The role of human papillomavirus in head and neck squamous cell carcinoma: A case control study on a southern Chinese population

Abstract

HPV plays a role in the development of a portion of head and neck squamous cell carcinoma (HNSCC), but only limited information on its role in southern Chinese population is available. A multicenter case-control study was conducted. HPV type, viral integration, E6/7 mRNA expression status, and TP53 mutation were determined. A total of 228 HNSCC were recruited including 137 (60.1%) oral SCC, 34 (14.9%) oropharyngeal SCC, 31 (13.6%) laryngeal SCC, 21 (9.2%) hypopharyngeal SCC, and 5 (2.2%) lip and paranasal sinus SCC. High-risk HPV infection was found in 7.5% (17/228) of HNSCC, but only a small proportion of samples had evidence of viral integration (5.3%, 12/228) or E6/7 mRNA expression (4.4%, 10/228). HPV infection with oncogenic phenotype (integration and E6/7 mRNA expression) was significantly more common in oropharyngeal SCC than controls (9/34, 26.5% vs. 0/42, 0.0%, P < 0.001). Smoking showed a significant association with HNSCC, oropharyngeal SCC, and laryngeal SCC. TP53 mutation was associated with HNSCC (P < 0.001). Older age, TP53 mutation, and HPV16 infection with oncogenic phenotypes were independently associated factors for HNSCC with odds ratios of 1.03 (1.02-1.05), 3.38 (1.71-6.66), and 9.19 (1.13-74.68), respectively. High-risk HPV infection of head and neck mucosa is not uncommon in the Hong Kong population. This study found that 26-30% of oropharyngeal carcinoma was associated with HPV infection, mostly HPV16, and that smoking which predisposes to TP53 mutations was another important risk factor.

Predictors for oral cancer in Brazil

“…However, Chor et al 17 did not establish the age variable as a risk factor for cancer in lip, oral cavity and oropharynx; this result differed from the study by Ribeiro et al…”

“…The oral cancers are generally grouped together in epidemiological studies because they share similar risk factors 11,[15][16][17][18][19] .…”

“…There was a predominance of squamous cell carcinoma in both the lip, oral cavity and oropharynx regions and in the other head and neck regions, which also occurred in other parts of the world 2,17,[20][21][22][23][24][25] .…”

“…The male gender is more commonly associated with cancers of the head and neck, especially those that involve the lip, oral cavity and oropharynx 11,17 . Radoï et al 23 identified an association between the consumption of alcohol and tobacco and the occurrence of oral cancer in men in France.…”

“…The characteristics of this study did not allow us to examine the association of cases with human papilloma virus (HPV) infection, which has been associated with the development of squamous cell carcinoma of the head and neck 17,21,25 , especially in the oropharyngeal region 17 . However, the characteristics did permit the association of factors frequently reported to be risk factors in studies with different designs, such as alcoholism 17,22 and smoking 22 .…”