Evaluation of the Prevalence Rate and the Prognostic Effect of Human Papilloma Virus Infection in a Group of Patients With Oral Cavity Squamous Cell Carcinoma

Abstract

BackgroundSquamous cell carcinoma (SCC) is the most common malignancy of the oral cavity. A relationship between the human papilloma virus (HPV) infection and the prognosis of oral cavity SCC (OCSCC) has been discussed before.ObjectivesWe investigated the prevalence rate of HPV status in patients with OCSCC, and its effects on clinicopathological characteristics of tumors and patients’ prognosis.Patients and MethodsSections of formalin-fixed, paraffin-embedded tissue blocks from 114 histopathologically confirmed OCSCC cases were investigated in this study. Polymerase chain reaction (PCR) was applied to evaluate the HPV status in the samples.ResultsFifteen (13.16%) cases were identified as HPV positive. The detected viral subtypes in this study were the subtypes 6 and 11. The stage and especially lymph node stage was significantly higher in the HPV positive group compared to the HPV negative group (P = 0.04). Disease free survival (DFS) was remarkably lower in the HPV positive group compared to the HPV negative group (13.9 vs. 49.9 months, P = 0.02). Overall survival (OS) was also significantly inferior in the HPV positive group (15.7 vs. 49.6 months, P = 0.01). In the current study, no significant differences were observed between two groups in relation to the variables of age, gender, tumors site, tumor size, tumor grading and also the recurrence rate.ConclusionsThe observed higher mortality rate among the HPV positive group indicates the poorer prognosis of this group in comparison with the HPV negative patients. The incidence rate of HPV infection was low in the studied samples; however, interaction of subtypes 6 and 11 of HPV in poorer prognosis of the patients and a carcinogenic role of HPV in OCSCC cannot be ruled out.

Molecular and serologic markers of HPV 16 infection are associated with local recurrence in patients with oral cavity squamous cell carcinoma

“…However, our current findings suggest that patients with HPV 16-associated OCSCC had worse 5-year LR rates following standard treatment compared to those without HPV 16 infections. Consistent with our data, recent studies show that patients with HPV-positive OCSCC had worse survival ( n : 300–1002) than those with HPV-negative OCSCC in India [ 39 ], Iran [ 40 ], Croatia [ 41 ], and Taiwan [ 5 , 9– 11 , 42 ]. Consequently, our data should caution against the reliance on radiotherapy alone as a general treatment strategy for patients with HPV-positive OCSCC.…”

The Frequency of Human Papillomavirus Positivity in Iranian Patients with Head and Neck Squamous Cell Carcinoma

“…In addition, there was a significant association between HPV positivity and the grade of the primary tumor (30,31). Interestingly, these studies could not find a significant correlation between HPV positivity and other prognostic markers, such as perivascular or perineural invasion, while associated with the overall survival rate (15,23,29).…”

“…Although a better survival rate in HPV positive HNSCC was reported by a couple of previous studies ( 15 ), the majority of studies, which investigated the prognostic role of HPV positivity in HNSCC patients, found it highly correlated with poor tumor-cell differentiation, which may act as a prognostic marker and play a vital role in the pathways that enhance lymphatic metastasis ( 28 , 29 ). A similar result was also reported in Iran with a higher mortality rate in HPV positive HNSCC ( 15 ). In addition, there was a significant association between HPV positivity and the grade of the primary tumor ( 30 , 31 ).…”

“…Among them, the presence of HPV in esophageal SCC has been extensively studied ( 13 ). However, studies investigating this relationship in the head and neck area have been limited to the tongue ( 14 ) and oral cavity ( 15 ). This paper aimed to study the presence of HPV in SCCs in a broader spectrum of locations in the head and neck area.…”

Clinical Significance and Prognostic Value of the Expression of LAMP3 in Oral Squamous Cell Carcinoma

“…To date, studies seeking potential predictive molecular markers for OSCC have been extensively performed and some markers were identified as significantly correlating with tumor biological response and clinical features in vitro and in vivo [ 28 – 32 ]. Some molecular markers are even enable to significantly influence survival [ 32 , 33 ].…”