, Syrjänen S, Syrjänen K. Detection of human papillomavirus in laryngeal squamous cell carcinoma: Systematic review and meta-analysis. Laryngoscope 2015; 126:885-93. [DOI: 10.1002/lary.25738] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Ricardo Ribeiro Gama
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - André Lopes Carvalho
- Department of Surgical Oncology; Head and Neck Surgery, Barretos Cancer Hospital; Barretos Brazil
| | - Adhemar Longatto Filho
- Laboratory of Medical Investigation (LIM) 14; Department of Pathology; University of São Paulo School of Medicine; São Paulo Brazil
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho; Braga Portugal
- ICVS/3B's-PT Government Associate Laboratory; Braga/Guimarães Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital; Barretos Brazil
| | | | | | - Jaana Rautava
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology; Institute of Dentistry, University of Turku; Turku Finland
| | - Kari Syrjänen
- Department of Clinical Research; Biohit HealthCare Plc; Helsinki Finland
| |
Collapse
|
25
|
Stephen JK, Worsham MJ. Human papilloma virus (HPV) modulation of the HNSCC epigenome. Methods Mol Biol 2015; 1238:369-79. [PMID: 25421671 DOI: 10.1007/978-1-4939-1804-1_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Currently, the human papilloma virus (HPV), in addition to tobacco and alcohol, is considered another independent risk factor for oropharyngeal squamous head and neck cancer (OPSCC), where the prevalence of HPV-16 increases to 50-90 % for the oropharynx. Also, incidence and mortality in head and neck SCC (HNSCC) continue to be higher in African Americans (AA) than in Caucasian Americans (CA). A recent study found that poorer survival outcomes for AA versus CA with oropharyngeal tumors were attributable to racial differences in the prevalence of HPV positive (+) tumors; HPV negative (-) AA and CA patients had similar outcomes (Settle et al., Cancer Prev Res (Phila) 2:776-781, 2009). Evidence indicates that a HPV+ diagnosis has significant prognostic implications; these patients have at least half the risk of death when compared with the HPV- patient, due in part to a better response to chemoradiotherapy (Fakhry et al., J Natl Cancer Inst 100:261-269, 2008).Epigenetic events of promoter hypermethylation are emerging as promising molecular strategies for cancer detection, representing tumor-specific markers occurring early in tumor progression. HPV infection is now recognized to play a role in the pathogenesis of OPSCC, where HPV+ and HPV- patients appear to be clinically and biologically distinct with reported genome-wide hypomethylation and promoter hypermethylation in HPV+ HNSCC tumors. A recent study from our group applying pathway analysis to investigate the biological role of the differentially methylated genes in HPV+ and HPV- HNSCC reported 8 signal transduction pathways germane to HNSCC (Worsham et al., Otolaryngol Head Neck Surg 149:409-416, 2013).
Collapse
Affiliation(s)
- Josena K Stephen
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Hospital, 1 Ford Place, 1D, Detroit, MI, 48202, USA
| | | |
Collapse
|
26
|
Kuan EC, Badran KW, St John MA. What is the role of human papillomavirus testing in head and neck cancer? Laryngoscope 2015; 125:2633-4. [PMID: 25779218 DOI: 10.1002/lary.25236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Edward C Kuan
- Department of Head and Neck Surgery, Los Angeles, California, U.S.A
| | - Karam W Badran
- Department of Head and Neck Surgery, Los Angeles, California, U.S.A
| | - Maie A St John
- Department of Head and Neck Surgery, Los Angeles, California, U.S.A.,Jonsson Comprehensive Cancer Center, Los Angeles, California, U.S.A.,UCLA Head and Neck Cancer Program, University of California, Los Angeles Medical Center, Los Angeles, California, U.S.A
| |
Collapse
|
27
|
Young RJ, Urban D, Angel C, Corry J, Lyons B, Vallance N, Kleid S, Iseli TA, Solomon B, Rischin D. Frequency and prognostic significance of p16(INK4A) protein overexpression and transcriptionally active human papillomavirus infection in laryngeal squamous cell carcinoma. Br J Cancer 2015; 112:1098-104. [PMID: 25688737 PMCID: PMC4366899 DOI: 10.1038/bjc.2015.59] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 11/18/2014] [Accepted: 01/19/2015] [Indexed: 12/30/2022] Open
Abstract
