Human Papillomavirus Infection and Prognostic Predictors in Patients with Oropharyngeal Squamous Cell Carcinoma

Hui Huang,You-Lin Qiao,Shuang-Mei Zhou,Li Gao,Ping-Zhang Tang,Yong-Xia Zhang,Zhen-Gang Xu,Bin Zhang,Wen Chen

doi:10.7314/apjcp.2012.13.3.891

Abstract

This study focused on infection rates and subtypes of human papillomavirus (HPV) in patients with oropharyngeal squamous cell carcinoma (OSCC), and the relationship between HPV status and prognosis of the disease. We evaluated sixty-six OSCC patients who met the enrollment criteria during the period from January 1999 to December 2009. The presence or absence of oncogenic HPV types in tumors was determined using the SPF10 LiPA25 assay. Overall survival (OS) and disease specific survival (DSS) for HPV positive and HPV negative patients were estimated using Kaplan-Meier analysis. The Cox regression model was applied for multivariate analysis. HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were type HPV-16, while other types were HPV-16/11, HPV-35, HPV-58/52, and HPV-33/52/54. Patients with HPV positive tumors were more likely to be female, non-smokers and non-drinkers (p=0.002, 0.001 and 0.001, respectively). After a median follow-up of 24.5 months, patients with HPV positive tumors had significantly better overall survival (HR=0.106[95%CI=0.014-0.787], p=0.016,) and disease specific survival (HR=0.121[95%CI=0.016-0.906], p=0.030). Patients with HPV positive OSCC have significantly better prognosis than patients with HPV negative tumors. HPV infection is an independent prognostic factor.

Highlights

Recent studies have shown an etiologic role of infection with high-risk human papillomavirus (HR-HPV) in a subset of oropharyngeal squamous cell carcinomas (OSCC) that present with a distinct biologic behavior (Gillison et al, 2000; Andrews et al, 2009; Joo et al, 2011; Klussmann et al, 2001)
This was the first study conducted in mainland China that retrospectively investigated the relationship between tumor HPV status and clinical outcomes of patients with oropharyngeal squamous cell carcinoma (OSCC)
Our results provide evidence that HPV positive OSCC is a distinct entity and tumor HPV status is an independent prognostic factor for patients with OSCC, which is consistent with the hypothesis that has been reported in several other studies (Gillison et al, 2000; Klussmann et al, 2001; Weinberger et al, 2006; Hafkamp et al, 2008; Worden et al, 2008; Andrews et al, 2009; Dayyani et al, 2010)

Summary

Introduction

Recent studies have shown an etiologic role of infection with high-risk human papillomavirus (HR-HPV) in a subset of oropharyngeal squamous cell carcinomas (OSCC) that present with a distinct biologic behavior (Gillison et al, 2000; Andrews et al, 2009; Joo et al, 2011; Klussmann et al, 2001). Previous studies have demonstrated that patients with high risk HPV (HR-HPV) positive OSCC have significantly better prognosis than those with HPV negative OSCC. Hafkamp and colleagues have demonstrated that patients with HPV positive tumors had a lower loco-regional recurrence rate than those with HPV negative tumors (12% vs 27%, p=0.039) (Hafkamp et al, 2008). Tumor-related mortality in patients with HPV positive tumors was significantly lower than in those with HPV negative tumors (HR=0.41; 95%CI=0.20-0.88) (Hafkamp et al, 2008)

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