Low prevalence of human papillomavirus in a geographic region with a high incidence of head and neck cancer

Miguel, Roberto Elias Villela; Villa, Luisa L.; Cordeiro, Anói Castro; Prado, José Carlos Mann; Sobrinho, João Simão; Kowalski, Luiz Paulo

doi:10.1016/s0002-9610(98)00246-3

Cited by 37 publications

(33 citation statements)

References 7 publications

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“…None of the examined normal samples were found to be positive, which lies in accordance with some studies (18,23,26,29,32). However, other groups have observed a surprisingly high infection percentage in normal mucosa (3,11,16,41), possibly because they analyzed normal tissues that were adjacent to neoplastic lesions. In patients who had proliferative disorders, HPV positivity exceeded the percentage of smoking (71.7%), which is considered a major risk factor for oral carcinogenesis (3).…”

Section: Discussionsupporting

confidence: 88%

“High Risk” HPV Types Are Frequently Detected in Potentially Malignant and Malignant Oral Lesions, But Not in Normal Oral Mucosa

et al. 2000

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Studies on the involvement of the human papillomavirus (HPV) in initiation and progression of oral neoplasia have generated conflicting results. The observed discrepancy is attributable mainly to the varying sensitivity of the applied methodologies and to epidemiologic factors of the examined patient groups. To evaluate the role of HPV in oral carcinogenesis, we analyzed 53 potentially neoplastic and neoplastic oral lesions consisting of 29 cases of hyperplasia, 5 cases of dysplasia, and 19 cases of squamous cell carcinomas, as well as 16 oral specimens derived from healthy individuals. A highly sensitive nested polymerase chain reaction (PCR) assay was used, along with type-specific PCR, restriction fragment length polymorphism analysis, dot blotting, and nonisotopic in situ hybridization. Nested PCR revealed the presence of HPV DNA in 48 of the 53 (91%) pathologic samples analyzed, whereas none (0%) of the normal specimens was found to be infected. Positivity for HPV was independent of histology and the smoking habits of the analyzed group of patients. At least one "high risk" type, such as HPV 16, 18, and 33, was detected by type-specific PCR in 47 (98%) infected specimens, whereas only 1 (2%) squamous cell carcinoma was solely infected by a "low risk" type (HPV 6). HPV 16 was the prevailing viral type, being present in 71% of infected cases. Single HPV 16 and HPV 18 infections were confirmed by restriction fragment length polymorphism. HPV 58 was detected by dot blotting in three hyperplastic lesions. HPV positivity and genotyping were further confirmed, and the physical status of this virus was evaluated by nonisotopic in situ hybridization. Diffuse and punctate signals, indicative of the episomal and integrative pattern of HPV infection, were observed for low-and high-risk types, respectively. Our findings are suggestive of an early involvement of high-risk HPV types in oral carcinogenesis.

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Section: Discussionsupporting

confidence: 88%

“High Risk” HPV Types Are Frequently Detected in Potentially Malignant and Malignant Oral Lesions, But Not in Normal Oral Mucosa

et al. 2000

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“…However, to date, the numerous existing studies, performed by sensitive PCR-based detection methods, have shown variable frequencies of the HPV prevalence in HN tumours either for all sites and for each single subsite. Some authors failed to reveal high HPV prevalence level in countries with a high incidence of HN cancers, demonstrating a scarce contribution of HPV in carcinogenesis (21,22) while others even reported the absence of HPV DNA in a Chinese population, though of small size (23). Reasons of these oscillations seem to be ascribed to population variability, ethnic factors and anatomic location as well as recognised exposures to risk factors such as smoking and alcohol, more than methodological differences (4,24).…”

