Squamous Cell Carcinoma of the Larynx in HIV-Positive Patients: Difficulties in Diagnosis and Management

Blenke, E. J. S. M.; Clement, William Andrew; Andrews, J. M.; Scanlon, Edward F.; Vernham, Guy A.

doi:10.1007/s00455-006-9034-7

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…In this study, the larynx was the most common site for HIV? HNSCC, which is consistent with other reports [9,43,44]. Age-matched analysis of the New York State Cancer Registry and the New York [45].…”

Section: Discussionsupporting

confidence: 91%

“…Confirmation of HPV typespecific sequences for the HCUB cases was performed using the INNO-LIPA HPV assay which is a microliter plate-based hybridization enzyme immunoassay. This assay which can identify 25 HPV genotypes (high-risk HPV: 16,18,31,33,35,39,45,51,52,56, 58, 59, 66, 68, 70 and low-risk: 6,11,34,40,42,43,44,53,54,74) in a single test. Ten ll of denatured HPV PCR product was hybridized to the genotype-specific probes immobilized as parallel lines on a nitrocellulose strip.…”

Section: Hospital Clinic University Of Barcelona Studiesmentioning

confidence: 99%

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Head and Neck Squamous Cell Carcinomas in HIV-Positive Patients: A Preliminary Investigation of Viral Associations

McLemore

Haigentz

Smith

et al. 2010

Head and Neck Pathol

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Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60%) men and 16 (40%) women. The larynx was most commonly involved (65%, n = 26); followed by the oropharynx (22.5%, n = 9). Four carcinomas arose from the oral cavity (10%) and one from the nasal cavity (2.5%). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5%) than the control group (27/102, 26%, p 0.001, chi-square). HPV was detected in 6 of 25 (24%) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83%) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3%) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24% of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.

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Section: Discussionsupporting

confidence: 91%

Section: Hospital Clinic University Of Barcelona Studiesmentioning

confidence: 99%

Head and Neck Squamous Cell Carcinomas in HIV-Positive Patients: A Preliminary Investigation of Viral Associations

McLemore

Haigentz

Smith

et al. 2010

Head and Neck Pathol

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“…Although this tumour is uncommon in HIV‐infected patients, a higher incidence of this neoplasm has been reported in HIV‐infected patients than in the general population [4,7]. According to the results of the present study and those of others [4,12], this tumour usually occurs at a younger age than those arising in the general population, on average presenting 15–20 years earlier. The close relationship between the development of LSCC in HIV‐infected persons and tobacco smoking was confirmed in this study, as all patients had been smokers for a long time.…”

Section: Discussionsupporting

confidence: 68%

Laryngeal squamous cell carcinoma in HIV‐positive patients: lack of association with human papillomavirus infection

Moyano¹,

Ordi²,

Caballero³

et al. 2009

HIV Medicine

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ObjectivesNeoplasms associated with human papillomavirus (HPV) infection occur at increased frequency in patients with HIV infection/AIDS. Although laryngeal squamous cell carcinomas (LSCCs) in HIVpositive patients are uncommon, a higher incidence of this malignancy in HIV-positive patients than in the general population has been reported. As a proportion of LSCCs are associated with HPV in the general population, the clinicopathological features of a series of LSCCs developing in HIV-positive patients were evaluated to investigate the possible relationship with HPV infection, and infection with other oncogenic viruses. MethodsAll HIV-positive patients with LSCC diagnosed at a single institution from 1998 to 2007 were retrospectively evaluated. The clinicopathological features were analysed and tissues were tested by polymerase chain reaction (PCR), using the short PCR fragment 10 (SPF10) primer, a highly sensitive method for HPV DNA detection. Immunohistochemical studies for HIV p24, p16INK4a and p53 were performed. Epstein-Barr virus (EBV) and human herpes virus 8 (HHV-8) were also investigated. ResultsSix out of 4987 HIV-infected patients seen in this period in the Infectious Diseases Department developed LSCC (median age 41.5 years; male to female ratio 1:1). All patients were heavy smokers and the tumours presented at an advanced clinical stage. HPV was not detected in any tumour, not even in two patients with coexisting HPV-associated gynaecological neoplasm. Staining for HIV p24 and p16INK4a was negative, whereas p53 was positive in half the cases. EBV and HHV-8 were also negative. ConclusionLSCC developing in HIV-positive patients is an infrequent neoplasm, not usually associated with HPV infection. It develops in young, heavy smokers and presents at an advanced clinical stage. Laryngeal squamous cell carcinoma (LSCC) in HIVinfected patients is uncommon. Nevertheless, it has been reported that HIV-positive patients have a higher incidence of this malignancy than the general population [4,7]. Interestingly, LSCC has been shown to be associated with HPV in 19-24% of cases in the general population [8,9]. Therefore, a close association between LSCC arising in HIVpositive patients and HPV infection could be hypothesized. In the present study we focused on the clinicopathological features of LSCCs developing in HIV-positive patients, and for the first time the possible association of these tumours with HPV infection was investigated using highly sensitive molecular methods. Moreover, other oncogenic viruses, including Epstein-Barr virus (EBV) and human herpes virus 8 (HHV-8), were also investigated. Patients and methods PatientsAll HIV-positive patients with LSCC seen in the Infectious Diseases Department of the Hospital Clinic, University of Barcelona between January 1998 and December 2007 were included in the study. During this period, 4987 HIVpositive patients were evaluated. Demographic data were obtained from the medical records. Tumour site and stage were determined from review of the surgical, radiolog...

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“…However, it has been pointed out that HIV-positive SCC patients have longer survival times under ART. Therefore, the prophylactic use of ART is recommended in patients who do not have low CD4+ cell counts as well (12).…”

Section: Discussionmentioning

confidence: 99%

Human Immunodeficiency Virus (HIV) Positive Case with Squamous Cell Larynx Cancer: Difficulties in the Choice of Treatment

Ünsal¹,

Türk²,

Akpınar³

et al. 2015

Turk Arch Otorhinolaryngol

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Squamous Cell Carcinoma of the Larynx in HIV-Positive Patients: Difficulties in Diagnosis and Management

Cited by 4 publications

References 19 publications

Head and Neck Squamous Cell Carcinomas in HIV-Positive Patients: A Preliminary Investigation of Viral Associations

Head and Neck Squamous Cell Carcinomas in HIV-Positive Patients: A Preliminary Investigation of Viral Associations

Laryngeal squamous cell carcinoma in HIV‐positive patients: lack of association with human papillomavirus infection

Human Immunodeficiency Virus (HIV) Positive Case with Squamous Cell Larynx Cancer: Difficulties in the Choice of Treatment

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