Human Papillomavirus in Head and Neck Squamous Cell Carcinoma

Abstract

Head and neck squamous cell carcinomas (HNSCCs) are the most common cancers in India. Association, clinical presentations, and pathology of human papillomavirus (HPV) infection in 50 HNSCC patients were assessed and compared with 50 patients having benign head and neck lesions in a prospective study. Punch biopsy from the lesion in all the patients was used for confirmation of the diagnosis and HPV DNA isolation by PCR assay. All HNSCC patients had poor oral hygiene, and 28% of them had uncommon sexual practices. Eighty-eight percent of patients were smokers while 68% were alcoholic. The association of HPV in HNSCC was 42% as compared to 8% in benign lesions (p = 0.001). Twenty-one of 50 HNSCC patients tested positive for HPV, of which 20 were positive for HPV 16 and 1 was positive for HPV 18 whereas only 4 out of 50 patients with benign lesions were HPV positive, all of which were positive for HPV 16. Out of 21 HPV-positive HNSCC patients, 9 (42%) had a history of uncommon sexual practices as compared to 5 out of 29 (17.2%) in HPV-negative HNSCC patients. It is concluded that the association of HPV in HNSCC was significantly high and a significant number of HPV-positive HNSCC patients were associated with uncommon sexual practices as compared to HPV-negative HNSCC patients. A larger study is recommended to further confirm this high association of HPV in malignancy and defining a role of vaccination program for the primary prevention of HNSCC.