Background: Human papillomavirus (HPV) infection is a powerful prognostic biomarker in a subset of head and neck squamous cell carcinomas, specifically oropharyngeal cancers. However, the role of HPV in non-oropharyngeal sites, such as the larynx, remains unconfirmed. Methods: We evaluated a cohort of 324 laryngeal squamous cell carcinoma (LSCC) patients for the expression of p16INK4A (p16) protein by immunohistochemistry (IHC) and for high-risk HPV E6 and E7 mRNA transcripts by RNA in situ hybridisation (ISH). p16 expression and HPV status were correlated with clinicopathological features and outcomes. Results: Of 307 patients assessable for p16 IHC, 20 (6.5%) were p16 positive. Females and node-positive patients were more likely to be p16 positive (P<0.05). There were no other significant clinical or demographic differences between p16-positive and -negative cases. There was no difference in overall survival (OS) between p16-positive and -negative patients with 2-year survival of 79% in each group (HR=0.83, 95% CI 0.36–1.89, P=0.65). There was no statistically significant difference in failure-free survival (FFS) with 2-year FFS of 79% and 66% for p16-positive and -negative patients, respectively (HR=0.60, 95% CI 0.26–1.36, P=0.22). Only seven cases were found to be HPV RNA ISH positive, all of which were p16 IHC positive. There was no statistically significant difference in OS between patients with HPV RNA ISH-positive tumours compared with -negative tumours with 2-year survival of 86% and 71%, respectively (HR=0.76, 95% CI 0.23–2.5, P=0.65). The 2-year FFS was 86% and 59%, respectively (HR=0.62, 95% CI 0.19–2.03, P=0.43). Conclusions: p16 overexpression is infrequent in LSCC and the proportion of cases with high-risk HPV transcripts is even lower. There are no statistically significant correlations between p16 IHC or HPV RNA ISH status and OS or disease outcomes.
Collapse
Affiliation(s)
- R J Young
- 1] Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia [2] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - D Urban
- 1] Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia [2] Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C Angel
- 1] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia [2] Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Corry
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - B Lyons
- Department of Surgery, St Vincent's Hospital, Melbourne, Australia
| | - N Vallance
- Department of Otorhinolaryngology, Monash Medical Centre, Melbourne, Australia
| | - S Kleid
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - T A Iseli
- Department of Surgery, Melbourne University, Royal Melbourne Hospital, Melbourne, Australia
| | - B Solomon
- 1] Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia [2] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia [3] Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - D Rischin
- 1] Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia [2] Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
28
|
Hernandez BY, Goodman MT, Lynch CF, Cozen W, Unger ER, Steinau M, Thompson T, Saber MS, Altekruse SF, Lyu C, Saraiya M. Human papillomavirus prevalence in invasive laryngeal cancer in the United States. PLoS One 2014; 9:e115931. [PMID: 25546150 PMCID: PMC4278830 DOI: 10.1371/journal.pone.0115931] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/27/2014] [Indexed: 12/21/2022] Open
Abstract
Purpose Human papillomavirus (HPV) is a major risk factor for specific cancers of the head and neck, particularly malignancies of the tonsil and base of the tongue. However, the role of HPV in the development of laryngeal cancer has not been definitively established. We conducted a population-based, cancer registry study to evaluate and characterize the genotype-specific prevalence of HPV in invasive laryngeal cancer cases diagnosed in the U.S. Methods The presence of genotype-specific HPV DNA was evaluated using the Linear Array HPV Genotyping Test and the INNO-LiPA HPV Genotyping Assay in formalin-fixed paraffin embedded tissue from 148 invasive laryngeal cancer cases diagnosed in 1993–2004 within the catchment area of three U.S. SEER cancer registries. Results HPV DNA was detected in 31 of 148 (21%) invasive laryngeal cancers. Thirteen different genotypes were detected. Overall, HPV 16 and HPV 33 were the most commonly detected types. HPV was detected in 33% (9/27) of women compared with 18% (22/121) of men (p = 0.08). After adjustment for age and year of diagnosis, female patients were more likely to have HPV-positive laryngeal tumors compared to males (adjusted OR 2.84, 95% CI 1.07–7.51). Viral genotype differences were also observed between the sexes. While HPV 16 and 18 constituted half of HPV-positive cases occurring in men, among women, only 1 was HPV 16 positive and none were positive for HPV 18. Overall 5-year survival did not vary by HPV status. Conclusions HPV may be involved in the development of a subset of laryngeal cancers and its role may be more predominant in women compared to men.
