Abstract
BackgroundHuman papillomavirus (HPV) is recognized as an important risk factor for laryngeal carcinogenesis. Although HPV-16 and 18 have been strongly implicated, the presence of other high-risk HPV (HR-HPV) genotypes or the coinfection with Epstein-Barr virus (EBV) or Merkel cell polyomavirus (MCPV) may increase the risk, but their etiological association has not been definitively established.MethodsWe characterized the genotype-specific HPV and the frequency of EBV and MCPV infections through the detection of their DNA in 195 laryngeal specimens of squamous cell carcinoma (SCC) histologically confirmed.ResultsHPV DNA was detected in 93 (47.7%) specimens. HPV-11 was the most frequent with 68 cases (73.1%), and HPV-52 was the most frequently HR-HPV found with 51 cases, which corresponds to 54.8% of all HPV-positive specimens. EBV DNA was detected in 54 (27.7%) tumor tissue specimens of which 25 (46.3%) were in coinfection with HPV. MCPV DNA was detected only in 11 (5.6%) cases of which 5 (45.4%) were in coinfection with an HR-HPV. No association between the presence of DNA of the three examined viruses and the patient smoking habits, alcohol consumption, age, the keratinization status, differentiation grade, or localization of the tumor in the larynx were found.DiscussionHPV-52 was the most prevalent HR-HPV, which may suggest that this and other genotypes in addition to HPV-16 and 18 could be considered for prophylaxis. However, further studies including non-cancer larynx cases and the evaluation of other molecular markers and viral co-infection mechanisms are needed to determine the role of the different HR-HPV genotypes, EBV, and MCPV in the etiology of SCC of the larynx.
Highlights
Laryngeal cancer is the second most common malignant neoplasm of the head and neck and squamous cell carcinoma (SCC) is the most frequent histological type with 90–95% of the cases (Akhter et al, 2011; Marioni et al, 2006)
Human papillomavirus (HPV) is one of the main viruses involved in the appearance of tumors since it constitutes a group of viruses with epithelial cell tropism and is associated with a great variety of cutaneous proliferations and mucosal squamous lesions (Benson et al, 2014; Kreimer et al, 2005)
Several epidemiologic and biological studies have implicated the high-risk HPV (HR-HPV) infection, mainly genotypes 16 and 18, as a potential etiological factor for the development of tumors in the upper aerodigestive tract but other well-defined oncogenic viruses, such as Epstein-Barr virus (EBV) or Merkel cell polyomavirus (MCPV), might have a role in the pathogenesis of this type of tumors (Gama et al, 2016; Sturgis, Wei & Spitz, 2004; De Oliveira et al, 2006) EBV belongs to the group of herpesviruses and its initial transmission is via the oropharynx, where it has been associated to the etiopathogenesis of an increasing number of cancers; the mechanism of the immunopathogenesis of the infection caused by this virus has not yet been elucidated (Hutt-Fletcher, 2017; Goldenberg et al, 2004; Muderris et al, 2013)
Summary
Laryngeal cancer is the second most common malignant neoplasm of the head and neck and squamous cell carcinoma (SCC) is the most frequent histological type with 90–95% of the cases (Akhter et al, 2011; Marioni et al, 2006). Several epidemiologic and biological studies have implicated the HR-HPV infection, mainly genotypes 16 and 18, as a potential etiological factor for the development of tumors in the upper aerodigestive tract but other well-defined oncogenic viruses, such as Epstein-Barr virus (EBV) or Merkel cell polyomavirus (MCPV), might have a role in the pathogenesis of this type of tumors (Gama et al, 2016; Sturgis, Wei & Spitz, 2004; De Oliveira et al, 2006) EBV belongs to the group of herpesviruses and its initial transmission is via the oropharynx, where it has been associated to the etiopathogenesis of an increasing number of cancers; the mechanism of the immunopathogenesis of the infection caused by this virus has not yet been elucidated (Hutt-Fletcher, 2017; Goldenberg et al, 2004; Muderris et al, 2013). No association between the presence of DNA of the three examined viruses and the patient smoking habits, alcohol
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