Human Papillomavirus Testing in Head and Neck Squamous Cell Carcinoma: Best Practice for Diagnosis

Schache, Andrew; Croud, James; Robinson, Max; Thavaraj, Selvam

doi:10.1007/978-1-4939-1050-2_13

Cited by 14 publications

(11 citation statements)

References 51 publications

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“…Immunohistochemical expression of p16, a tumor suppressor protein, is a widely accepted biomarker for assessing HPV status and is considered the standard for treatment stratification in clinical trials [10]. Following mucosal infection, two HPV-encoded oncoproteins, E6 and E7, inactivate tumor suppressor genes TP53 and pRb , respectively.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of non-HPV16 genotypes in oropharyngeal squamous cell carcinoma

et al. 2016

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Objectives Recent studies have found that cases with oropharyngeal squamous cell carcinoma (OPSCC) positive for HPV16 genotype have better overall survival compared with cases positive for other HPV genotypes. We sought to further replicate these studies and determine if this relationship is modified by expression of p16 tumor suppressor protein. Material and Methods We identified 238 OPSCC cases from the Carolina Head and Neck Cancer Study (CHANCE) study, a population based case-control study. Tumors that tested positive solely for HPV16 genotype and no other genotypes with PCR were classified as HPV16-positive. Tumors positive for any other high-risk HPV genotype were classified as non-HPV16-positive. Expression of p16 in the tumor was determined with immunohistochemistry. Follow-up time was calculated from the date of diagnosis to date of death or December 31, 2013. Overall survival was compared with the Kaplan-Meier curves and log-rank test. Hazard ratios (HR) adjusted for smoking, alcohol use, sex, race, and age was calculated with the Cox proportional hazard regression. Results Cases with HPV16-positive OPSCC had better overall survival than cases with non-HPV16-positive OPSCC (log-rank p-value: 0.010). When restricted to OPSCC cases positive for p16 expression, the same trend continued (log-rank p-value: 0.002). In the adjusted model, cases with non-HPV16-positive OPSCC had greater risk of death compared to cases with HPV16-positive tumors (HR: 1.92; 95% CI: 1.03, 3.60). Conclusions This finding indicates that HPV genotyping carries valuable prognostic significance in addition to p16 status and future survival studies of OPSCC should take into account differing HPV genotypes.

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Section: Introductionmentioning

confidence: 99%

Prognostic significance of non-HPV16 genotypes in oropharyngeal squamous cell carcinoma

et al. 2016

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“…p16 expression with diffuse positivity in more than 70% of cells has been suggested as a surrogate marker of active high-risk HPV oncogene expression in oral and oropharyngeal carcinomas. (20)(21)(22) Using this criterion, our study points to a prevalence of HPV in oral and oropharyngeal carcinomas to be around 23.2% in our tertiary care centre. HPV prevalence in squamous cell carcinomas of the oral cavity and oropharynx in India has been reported to be ranging from 15% to 51% (9,(23)(24)(25) and in developed nations highly variable ranging from as low as 10% to as high as 80%.…”

Section: Discussionmentioning

confidence: 89%

PREVALENCE OF HUMAN PAPILLOMA VIRUS IN A TERTIARY CARE CENTRE IN CENTRAL INDIA USING p16 IMMUNOEXPRESSION AS A SURROGATE MARKER