Collapse
Affiliation(s)
- Brenda Y. Hernandez
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, United States of America
- * E-mail:
| | - Marc T. Goodman
- Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Charles F. Lynch
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, United States of America
| | - Wendy Cozen
- Norris Comprehensive Cancer Center and Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Martin Steinau
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Trevor Thompson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Maria Sibug Saber
- Norris Comprehensive Cancer Center and Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Sean F. Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Christopher Lyu
- Battelle Memorial Institute, Durham, North Carolina, United States of America
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | |
Collapse
|
29
|
Saulle R, Semyonov L, Mannocci A, Careri A, Saburri F, Ottolenghi L, Guerra F, La Torre G. Human papillomavirus and cancerous diseases of the head and neck: a systematic review and meta-analysis. Oral Dis 2014; 21:417-31. [PMID: 24962169 DOI: 10.1111/odi.12269] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 05/30/2014] [Indexed: 12/21/2022]
Abstract
The increasing incidence of head and neck cancer (HNSCC) highlights the need to better understand the role of human papillomavirus (HPV) in the development of these cancers. The aims of this study were to conduct a systematic review and a meta-analysis concerning observational studies on the association between HPV infection and HNSCC and to quantify this association, thereby obtaining a reliable estimation of the risk of HPV infection in the development of head and neck cancer. Literature searches were performed using PubMed and Scopus databases. StatsDirect 2.7.8 program was used for the analysis. We found 15 case-control studies, 63 prevalence studies, and no cohort studies. The pooled odds ratio (OR) for all the included case-control studies resulted in a value of 1.63 (95% CI 1.27-2.09; P < 0.0001). The highest pooled OR resulted from the analysis of all the studies that examined HPV 16 genotype in association oral cavity (OR 5.36; 95% CI 1.4-20). The strong evidence of association between HPV infection and HNSCC highlights the importance of the introduction of specific tests in the cancer prevention practices to evaluate the presence of the virus, especially in the oral cavity, and the possibility of an extension of the vaccine anti-HPV in the male population too.
Collapse
Affiliation(s)
- R Saulle
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | | | | | | | | | | | | | | |
Collapse
|
30
|
The Role of Protein p16INK4a in Glottic Laryngeal Squamous Cell Carcinoma. Pathol Oncol Res 2014; 20:909-15. [DOI: 10.1007/s12253-014-9773-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
|
31
|
Jiang H, Lin PF. Human papillomavirus infection a favorable prognostic factor in laryngeal squamous cell carcinoma is associated with the expression of proliferating cell nuclear antigen. Pak J Med Sci 2013; 29:1173-7. [PMID: 24353714 PMCID: PMC3858942 DOI: 10.12669/pjms.295.3606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 07/13/2013] [Indexed: 11/28/2022] Open
Abstract
Objective: It has been documented that human papilloma virus (HPV) DNA replication requires proliferating cell nuclear antigen (PCNA). However the association between them in tumors is still controversial. Up to now, the role of HPV in laryngeal squamous cell carcinoma (LSCC) has not been clearly established, and the correlation between HPV and PCNA in LSCC remains poorly explored. Methods: We retrospectively reviewed the clinicopathological features and follow-up data of 71 patients with LSCC. The lesions were examined for PCNA using immunohistochemistry, and for HPV using in situ hybridization. Results: 31 (43.7%) cases showed infection of HPV and 38 (53.5%) showed overexpression of PCNA. No significant difference of HPV status in clinicopathological features was found. While there was a significant difference of PCNA expression in histology grade but no significant difference of PCNA expression in other clinicopathological features could be detected, and the expression of PCNA is not a significant predictor of survival in LSCC patients. However, HPV infection is a favorable prognostic factor in LSCC patients. Moreover, HPV infection is associated with PCNA overexpression. Conclusion: Human papilloma virus (HPV) infection is an indicator of better prognosis in LSCC and associated with the expression of PCNA.
