Understanding the Pattern of Oropharyngeal Cancers from North-East Romanian Patients

Abstract

Background: Human papilloma virus (HPV) is acknowledged as a risk factor for oropharyngeal squamous cellular cancers (OPSCC), of which the dominant types are tonsillar (TSCC) and base of tongue cancer (BOTSCC). Objective: To assess the role of HPV in selected OPSCC cases, from Romanian patients by sensitive and complementary molecular assays. Material and Methods: Fifty-four formalin fixed paraffin embedded (FFPE) OPSCC samples were analyzed for HPV DNA by a PCR-based bead-based multiplex-assay. Thirty-four samples were tested for HPV RNA and for overexpression of p16INK4a by immunohistochemistry. Twenty samples were evaluated by Competitive Allele-Specific Taqman PCR (CAST-PCR) for fibroblast growth factor receptor 3 protein (FGFR3) status. Results: A total of 33.3% (18/54) OPSCC samples were positive for HPV DNA. HPV16 was the most frequent type (30%, 16/54); followed by HPV18 (3.7%, 2/54); and 1 sample (1.8%) was positive for both HPV16 and 18. HPV18 E6*I was detected in a HPV18 DNA-positive oropharynx tumor. Four samples positive for HPV16 were also positive for p16INK4a. All the tested samples were negative for FGFR3. Conclusions: The increased HPV16 prevalence is in line with similar studies and is a new confirmation that HPV16 is the most prevalent type in our country; supporting the potential benefit of prophylactic vaccines. Overall, there is no concordance between DNA and any of the two other analytes that are considered being markers of HPV-driven cancers. There is a need to explore novel screening strategies that could be broadly used in the clinical routine to initiate preventive measures.

Immunotherapy with PD-1 Inhibitor Nivolumab in Recurrent/Metastatic Platinum Refractory Head and Neck Cancers—Early Experiences from Romania and Literature Review

“…Even so, it is worth mentioning the results published by Ursu et al, who evaluated the HPV status in HNC patients from NE Romania: only 2 HNSCC cases were found to be driven by HPV out of 189 samples. The authors concluded that a very small proportion of HNC can be attributed to the HPV virus, specifically the HPV 16 subtype, which seems to be the most prevalent in our country [ 69 , 70 ].…”

The Quantification of Salivary Flow and pH and Stomatognathic System Rehabilitation Interference in Patients with Oral Diseases, Post-Radiotherapy

“…In our area, NE part of Romania, the external beam radiation therapy (EBRT) with IMRT (intensity modulated radiotherapy) technique is commonly used. Doses are reported in 60 Gy/30 fractions/6 weeks, 70 Gy/35 fractions/7 weeks, or 66 Gy/33 fractions/6.5 weeks, 2 Gy/fraction [16,17].…”