Human papillomavirus infection in oral squamous cell carcinomas: correlation with histologic variables and survival outcome in a high risk population

Abstract

Aim: Cancer of the oral cavity is extremely prevalent in Pakistan. Human papillomavirus (HPV) has been shown to play a role in the development of oral squamous cell carcinoma (OSCC) and may even improve overall and disease-free survival. The purpose of this study was to determine prevalence and types of HPV in a high risk population and its correlation with overall and disease-free survival, chewing habits and histologic variables. Material and methods: A total of 140 patients of OSCC, having a long-term follow-up, were included in this study. HPV-general and type-specific 16 and 18 infection were investigated by means of polymerase chain reaction. Results: Out of 140 patients, HPV was detected in 95 (68%) patients, out of whom, 85 (90%) contained HPV16. HPV positive patients had comparatively prolonged overall survival when compared with HPV-negative patients, but this difference was not statistically significant (P = 0.97). HPV presence was also not found to correlate significantly with disease-free survival (P = 0.58). The male were significantly correlated [odds ratio (OR) = 2.34; 95% confidence interval (CI) = 1.13–4.84] with the HPV infection. Betel quid chewer were comparatively more prone to HPV positivity (OR = 2; 95% CI = 1.1–4.31). Conclusion: Our study found a high prevalence of HPV16 in OSCC of Pakistani patients with male sex showing significant correlation with HPV infection. However, we did not find a statistically significant favourable association between HPV, survival and histologic variables. Borderline significance of HPV positivity was also seen with betel quid chewing (P = 0.049

TP53 protein overexpression in oral squamous cell carcinomas (OSCC): correlation with histologic variables and survival outcome in Pakistani patients

“…It is suggested that the oral cavity is exposed more intensely to the synergistic carcinogenic effect of chewing tobacco, smoking, alcohol and HPV infection. HPV infection is a significant factor that causes TP53 alteration, and we have seen that HPV infection is common in Pakistani cancer patients 47,48 . Some studies have shown strong association between TP53 expression and smoking 49,50 , betel quid chewing 51 and alcohol drinking 49,50 , but in our study, we did not found any association between patient habits (smoking, chewing tobacco and betel‐quid consumption) and TP53 overexpression.…”

Correlation of human papillomavirus infection and clinical parameters with five-year survival in oral squamous cell carcinoma

“…This yielded a positive result for 95 patients (67.9 per cent). The HPV polymerase chain reaction findings were further specified according to the type: 85 patients were HPV 16 positive, while 2 were HPV 18 positive 11 . Six patients were positive for HPV other than the 16 and 18 subtypes.…”

“…Following our 2008 study, the patients’ HPV status and clinical characteristics were already known, and the same data were utilised in our study 11 . The results were recorded by the study investigators.…”

“…Given what we now know about HPV and OSCC, it is important to study their relationship, as well as the carcinogenicity and survival rates of HPV-positive SCCs 4 . Previously, a study was carried out using the same patient dataset to understand HPV prevalence, and its effects on overall survival and disease-free survival 11 . As five-year survival analysis is the ‘gold standard’ by which we judge the viability of any biomarker, a five-year survival analysis was scheduled for the future (the patients had just been enrolled in that study and the required data were unavailable at that time).…”

Infectious Aetiology of Cancer: Developing World Perspective

“…Clearly, the HPV status of patients with OSCC would be an important determinant for prognosis and treatment options in the future. Recently, in a retrospective study of 140 patients with primary OSCC and a long-term follow up, Ali et al reported from Karachi, Pakistan, 68% of cases to be positive for HPV (Ali et al, 2008). Approximately 90% of these cases were infected with HPV16, (Figure 3 & 4) the predominant subtype in the US population as well.…”