Collapse
Affiliation(s)
- Hua Jiang
- Hua Jiang, MD, PhD, Department of Otolaryngology, 2nd Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
| | - Peng-Fang Lin
- Peng-Fang Lin, MD, Department of Otolaryngology, 2nd Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
| |
Collapse
|
32
|
Worsham MJ, Chen KM, Ghanem T, Stephen JK, Divine G. Epigenetic modulation of signal transduction pathways in HPV-associated HNSCC. Otolaryngol Head Neck Surg 2013; 149:409-16. [PMID: 23736812 DOI: 10.1177/0194599813490895] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Human papilloma virus (HPV) positive and HPV negative head and neck squamous cell cancer (HNSCC) are biologically distinct with a prognostic advantage for HPV positive patients compared to HPV negative cases. DNA promoter methylation is central to human diseases such as cancer, including HNSCC, with reported genome-wide hypomethylaton and promoter hypermethylation in HPV positive HNSCC tumors. The goal of this study was to identify differentially methylated genes in HPV positive versus HPV negative primary HNSCC genomes with clues to signaling networks. STUDY DESIGN Laboratory-based study. SETTING Primary care academic health care system. SUBJECTS AND METHODS DNA from 4 HPV positive and 4 HPV negative freshly frozen primary HNSCC were subject to comprehensive genome-wide methylation profiling. Differentially methylated gene lists were examined using the Signal Transduction Pathways (canonical) filter in the Genomatix Pathway System (GePS). RESULTS Twofold methylation differences were observed between HPV positive and HPV negative cases for 1168 genes. Pathway analysis applied to investigate the biological role of the 1168 differentially methylated genes revealed 8 signal transduction pathways forming a network of 66 genes, of which 62% are hypermethylated. CONCLUSION Our study reveals a predominant hypermethylation profile for genes in signal transduction pathways of HPV positive HNSCC tumor genomes. Because signaling events in the cell play a critical role in the execution of key biological functions, insights into how complex cellular signaling cascades and networks may be programmed in HNSCC are likely to be critical in the development of new biological agents designed to hit multiple targets.
Collapse
Affiliation(s)
- Maria J Worsham
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, Michigan 48202, USA.
| | | | | | | | | |
Collapse
|
33
|
Worsham MJ, Stephen JK, Chen KM, Mahan M, Schweitzer V, Havard S, Divine G. Improved survival with HPV among African Americans with oropharyngeal cancer. Clin Cancer Res 2013; 19:2486-92. [PMID: 23532894 DOI: 10.1158/1078-0432.ccr-12-3003] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE A major limitation of studies reporting a lower prevalence rate of human papilloma virus (HPV) in African American patients with oropharyngeal squamous cell cancer (OPSCC) than Caucasian Americans, with corresponding worse outcomes, was adequate representation of HPV-positive African American patients. This study examined survival outcomes in HPV-positive and HPV-negative African Americans with OPSCC. EXPERIMENTAL DESIGN The study cohort of 121 patients with primary OPSCC had 42% African Americans. Variables of interest included age, race, gender, HPV status, stage, marital status, smoking, treatment, and date of diagnosis. RESULTS Caucasian Americans are more likely to be HPV positive (OR = 3.28; P = 0.035), as are younger age (age < 50 OR = 7.14; P = 0.023 compared with age > 65) or being married (OR = 3.44; P = 0.016). HPV positivity and being unmarried were associated with being late stage (OR = 3.10; P = 0.047 and OR = 3.23; P = 0.038, respectively). HPV-negative patients had 2.7 times the risk of death as HPV-positive patients (P = 0.004). Overall, the HPV-race groups differed (log-rank P < 0.001), with significantly worse survival for HPV-negative African Americans versus (i) HPV-positive African Americans (HR = 3.44; P = 0.0012); (ii) HPV-positive Caucasian Americans (HR = 3.11; P = < 0.049); and (iii) HPV-negative Caucasian Americans (HR = 2.21; P = 0.049). CONCLUSIONS HPV has a substantial impact on overall survival in African American patients with OPSCC. Among African American patients with OPSCC, HPV-positive patients had better survival than HPV negative. HPV-negative African Americans also did worse than both HPV-positive Caucasian Americans and HPV-negative Caucasian Americans. This study adds to the mounting evidence of HPV as a racially linked sexual behavior life style risk factor impacting survival outcomes for both African American and Caucasian American patients with OPSCC.