Section: Discussionmentioning

confidence: 99%

Molecular analyses and prognostic relevance of HPV in head and neck tumours

Badaracco¹,

Rizzo

Mafera

et al. 2007

Oncol Rep

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Abstract. HPV involvement in head and neck (HN) cancer is still under active investigation. Fresh frozen and archival clinical samples from 115 patients affected by HN carcinomas were analysed by PCR-based methods and direct sequencing. HPV types, intra-type variants, physical status, viral load and viral transcript presence were determined. HPV positivity was correlated with the main clinical-pathological features, including smoker and drinker status, and the clinical outcome. Twenty-one tumours were HPV positive (18.3%) with HPV16 being the most frequent type (n=14) followed by HPV6 (n=4), HPV33, HPV35, and HPV58 (n=1, each type). Tonsil carcinomas contained more high-risk HPV types (6/8; 75%) than all other sites (p=0.0004). HPV16 genome was integrated in all analysed tumours, as pure integrated form or mixed with concomitant episomal forms (4 cases). The viral load showed a wide variability (range, 0.7-485 copies per cell) with the highest value detected in a larynx tumour and the lowest one in a case of cancer of the oral cavity. In 9 HPVpositive samples where mRNA was available, transcripts of viral early oncogenes originating by integrated, episomal or mixed forms of the viral genome were found. A statistically significant correlation was evidenced between HPV and tumour differentiation, being the virus more associated with tumour grade G3/G4. Multivariate Cox regression analysis revealed that lymph-node and grade status were significant independent factors for a worse disease-free survival and overall survival, whereas the HPV status was associated with a better overall survival (OR, 0.33; 95% CI, 0.13-0.81; p=0.01). Taken together these results indicate that distinct pathological mechanisms for the malignant transformation in each single HN subsite should be taken in account; HPV molecular analyses should be considered a valid tool to distinguish subsets of oropharyngeal tumours and HPV presence could be useful for the prognostic assessment of HNSCC. IntroductionTumours of the oral cavity and pharynx have been estimated at 643,000 cases for 2002, with 349,000 deaths (1). The incidence of these cancers is traditionally found to be very high in some areas of the world (e.g., France and South India), but in the last decade other areas (e.g., Eastern Europe and Japan) reported an increasing incidence of head and neck (HN) squamous cell carcinomas (SCC) (2). HN cancer constitutes one of the most difficult pathologies to eradicate. Recurrences are frequent and about a half of patients die (1). The heterogeneity of treatment response and the lack of prognostic factors could be the main causes of the adverse clinical outcome. Moreover, the behaviour variability of each individual tumour has also emphasized the difficulties of managing these tumours.Life habits such as the intake of toxic agents present in tobacco smoke, alcohol drink and betel chewing, or poor hygiene remain major risk factors for these tumours. However, the fraction of HN cancers attributable to these risk factors is close to 80-90%, while the...

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“…Markers for transcriptionally active HPV include p16 over-expression, and expression of E6 and E7 proteins (Wiest et al, 2002;Weinberger et al, 2006). HPV has been identified in 0-100% of oral cavity pre-malignant lesions (Chang et al, 1991;Holladay and Gerald, 1993;Fouret et al, 1995;Franceschi et al, 1996;Bouda et al, 2000;Sand et al, 2000;Mork et al, 2001;Ha et al, 2002), as well as in 0-100% of oral cancers (Greer et al, 1990;Mao et al, 1996;Matzow et al, 1998;Miguel et al, 1998;Bouda et al, 2000); however, the majority of studies relied on PCR for detection and did not quantitate HPV viral load or identify markers of HPV transcriptional activity. PCR is a highly sensitive technique that can amplify exceedingly small fragments of HPV DNA, resulting in detection of non-pathologic HPV infections or sample contamination.…”

Section: Risk Factors For Hpv-positive Hnsccmentioning

confidence: 99%

Human Papillomavirus and Head and Neck Squamous Cell Carcinoma: Recent Evidence and Clinical Implications

2009

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Over the past 20 years, high-risk human papillomavirus (HPV) infection has been established as a risk factor for developing head and neck squamous cell carcinoma, independent of tobacco and alcohol use. In particular, HPV is strongly associated with the development of oropharyngeal cancer and a small minority of oral cavity cancers. In this review, we summarize what is currently known about the biology of HPV, the mechanisms by which it effects malignant transformation, and the potential impact of HPV status on the clinical management of persons with head and neck cancer.

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Low prevalence of human papillomavirus in a geographic region with a high incidence of head and neck cancer

Cited by 37 publications

References 7 publications

“High Risk” HPV Types Are Frequently Detected in Potentially Malignant and Malignant Oral Lesions, But Not in Normal Oral Mucosa

“High Risk” HPV Types Are Frequently Detected in Potentially Malignant and Malignant Oral Lesions, But Not in Normal Oral Mucosa

Molecular analyses and prognostic relevance of HPV in head and neck tumours

Human Papillomavirus and Head and Neck Squamous Cell Carcinoma: Recent Evidence and Clinical Implications

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