Human papillomavirus: a predictor of better survival in ocular surface squamous neoplasia patients

Abstract

Background Although human papillomavirus (HPV) has been implicated in the pathogenesis of ocular surface squamous neoplasia (OSSN), no study has so far dealt with the prognostic role of HPV. In this study the presence and significance of HPV in OSSN and its correlation with p16INK4a immunoexpression was determined. Methods HPV was detected by HPV-L1 capsid genespecific multiplex PCR using PGMY09/11 primers, and genotyping was done by linear array on 64 OSSN patients and 15 conjunctival controls. p16INK4a immunoexpression as a marker for HPV presence was also evaluated. Results The HPV genome was detected in 11% of cases by multiplex PCR, and all positives belonged to a high-risk HPV16 genotype. p16INK4a Overexpression was seen in 28% (18/64) of cases. Control conjunctival tissues were negative for HPV and p16INK4a expression. The presence of HPV was associated with significantly improved disease-free survival ( p=0.02) as well as p16INK4a overexpression ( p=0.001). The sensitivity and specificity of p16INK4a as a marker for HPV presence was 86% and 79%, respectively, with a positive predictive value of 33% and a negative predictive value of 98%. Conclusions The results of this study point towards HPV as a predictor of better survival in a subset of HPV-positive OSSN patients. Although p16 INK4a immunoexpression is a useful indicator of HPV presence in OSSN, confirmation by multiplex PCR is necessary.

American Joint Committee on Cancer Staging and Clinicopathological High-Risk Predictors of Ocular Surface Squamous Neoplasia: A Study From a Tertiary Eye Center in India

“…Human papillomavirus and human immunodeficiency virus have also been cited as possible cofactors in OSSN that may influence the prognosis. 3,[18][19][20] Recurrence developed in 17% of 48 patients herein with follow-up data, which is similar to that in other studies (17%-41%). 1,7 Larger tumors (2 cm) and those with a diffuse growth pattern had a higher risk of recurrence.…”

Equine ocular squamous cell carcinoma: a case report

“…In human pathology the prevalence of HPV in ocular surface disease varies dramatically, according to variations in the assays used to detect the virus, as well as geography and genetic susceptibility (Woods et al 2013), and the utility of p16INK4a immunoexpression for predicting HPV in ocular surface squamous neoplasia was evaluated but, unlike cervical cancers, it seems that there is no correlation. In fact, the overexpression of p16INK4a in OSSN was significantly associated with HPV (Chauhan et al 2012), while Auw-Haedrich et al (2008) have reported HPV and p16INK4a positivity in conjunctival intraepithelial neoplasias (CIN) but they did not observe any association between p16INK4a and HPV.…”

Human Papillomavirus Infection and Human Cancer

“…Ocular surface squamous neoplasia, that is conjunctival squamous neoplasia, is a highly intersting tumour which is evaluated by Scott et al [2002], Biswas et al [2010], Aktas et al [2012], Chauhan et al [2012], Di Girolamo [2012 as well as by Kao et al [2012].…”

“…In a material of 64 cases of OSSN, HPV infection was detected in 11% -it also indicated a better prognosis [Chauhan et al 2012]. …”