Collapse
Affiliation(s)
- Maria J Worsham
- Department of Otolaryngology/Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
| | | | | | | | | | | | | |
Collapse
|
34
|
Recommendations for the diagnosis of human papilloma virus (HPV) high and low risk in the prevention and treatment of diseases of the oral cavity, pharynx and larynx. Guide of experts PTORL and KIDL. Otolaryngol Pol 2013; 67:113-34. [PMID: 23719268 DOI: 10.1016/j.otpol.2013.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/09/2013] [Indexed: 11/20/2022]
Abstract
The role of human papilloma viruses (HPV) in malignant and nonmalignant ENT diseases and the corresponding epidemiological burden has been widely described. International head and neck oncology community discussed growing evidence that oral HPV infection contributes to the risk of oro-pharyngeal carcinoma (OPC) and recommended HPV testing as a part of the work up for patients with OPC. Polish Society of ENT Head Neck Surgery and National Chamber of Laboratory Diagnosticians have worked together to define the minimum requirements for assigning a diagnosis of HPV-related conditions and testing strategy that include HPV specific tests in our country. This paper briefly frames the literature information concerning low risk (LR) and high risk (HR) HPV, reviews the epidemiology, general guidance on the most appropriate biomarkers for clinical assessment of HPV. The definition of HPV-related cancer was presented. The article is aiming to highlight some of major issues for the clinician dealing with patients with HPV-related morbidities and to introduce the diagnostic algorithm in Poland.
Collapse
|
35
|
Chen KM, Stephen JK, Ghanem T, Stachler R, Gardner G, Jones L, Schweitzer VP, Hall F, Divine G, Worsham MJ. Human papilloma virus prevalence in a multiethnic screening population. Otolaryngol Head Neck Surg 2013; 148:436-42. [PMID: 23300223 DOI: 10.1177/0194599812471938] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The goal was to determine the prevalence of high-risk HPV16 using saliva in a screening population in Detroit, Michigan. MATERIALS AND METHODS Real-time quantitative polymerase chain reaction was applied to detect HPV16 in saliva DNA from 349 screening subjects without head and neck cancer (HNC), 156 with HNC, and 19 controls. Cut points for human papilloma virus (HPV) positivity were >0 and >0.001 copy/cell. Proportions were compared between groups using exact χ(2) or Fisher exact tests (P < .05). RESULTS At a cut point >0, each group had an overall HPV prevalence of more than 5%, with a higher prevalence of 30.8% in the HNC patient group. At a cut point >0.001, the prevalence was lower: 0% in the control, 1.2% in the screening, and 16.7% in the HNC group. In the latter, for both cut points, HPV prevalence was different across sites (<0.001) and significantly higher in the oropharynx than larynx or site as other after Hochberg's adjustment. At >0, women in the screening group had a higher prevalence of HPV than did men (P = .010), and at >0.001, the prevalence was higher for men in the HNC group than for women (P = .035). In the screening group, at >0, only African Americans had a higher prevalence than Caucasian Americans (P = .025). CONCLUSIONS In the screening group, a 6.9% and 1.2% screening rate was noted at cut points >0 and >0.001, respectively. The results provide data to inform public health considerations of the feasibility of saliva as a screening tool in at-risk populations with the long-term goal of prophylactic vaccination against oral HPV.
