Prevalence of human papilloma virus in oropharyngeal, tongue and lip squamous cell carcinoma: An experience from the Egyptian National Cancer Institute

Abstract

Human papilloma virus (HPV) is now a well-known risk factor for head and neck cancer besides smoking and alcohol. Most studies mentioned that patients affected with high-risk HPV cancers have a better outcome, and many clinical trials are trying to prove that such group of patients can receive a different and less aggressive treatment than the HPV-negative group. Although such field has received great interest within different countries and continents, African and Egyptian populations are not yet well studied within the literature. Our aim was to detect the prevalence of HPV in oropharyngeal (OP), lip and tongue squamous cell carcinoma (SSC) and correlate the viral prevalence with different clinicopathologic parameters as well as patients’ outcome. HPV detection was done on 99 cases from the lip (29), tongue (38) and oropharynx (32) diagnosed at the Pathology Department of the National Cancer Institute, Cairo University. p16 immunohistochemistry was performed on all cases, followed by HPV DNA in situ hybridization (ISH) for p16-positive cases. The prevalence of HPV in OPSSC was 28% and in lip and tongue cancers lumped together was 37%. There was more than 90% concordance between p16 and HPV DNA ISH results. HPV positivity showed a statistically significant correlation with better disease-free survival (DFS), which was also maintained for OP cases. HPV is highly prevalent in OP and common oral cavity cancers in the Egyptian population. HPV positivity correlated significantly with better DFS, especially in OP cancers.

Prevalence of HPV Infection in Head and Neck Cancer Patients in Egypt: National Cancer Institute Experience.

“…In contrast, a slightly higher prevalence (28%) of HPV DNA in oropharyngeal Squamous Cell Carcinoma (OPSCC) has been reported in a group of Egyptian patients assessed by Tealab et al, who investigated the presence of HPV in 99 para n embedded tissue samples. [8] This relatively high prevalence compared to our results may be due to the difference in methods and type of samples used, where they detected HPV by P16…”

“…In the last few decades, a signi cant increase of HPV infection in younger males with higher Socioeconomic status was observed in the United states [7]. However, the situation in Egypt is still unclear where limited data is available with only few studies in this issue (8,9). This highlights the need to asses this topic and to investigate the association between HPV infection and HNSCC in Egyptian patients.…”

A Contemporary Systematic Review on Repartition of HPV-Positivity in Oropharyngeal Cancer Worldwide

“…HPV detection methods varied among the included studies. Fifteen studies were based on double positivity with both HPV DNA PCR and p16 IHC ( n = 6624) [ 4 , 16 , 19 , 20 , 22 , 23 , 28 , 30 , 32 , 33 , 34 , 35 , 38 , 39 , 40 ], eight studies were based on HPV DNA alone ( n = 426) [ 12 , 14 , 15 , 24 , 25 , 29 , 36 , 41 ], six on p16 alone ( n = 391) [ 17 , 18 , 21 , 26 , 27 , 31 ], one study was based on both HPV DNA and HPV RNA ( n = 99) [ 37 ] and one study did not report a detection method ( n = 42,024) [ 13 ]. Most studies using p16 IHC defined p16-positivity (p16+) according to ASCO guidelines with ≥70% positive staining [ 42 ] ( n = 2663), but one study defined p16+ as ≥10% positive staining ( n = 30) [ 30 ], four studies defined p16+ as ≥75% positive staining ( n = 2678) [ 4 , 22 , 31 , 32 ] and one study did not account for p16-positivity ( n = 926) [ 35 ].…”

Patterns of Immune Infiltration in HNC and Their Clinical Implications: A Gene Expression-Based Study

“…According to statistics from the National Central Cancer Registry of China (21) and the National Cancer Institute of USA (22), HSC is still the primary cancer disease worldwide. Especially in China, HNC is in the top ten causes of incidence rates and mortality in urban and rural regions in China (21).…”