A Study of Prognostic Factors in Young Patients With Non-HPV Oral Cancer in Central Europe

Abstract

The etiological factors of squamous cell carcinomas of the head and neck have been well known for a long time. It is also well known that the incidence of oral cancer diagnosed in younger patients is on the rise. Due to the young age of these patients, the increase in the number of these cases and the fact that many of them neither smoke nor drink alcohol it has been suggested that other factors might be at play in the carcinogenesis of oral cancer. Thus, along the classic etiological factors of smoking and alcohol abuse certain molecular marker anomalies and the human papilloma virus (HPV) have emerged as potential factors. The aim of the present study is to verify the potential prognostic factors and to map the differences in biomarker expression between the young and the old patient groups. In the present study the immunohistochemical profile of samples obtained from oral squamous cell carcinomas was studied and compared with various clinico-pathological parameters. In 88 samples the expressions of p16, p53, Ki67, EGFR were studied with a tissue microarray technique under standard reaction conditions as well as the detection and typing of HPV infection with the Full Spectrum HPV DNA method. The biomarker expression profile of young patients with oral squamous cell carcinoma was compared to that of older patients (above 50). A significant difference was found between the immunohistochemical profile of the young and old patient groups in p16, Ki67 expression. The overall survival and progression free survival were influenced by p16 expression in young age.

The characteristics of head and neck squamous cell cancer in young adults: A retrospective single-center study

“…Although the duration of the exposure is necessarily shorter (by decades) among young patients, prevalence of tobacco and alcohol consumption in our study population was significantly higher compared to the >15 years old regional general population (30.6% ( 19 ); 32.3% ( 20 ) respectively. A recent Hungarian report of oral squamous cell cancer cases has also stated that the number of smokers was high in both the older and younger oral cancer patient groups ( 21 ) however, the definition of drinkers is often used inconsistently, which makes the comparisons less exact between various studies. We hypothesize that the sufficiency of lower cumulative doses of these harmful agents suggests an increased vulnerability of this population to lifestyle-related risks, which might originate from a diminished damage control on the cellular level, or a weaker capacity to eliminate tumor cells by the innate immune responses.…”