Abstract
Human papillomavirus (HPV) is a virus with the potential to infect human epithelial cells and an etiological agent of many types of cancer, including head and neck cancer. The aim of the study was to determine the prevalence of HPV infection in patients with head and neck squamous cell carcinoma (HNSCC), patients with chronic tonsillitis, and healthy individuals, and to establish high- and low-risk HPV genotypes in these groups. The objectives also comprised the delineation of the relationship between the infection with high- or low-risk HPV subtypes and clinicopathological and demographic characteristics of the study groups. This study was composed of 76 patients diagnosed with HNSCC, 71 patients with chronic tonsillitis, and 168 cases without either of these conditions (the control group). HPV detection and identification of subtypes were performed on isolated DNA using a test which allowed detection of 33 common high-risk and low-risk HPV subtypes. The prevalence of HPV infection was 42.1%, 25.4%, and 37.5% in HNSCC, chronic tonsillitis, and control groups, respectively. HPV 16 was the most prevalent genotype in all groups and the non-oncogenic HPV 43/44 was frequent in HNSCC patients. This analysis provides insight into the prevalence of oral oncogenic and non-oncogenic HPVs in patients with head and neck cancer, patients with chronic tonsillitis and healthy individuals, and leads to the conclusion that further investigations are warranted to examine a larger cohort of patients focusing on high- and low-risk HPV genotypes. Efforts should be focused on screening and prevention strategies, and therefore, it is important to introduce tools for effective detection of HPV genotypes. Furthermore, given the role of vaccines against oral HPV infection, our observations lead to the suggestion that HPV vaccination should be of considerable importance in public health strategies.
Highlights
Human papillomavirus (HPV) is a double-stranded DNA virus with the potential to infect human epithelial cells, an etiological agent of many types of cancer [1], and the primary cause of cervical cancer [2]
HPV 43/44 was the second most prevalent type and was significantly more common in the head and neck squamous cell carcinoma (HNSCC) group than in the control group (z = 2.674, p < 0.001) and in the HNSCC group compared with the chronic tonsillitis group (z = 2.283, p < 0.05)
The HNSCC group had a greater probability of HPV-positive status than the chronic tonsillitis group (OR = 2.1, 95%confidence interval (CI): 1.1–4.3)
Summary
Human papillomavirus (HPV) is a double-stranded DNA virus with the potential to infect human epithelial cells, an etiological agent of many types of cancer [1], and the primary cause of cervical cancer [2]. Incidence rates for oral and oropharyngeal cancer related to HPV infections are on the increase in some countries, especially among men [9,10,11], but the global prevalence and the genotype of HPV infection in head and neck squamous cell carcinoma (HNSCC) remain obscure [8,9]. Patients with oral cancer often present with symptoms at a late stage and show high recurrence rates after treatment [13]. A rising incidence of oropharyngeal cancers was observed in developed countries, at younger ages, and a significant increase in women was noted in European countries, including Poland [10]. To the consumption of alcohol and tobacco, HPV infection is a risk factor for head and neck cancer [7,14]
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