Collapse
Affiliation(s)
- Kang Mei Chen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, Michigan 48202, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Stephen JK, Divine G, Chen KM, Chitale D, Havard S, Worsham MJ. Significance of p16 in Site-specific HPV Positive and HPV Negative Head and Neck Squamous Cell Carcinoma. ACTA ACUST UNITED AC 2012; 2:51-61. [PMID: 23935769 DOI: 10.5539/cco.v2n1p51] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Expression of p16INK4A (p16 positive) is highly correlated with human papilloma virus (HPV) infection in head and neck squamous cell carcinoma (HNSCC), however, p16-positivity is not limited to HPV positive tumors and therefore, not a perfect surrogate for HPV. p16 survival outcomes are best documented for the oropharyngeal site (OP); non-OP sites such as the oral cavity (OC), larynx, and hypopharynx (HP) are understudied. The goal of this study was to evaluate p16 in the context of HPV16 and examine p16 survival outcomes in HPV16 positive and HPV16 negative site-specific HNSCC. p16 and HPV16 status were determined by immunohistochemistry and qPCR respectively, on 80 primary HNSCC from four sites: OC, OP, larynx and HP. p16 expression was different across sites (p<0.001), was more frequent in OP than non-OP sites (p<0.0001), and was different between Caucasian Americans (CA) and African Americans (AA) (p=0.031), similar to HPV (p=0.013). p16 was associated with marital status (p=0.008) and smoking (p=0.014). p16 positive patients had improved survival (similar to HPV16 positive cases). Patients with p16 negative/HPV16 negative status had the worst survival for all sites combined as well as for OP. p16 status is an important prognostic indicator in both OPSCC and non-OPSCC and the p16 positive/HPV16 negative group is likely a distinct subgroup lacking any HPV genotype. Cohorts with larger representations of non-OP sites examining multiple molecular markers will be key to deciphering and dissecting out p16's role as a useful prognostic indicator when assessed in combination with HPV status.
Collapse
Affiliation(s)
- Josena K Stephen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, USA
| | | | | | | | | | | |
Collapse
|
37
|
Li X, Gao L, Li H, Gao J, Yang Y, Zhou F, Gao C, Li M, Jin Q. Human papillomavirus infection and laryngeal cancer risk: a systematic review and meta-analysis. J Infect Dis 2012; 207:479-88. [PMID: 23175764 DOI: 10.1093/infdis/jis698] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A number of molecular epidemiological studies have been conducted to explore the association of human papillomavirus (HPV) infection with laryngeal cancer. However, the findings are heterogeneous. METHODS We systematically reviewed studies on HPV infection and laryngeal cancer published up to 15 May 2012 and quantitatively summarized the prevalence of HPV infection and its association with the risk of laryngeal cancer by means of meta-analysis. RESULTS In total, 55 eligible studies were included. The overall HPV prevalence in laryngeal cancer tissues was 28.0% (95% confidence interval [CI], 23.5%-32.9%). A total of 26.6% laryngeal cancer patients were infected with high-risk HPV types only, and HPV-16 was most frequently observed type, with a prevalence of 19.8% (95% CI, 15.7%-24.6%). The meta-analysis based on 12 eligible case-control studies suggests a strong association between HPV infection and laryngeal squamous cell carcinoma, with a summary odds ratio (OR) of 5.39 (95% CI, 3.25-8.94). Different magnitudes of association were observed for HPV-16 (OR, 6.07; 95% CI, 3.44-10.70) and HPV-18 (OR = 4.16; 95% CI, .87-20.04; P < .01). Stratified analyses were performed with respect to HPV genotypes and characteristics of the study population. CONCLUSIONS HPV infection, especially infection due to the high-risk type HPV-16, was found to be significantly associated with the risk of laryngeal squamous cell carcinoma.
