Association of viral load and physical status of HPV-16 with survival of patients with head and neck cancer

Abstract

Introduction: Head and neck cancers (NHCs) are of multifaceted origins, and tobacco and alcohol are the primary risk factors. Currently, other factors associated with the genesis of these tumours are being considered, among these viral infections, especially human papillomavirus (HPV) infection. Objective: The objective was to evaluate HPV infection, HPV-16 E6 load and its physical status in patients with squamous cell carcinoma in the head and neck and evaluate its effects in the survival of these patients. Methodology: A total of 80 fresh biopsies of HNC were evaluated. The genetic material was extracted using the commercial kit QIAGEN. The detection and classification of HPV were carried out using INNO-LiPA, whereas the quantification and analysis of integration of the viral genome into the host cell were carried out using real-time PCR. Results: The average age of the patients included was 60.34 ± 14.48 years, with a predominance of the male gender. The most frequent HPV infection was genotype 16 (52.8%), with an average of 10 copies of the HPV-16 E6/β-globin gene. Furthermore, an integration of the viral genome in the host cell was observed in 86% of cases with a statistically significant relationship between the location of the tumour and the viral load (p < 0.05). Conclusions: HPV-16 is the most common infection, and its physical status in the host cell is the determining factor in establishing response to treatment. However, more studies are needed to demonstrate the role of HPV infection in carcinogenesis.

The Prevalence of High- and Low-Risk Types of HPV in Patients with Squamous Cell Carcinoma of the Head and Neck, Patients with Chronic Tonsillitis, and Healthy Individuals Living in Poland

“…HPV 44 belongs to a mucosotropic group of HPVs found in benign and malignant lesions of the anogenital tract and fortuitously in tissues and lesions of the oral cavity, oropharynx, and esophagus [ 27 ]. A number of samples in our study contained more than one HPV type, which is in line with some [ 32 , 35 , 42 , 43 , 44 , 57 , 65 ] but not all studies [ 33 ].…”

“…Some researchers have used tests to detect all known high-risk and low-risk genotypes. However, HPV 43/44 was not observed [ 37 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. There are no guidelines for HPV testing as regards head and neck cancer, and the methods to detect HPV DNA in oral samples have not been standardized yet [ 37 ].…”

“…In our study, HPV 16 was more frequently observed in tumors in the palatine tonsil and less frequently in the oral cavity region (mandible), which is in line with the data that HPV 16 is more related to oropharyngeal primaries than to those located in the oral cavity [ 75 ]. However, one study reported that the oral cavity was more frequently infected by HPV [ 42 ] and another study showed that HPV was slightly more prevalent in the oral cavity than in oropharyngeal cancer [ 43 ].…”

“…HPV detection and identification of subtypes were performed by GenoFlow HPV (Human Papillomavirus) Array Test Kits (DiagCor Bioscience Inc., Hong Kong) which use biotin-labeled primers, specific probes, PCR and "flow-through" hybridization technology, which allows detection of 33 common HPV subtypes. The following are considered highrisk (16,18,31,33,35,39,45,51,52,53,56,58,59,66,68,73,82) and low-risk (6,11,26,40,42,43,44,54,55,57,61,70,71,72,81,84) subtypes based on their phylogenetic and epidemiological criteria and the biological niche. The extracted DNA was mixed with PCR reagent mix and DNA Taq Polymerase provided with the kit and amplified using a Mastercycler Personal Thermal Cycler (Eppendorf, Hamburg, Germany) according to the manufacturer's protocol.…”

Causes and Consequences of HPV Integration in Head and Neck Squamous Cell Carcinomas: State of the Art

“…Of the 28 HPV16 positive samples, 86% displayed integration, possessed low viral load and correlated to poor prognosis. [100]. Supporting these results, Koneva et al showed that patients with (RNAseq determined) integration-positive oropharyngeal and oral cavity tumors had statistically significant worse survival than patients with integration-negative tumors and similar survival as patients with HPV-negative HNSCCs [80].…”