HPV Status and TP53 Mutational Status as Prognostic Markers in Head and Neck Cancer

Abstract

Objectives: The mutation of TP53 is one of the most important genetic alterations in head and neck squamous cell carcinomas (HNSCCs). Human papillomavirus (HPV) is detected in a subset of HNSCCs. Several retrospective studies have shown that HNSCCs patients without TP53 mutations and HPV positive patients have significantly improved survival compared to other patients. We analyzed the HPV status and the TP53 mutations in the HNSCCs and examined the association with prognosis. Methods: A total of 67 patients with newly diagnosed stage III and IV squamous cell carcinoma of the head and neck which are all treated by chemoradiotherapy for organ preservation were enrolled in this study. TP53 mutations were analyzed using direct sequencing methods for exon 2 to 11. HPV detection and typing were analyzed by polymerase chain reaction (PCR) assay targeted to the E6 and E7 regions of the viral genome. TP53 mutational status and HPV status were compared with clinical outcome. Results: The high-risk HPV was detected in 11 cases (16.4%) which were all oropharyngeal cancers. In addition, TP 53 mutation was detected in 41 cases (61.2%). The overall survival was good in order of an HPV-positive group, TP53 wild type group and TP53 mutant group. Multivariate analysis revealed not only the T stage but also that this genetic classification correlated significantly to overall survival in HNSCCs. Conclusions: TP53 mutational status and HPV status are associated with prognosis and these genetic statuses are considered to be useful as molecular biomarkers for personalized treatment in HNSCCs.