HPV Associated Oral and Oropharyngeal Cancer

Abstract

1.Duncan LD, Winkler M, Carlson ER et al: p16 immunohistochemistry can be used to detect human papillomavirus in oral cavity squamous cell carcinoma. J Oral Maxillofac Surg 71, 2013.This paper provides support for the use of p16 as a biomarker for the identification of human papillomavirus in oral cancer specimens. In particular the patient data provided statistical correlation among PCR positivity, p16 3+ positivity and younger age of patients with HPV related oral cancers.2.Gillison ML, Broutian T, Pickard et al: Prevalence of Oral HPV Infection in the United States, 2009-2010. JAMA 307: 693-703, 2012.The authors performed a cross-sectional study as part of the National Health and Nutrition Examination Survey (NHANES), a statistically representative sample of the civilian noninstitutionalized United States population. The prevalence of oral HPV infection among 5579 men and women aged 14 to 69 years was 6.9% and the prevalence was higher among men than among women.3.Holzinger D, Schmitt M, Dyckhoff et al: Viral RNA patterns and high viral load reliably define oropharynx carcinomas with active HPV 16 involvement. Cancer Res 72: 4993-5003, 2012.These authors analyzed 199 oropharyngeal squamous cell carcinoma specimens for HPV DNA, viral load, RNA expression patterns and p16. Their findings indicated that the viral load or RNA pattern analysis is better suited than p16 expression to identify HPV positive oropharyngeal squamous cell carcinomas.4.Huang SH, Perez-Ordonez B, Weinreb I et al: Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer. Oral Oncology 49: 79-85, 2013.This study of 457 HPV positive cancers and 167 HPV negative cancers demonstrated a clinically distinct difference in the natural history of disease dissemination between HPV positive and HPV negative oropharyngeal cancers. In particular, the authors identified that distant metastasis was the predominant form of failure for HPV positive cancer patients and that these distant metastases manifested after a longer interval following radiation therapy than the HPV negative cancers.5.Joseph AW, D'Souza G: Epidemiology of human papillomavirus-related head and neck cancer. Otolaryngol Clin N Am 45: 739-764, 2012.These authors provided an epidemiologic overview of HPV related head and neck cancer. Their summary indicated that HPV related head and neck squamous cell carcinoma is more likely than HPV unrelated squamous cell carcinoma to occur in whites, never-drinker/never-smokers, those who have had more than 6 lifetime oral sexual partners and those patients who are diagnosed with their cancer at a younger age.6.Koch WM: Clinical features of HPV-related head and neck squamous cell carcinoma: presentation and workup. Otolaryngol Clin N Am 45: 779-793, 2012.This author provides a general review of the clinical features of HPV related head and neck squamous cell carcinoma while minimizing the incidence of HPV in oral cavity squamous cell carcinoma. Post-treatment surveillance of HPV related cancers is affected by the improved response of these cancers to chemoradiation as well as a lower likelihood of second primary cancers in the head and neck.7.Kostareli E, Holzinger D, Hess J: New concepts for translational head and neck oncology: lessons from HPV-related oropharyngeal squamous cell carcinomas. Front Oncol 2: 1-10, 2012. (http://dx.doi.org/10.3389/fonc.2012.00036)This review summarizes the most recent advances in the understanding of the molecular principles of HPV related oropharyngeal squamous cell carcinoma, mainly based on functional genomic approaches, but also emphasizes the significant role played by the tumor microenvironment, especially the immune system, for improved clinical outcome and differential sensitivity of HPV related cancers to current treatment options.8.Lingen MW, Xiao W, Schmitt A: Low etiologic fraction for high-risk human papillomavirus in oral cavity squamous cell carcinoma. Oral Oncology 49: 1-8, 2013.These authors studied 409 oral squamous cell carcinomas with PCR followed by type-specific high risk HPV E6/7 oncogene expression by quantitative reverse transcriptase PCR and p16 immunohistochemistry. The authors determined that the etiologic fraction for high risk HPV in oral squamous cell carcinoma was 5.9%. p16 immunohistochemistry had good to excellent sensitivity, specificity and negative predictive value but a poor positive predictive value.9.Maxwell JH, Kumar B, Feng FY et al: Tobacco use in human papillomavirus-positive advanced oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence. Clin Cancer Res 16: 1226-1235, 2010.The authors studied 124 patients with advanced squamous cell carcinoma of the oropharynx. One hundred and two patients (82.3%) had HPV positive tumors. Among the HPV positive patients, current tobacco users were at significantly higher risk of disease recurrence than never-tobacco users. All HPV negative patients were tobacco users and had significantly shorter times to recurrence, had reduced disease specific survival and overall survival compared with HPV positive patients.10.Tezal M, Scannapieco FA, Wactawski-Wende J et al: Local inflammation and human papillomavirus status of head and neck cancers. Arch Otolaryngol Head Neck Surg 138: 669-675, 2012.The authors studied 124 patients with head and neck cancer and determined 50 of 124 patients to have HPV positive cancer (40.3%). Each millimeter of alveolar bone loss was associated with 2.6 times increased odds of HPV positive tumor status after adjustment for age at diagnosis, sex, and smoking status. As such, the authors concluded that chronic inflammatory dental disease may be associated with tumor HPV status in these patients.