Incidence and characteristics of human papillomavirus-positive oropharyngeal cancers by p16 expression

M. Nagarajan, R. Banu, Ananthakrishnan Radha, Sasikala Saranya
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Abstract

Background: Head-and-neck cancers are one of the most common cancers in the Indian subcontinent. The rising incidence of human papillomavirus (HPV), especially in oropharyngeal cancers is likely to increase the burden by many folds. Hence, we decided to study the incidence of HPV in oropharyngeal carcinoma and its characteristics. Materials and Methods: Patients with primary squamous cell carcinoma (SCC) of the oropharynx registered in our hospital between September 2018 and July 2020 were included in the study after obtaining informed consent. A total of 60 patients were included in the study. The evaluation of HPV status was done by immunohistochemistry for p16 expression. Results: The median age of presentation was 60 years (range: 38–85 years). Fifty-four patients were male and six patients were female. The incidence of HPV in oropharyngeal carcinoma was 21.7% (n = 13). There was no difference seen when we compare HPV-positive patients with HPV-negative patients as well as with the entire study population for the demographic characteristics such as age (P = 0.569), gender (P = 0.754), smoker (P = 0.368), history of alcohol consumption (P = 0.558), and history of tobacco chewing (P = 0.781). We did not find any association between HPV-positive and HPV-negative patients with anatomical subsites (P = 0.369), tumor stage (P = 0.397), and nodal stage (P = 0.592). HPV-positive oropharyngeal SCC (OPSCC) patients presented more at early stage as compared to HPV-negative patients (P = 0.005). HPV-positive patients had higher incidence of histological poor differentiation than HPV-negative patients (P = 0.024). Conclusion: The study highlighted the incidence of HPV (21.7%) among OPSCC patients using p16 expression. HPV-positive patients have propensity for early stage of presentation and histological poor differentiation. The demographic characteristics and anatomical subsites of OPSCC had no impact on HPV status.
人乳头瘤病毒阳性口咽癌p16表达的发生率及特点
背景:头颈癌是印度次大陆最常见的癌症之一。人乳头瘤病毒(HPV)发病率的上升,特别是在口咽癌中,可能会使负担增加许多倍。因此,我们决定研究HPV在口咽癌中的发病率及其特征。材料与方法:2018年9月至2020年7月在我院登记的口咽部原发性鳞状细胞癌(SCC)患者经知情同意后纳入研究。共有60名患者被纳入研究。免疫组化检测p16表达,评估HPV状态。结果:患者的中位年龄为60岁(38-85岁)。男性54例,女性6例。口咽癌中HPV的发病率为21.7% (n = 13)。当我们比较hpv阳性患者与hpv阴性患者以及整个研究人群的人口统计学特征,如年龄(P = 0.569)、性别(P = 0.754)、吸烟者(P = 0.368)、饮酒史(P = 0.558)和咀嚼烟草史(P = 0.781)时,没有发现差异。我们没有发现hpv阳性和hpv阴性患者与解剖亚位(P = 0.369)、肿瘤分期(P = 0.397)和淋巴结分期(P = 0.592)有任何关联。与hpv阴性患者相比,hpv阳性的口咽SCC (OPSCC)患者在早期表现更多(P = 0.005)。hpv阳性患者组织学差分化发生率高于hpv阴性患者(P = 0.024)。结论:研究表明,使用p16表达的OPSCC患者中HPV的发病率为21.7%。hpv阳性患者有早期表现和组织学分化差的倾向。OPSCC的人口统计学特征和解剖亚位对HPV状态没有影响。
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