Abstract
Aims Human papillomavirus (HPV)-positive OPSCC accounts for 25% of OPSCC. HPV E6 and E7 proteins inactivate the retinoblastoma gene causing overexpression of the p16 protein, which is regarded as HPV surrogate. There is evidence that p16 expression is an independent prognostic factor and cyclin D1 overexpression associated with poor prognosis in OPSCC. HPV+ OPSCC carries better prognosis than HPV–OPSCC, and is characterised by histological poor squamous differentiation (PD) and advanced regional nodal metastasis. This study aimed to study correlation among the morphology, immunophenotype and HPV DNA in OPSCC. Methods The morphology, immunophenotype and HPV DNA in OPSCC of 147 patients in Hong Kong were studied, using an immunoautostainer (p16 and cyclin D1), polymerase chain reaction and typing by sequencing for HPV DNA detection. Results Twenty-seven (18%) tumours carried HPV16 DNA, 56 (38%) were p16+ and 105 (72%) cyclin D1+. Fifty-two (35%) were PD tumours. Strong statistical correlation (p Discussion This study showed that p16 is strongly correlated with the good prognostic feature PD, while cyclin D1 is correlated with the poor prognostic features p16– and HPV DNA–. We conclude a simple immunophenotypic panel of p16 and cyclin D1 is a practical approach for prognostication of HPV+ OPSCC.
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