Abstract

BackgroundThere is increasing evidence for the role of High Risk (HR) Human PapillomaVirus (HPV) in the pathogenesis of Oral Squamous Cell Carcinoma (OSCC). The E6 and E7 oncogenes from HR HPVs are responsible for the deregulation of p53 and pRB proteins involved in cell cycle and apoptotic pathways. In cell lines experiments, the HPV E7 protein seems to be able to enhance Hypoxia Inducible Factor-1 alpha (HIF-1α) activity, normally involved in the response to hypoxia and able to enhance angiogenesis.ResultsWe studied tumor specimens from 62 OSCC; a higher prevalence of tumors in TNM stage II and also in pT2 class between OSCC infected positive HPV16 DNA than non-infected ones was observed. HIF-1α positivity was detected throughout the analysed fields, not associated with areas of necrosis and also observed in cells immediately adjacent to blood vessels. A significant increase in mean values of the HIF-1α labeling indexes was observed for pT1-T2, as well for stage I-II, in the infected positive HPV16 DNA tumors than non-infected ones. HIF-1α and HPV16 E7 labeling indexes showed a significantly positive correlation which suggested a positive association between HPV16 E7 and HIF-1α expression.ConclusionsIn our specimens HIF-1α immunoreactivity hints for an O2-independent regulatory mechanism in infected positive HPV16 DNA tumors, especially for pT1-T2 and stage I-II tumors, suggesting a very early involvement in the development of HPV-induced OSCC. HIF-1α and HPV16 E7 labeling indexes suggest also a positive association between the two proteins in infected positive HPV16 DNA OSCC.

Highlights

  • There is increasing evidence for the role of High Risk (HR) Human PapillomaVirus (HPV) in the pathogenesis of Oral Squamous Cell Carcinoma (OSCC)

  • HPV16, the most common HR HPV type detected in biopsies from women with cervical squamous cell carcinoma (55%) [17,18], was the most common type detected in OSCC (16%), accounted for 68.2% of all HPV+ OSCC [19,20]

  • Several studies have investigated the role of HPV in oral carcinogenesis, confirming that HPV plays a role in oral carcinogenesis and HPV cancers are specific type of tumors with numerous important differences reported in typology of risk patient, histological grading, histotype and clinical outcome in term of overall survival [34,35,36,37]

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Summary

Introduction

There is increasing evidence for the role of High Risk (HR) Human PapillomaVirus (HPV) in the pathogenesis of Oral Squamous Cell Carcinoma (OSCC). The E6 and E7 oncogenes from HR HPVs are responsible for maintaining differentiating cells active in cell cycling and are able to transform both cervical and upper aero-digestive tract epithelia via expression of the viral oncoproteins E6 and E7 and the following deregulation of cell cycle and apoptotic pathways [21,22]. These 2 proteins promote the degradation of cellular tumor suppressors: p53 in the case of E6 and pRb family members in the case of E7. Among the additional factors bound by E7 are histone deacetylases (HDAC), which catalyze the deacetylation of histones and other transcriptional regulatory proteins [24]

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