Collapse
Affiliation(s)
- Xiangwei Li
- MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Human papillomavirus in non-oropharyngeal head and neck cancers: a systematic literature review. Head Neck Pathol 2012; 6 Suppl 1:S104-20. [PMID: 22782230 PMCID: PMC3394168 DOI: 10.1007/s12105-012-0368-1] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 05/10/2012] [Indexed: 12/20/2022]
Abstract
Perhaps one of the most important developments in head and neck oncology of the past decade is the demonstration that patients with human papillomavirus (HPV)-mediated oropharyngeal cancers have significantly improved outcomes, compared to HPV-negative counterpart patients. This has become the basis for clinical trials investigating the impact on "treatment deintensification" for patients with HPV-mediated oropharyngeal cancers. Unfortunately, the significance of HPV in non-oropharyngeal head and neck cancers is much less certain. Our goal is to systematically review the published data regarding the role HPV in carcinomas of the oral cavity, larynx, sinonasal tract and nasopharynx with respect to HPV detection frequency, viral activity, and association with outcome. We also present preliminary data on HPV16/18 transcriptional status in oral cavity carcinomas, as well as salivary gland neoplasia, as determined by nested reverse transcription PCR for HPV E6/E7 RNA. The weighted prevalence (WP) of HPV DNA detection in 4,195 oral cavity cancer patients is 20.2 %, (95 % CI 16.0 %, 25.2 %). HPV16 is the most common type detected. Importantly, no data currently demonstrates a significant association between the presence of HPV DNA and improved outcome. The WP of HPV DNA in 1,712 laryngeal cancer patients is 23.6 %, (95 % CI 18.7 %, 29.3 %). Similarly, no association has yet been demonstrated between HPV DNA status and outcome. The WP of HPV DNA detection in 120 sinonasal cancer patients is 29.6 % (95 % CI 17.8 %, 44.9 %), and in 154 nasopharyngeal carcinoma patients is 31.1 %, (95 % CI 20.3 %, 44.5 %). Recent preliminary data also suggests an association between HPV and certain salivary gland neoplasms. The clinical significance of these findings is unclear. The published data strongly support the need for studies on patients with oral and laryngeal carcinomas that will be powered to find any differences in clinical outcome with respect to HR-HPV and p16 overexpression.
Collapse
|
39
|
Clauditz TS, Wang CJ, Gontarewicz A, Blessmann M, Tennstedt P, Borgmann K, Tribius S, Sauter G, Dalchow C, Knecht R, Münscher A, Wilczak W. Expression of insulin-like growth factor II mRNA-binding protein 3 in squamous cell carcinomas of the head and neck. J Oral Pathol Med 2012; 42:125-32. [PMID: 22643116 DOI: 10.1111/j.1600-0714.2012.01178.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Insulin-like growth factor II mRNA-binding protein 3 (IMP3) was found overexpressed in various cancer types suggesting its possible role in carcinogenesis. Analysis of IMP3 expression in head and neck squamous cell carcinomas (HNSCC) is rare so that we evaluated it using tissue microarray method. METHOD Immunohistochemical analysis of IMP3 was performed on samples from over 400 patients. The expression was measured semiquantitative, subsequently divided into four categories (negative, weak, medium, or strong) and correlated with several available clinicopathologic parameters. RESULTS For HNSCC, positive IMP3 expression was observed in patients with all tumor stages (pT1-4) and nodal stages (pN0-3), showing also significant statistical correlation (P=0.023 and P=0.0013, respectively). No further correlations were found. Separate analysis according to tumor localization (oral cavity, oropharyngeal, and laryngeal) showed a significant correlation of positive IMP3 expression and overall survival (P=0.038) only in patients with tumors of the oral cavity. Multivariate analysis showed IMP3 as an independent predictive marker for oral squamous cell carcinomas (OSCC). CONCLUSION Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression might be used as an independent prognostic factor in the subgroup of OSCC.
Collapse
Affiliation(s)
- T S Clauditz
- Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|