Yadav¹,

Tandon²

2019

jemds

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BACKGROUND High risk Human Papilloma Virus (HR-HPV) has now emerged as one of the major etiological factors in oral and oropharyngeal cancer. Knowing HPV status is crucial as it has a significant impact on therapeutic front as well as on prognosis. As p16 immunoexpression can serve as surrogate marker for HR-HPV infection, in the current study we used p16 immunoexpression to determine the prevalence of HPV in a tertiary care centre in Central India. MATERIALS AND METHODSThis is hospital based cross sectional study conducted in oral biopsy tissues (for neoplastic lesions) received for histopathological evaluation over a period of one and half years. The sections were processed for H & E staining, and 112 cases were chosen for immunohistochemical study. The data was analysed by chi-square and Z-tests using software SPSS. RESULTSPositive diffuse p16 immunoexpression was present in 23.2% of the cases irrespective of histological type/grade of the lesion. We found significant correlation between degree of dysplasia and p16 immunoexpression with 16.7% of cases showing positivity in OIN I cases as compared to 25% in OIN II and 77.8 % in OIN III. Poorly differentiated tumours had high proportion of cases with positive p16 immunoexpression (75%) compared to well differentiated (29.3%) and moderately differentiated squamous cell carcinomas (35.5%). Additionally, higher proportion of female patients (43.8%) had diffuse p16 positivity than males (17%). CONCLUSIONWe conclude that HPV prevalence in our tertiary care centre is approximately 23.2%. This subset of cases was found to be associated more with oropharyngeal lesions and was present in higher proportions in female patients. Apart from serving as a surrogate marker for HR-HPV, p16 immunoexpression also correlates with the degree of dysplasia in oral and oropharyngeal lesions.

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“…p-16 expression with diffuse positivity in more than 70% of cells has been suggested as a surrogate marker of active high-risk human papillomavirus (HPV) oncogene expression in oral and oropharyngeal carcinomas. [1819] HPV prevalence in SCC of the oral cavity and oropharynx in India has been reported to be ranging from 15% to 51%. [2021] In our study, irrespective of the histology, 23.2% of cases displayed a diffuse positivity.…”

Section: Discussionmentioning

confidence: 99%

Expression of p-16, Ki-67 and p-53 markers in dysplastic and malignant lesions of the oral cavity and oropharynx

Yadav

Malik

Balani

et al. 2019

J Oral Maxillofac Pathol

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Background: Understanding the markers for predicting degree of dysplasia and progression to malignancy can help early identification and prompt treatment of patients with oral cancers. In this study, we aim to identify and characterize different tumor suppressor genes such as p-53 and p-16 and proliferation marker Ki-67 in defining stages of dysplasia of oral mucosa and grading of tumor. Settings and Design: Oral biopsy tissues (for neoplastic lesions) received for histopathological evaluation were included in the study. The sections were processed for H&E staining, and 112 cases were chosen for immunohistochemical study. The data were analyzed by Chi-square and z-tests using software SPSS. Results: We found significant correlation between degree of dysplasia and p-16 immunoexpression with 16.7% of cases showing positivity in oral intraepithelial neoplasia (OIN) I cases as compared to 25% in OIN II and 77.8% in OIN III. Ki-67 immunoexpression correlated significantly with both histological type and grade of tumor with increased expression and intensity seen in malignant cases (66.3%) as compared to benign (10%) and premalignant cases (37%) and higher Ki-67 immunoexpression in poorly differentiated tumors (75%) than well-differentiated tumors (12.2%). Regarding p-53 immunoexpression, positive staining was seen in only malignant cases and premalignant cases. Conclusions: Ki-67 and p-16 can be useful as a marker of degree of dysplasia and transformation to malignancy. Ki-67 can also serve as a marker of degree of differentiation of tumors. Hence, they can serve as important ancillary markers to analyze the transition to carcinoma, dysplasia and progression of tumor.

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Human Papillomavirus Testing in Head and Neck Squamous Cell Carcinoma: Best Practice for Diagnosis

Cited by 14 publications

References 51 publications

Prognostic significance of non-HPV16 genotypes in oropharyngeal squamous cell carcinoma

Prognostic significance of non-HPV16 genotypes in oropharyngeal squamous cell carcinoma

PREVALENCE OF HUMAN PAPILLOMA VIRUS IN A TERTIARY CARE CENTRE IN CENTRAL INDIA USING p16 IMMUNOEXPRESSION AS A SURROGATE MARKER

Expression of p-16, Ki-67 and p-53 markers in dysplastic and malignant lesions of the oral cavity and oropharynx

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