口咽鳞癌组织中HPV16感染和p16蛋白表达的临床意义

目的:检测口咽鳞癌中HPV16感染及p16表达率,并分析临床意义。方法:采用原位杂交法检测60例口咽鳞癌组织中HPV16的表达,免疫组化法检测95例口咽鳞癌组织p16的表达情况,分析HPV16与p16的相关性,总结上述两种蛋白在口咽癌中的临床意义。结果:口咽鳞癌组织中HPV16感染率为48.3%（29/60）,p16阳性表达率为52.6%（50/95）,60例标本中HPV16感染与p16表达显著相关（P<0.001）,用p16表达预测HPV16感染的正确率可达90%（54/60）,跟国内外报道一致。p16阳性组相比p16阴性组,吸烟、饮酒、非嚼槟榔、T3+T4、有淋巴结转移、III-IV临床分期和高分化者所占比例更低,但不具有统计学差异(P>0.05)。平均随访时间38个月,随访率65.3%（62/95）,62例口咽鳞癌病人中p16阳性组和p16阴性组的3年总体生存率和无瘤生存率分别为70.4%对比40.0%（P=0.008）和63.0%对比25.7%（P=0.004）。总体生存率多因素分析提示,p16阴性病人死亡风险是p16阳性病人的2.12倍(HR 0.471,95%CI 0.201-1.103,P=0.083),无瘤生存率多因素分析提示,p16阴性病人死亡风险是p16阳性病人的2.36倍(HR 0.432,95%CI 0.201-0.891,P=0.024),p16与口咽癌的预后密切相关。结论:p16表达和HPV16表达存在紧密相关性,p16可以替代HPV16来预测预后,p16蛋白阳性口咽癌患者具有非吸烟、非饮酒、嚼槟榔和肿瘤分化程度低的趋势,检测p16表达对口咽癌病人预后判断有重要的提示意义。     

口咽鳞癌组织中人乳头状瘤病毒DNA状态与p16蛋白表达的相互关系及临床意义

目的 探讨联合检测口咽鳞癌组织标本中人乳头状瘤病毒(HPV)的感染情况与p16蛋白表达的临床意义.方法 选择66例口咽鳞癌活检或手术标本,采用“三明治”技术对组织标本进行切片,以SPF10-DNA LiPA分型方法检测HPV-DNA状态,采用免疫组织化学法检测p16蛋白的表达情况,分析不同HPV-DNA和p16蛋白表达患者的预后.结果 66例口咽鳞癌患者中,HPV-DNA阳性11例,阳性率为16.7％ (11/66).11例HPV-DNA阳性患者中,p16蛋白阳性9例,阴性2例.55例HPV-DNA阴性患者中,p16蛋白阳性12例,阴性43例.在口咽鳞癌中,HPV-DNA的表达与p16蛋白的表达具有显著的相关性(P ＜0.001).HPV-DNA和p16蛋白均为阳性组(A组)9例,HPV-DNA阳性/p16蛋白阴性或HPV-DNA阴性/p16蛋白阳性组(B组)14例,HPV-DNA和p16蛋白均为阴性组(C组)43例.A组、B组和C组患者的3年总生存率分别为100％、77.8％和42.0％,差异有统计学意义(P=0.001);3年疾病特异性生存率分别为100％、77.8％和46.4％,差异有统计学意义(P =0.004).结论 在口咽鳞癌中,HPV-DNA的表达与p16蛋白的表达具有显著的相关性,p16蛋白是较为可靠的预测HPV状态的替代标志.联合检测HPV-DNA和p16蛋白的状态,有助于更加准确地对口咽鳞癌进行分层,并判断预后.     

口咽鳞癌中HPV感染与血管生成的关系

目的:研究口咽鳞癌(oropharyngeal squamous cell carcinomas,OSCC)中人乳头瘤病毒(human papillomavirus,HPV)感染与血管内皮生长因子(vascular endothelial growth factor,VEGF)、CD31标记的微血管密度(microvessel density,MVD)表达的关系,探讨它们在口咽鳞癌发生中的相互关系.方法:采用多重实时荧光定量聚合酶链反应(multiplex real-time polymerase chain reaction,MT-PCR)检测60例口咽鳞癌HPV DNA及型别,通过HPV DNA分析进行HPV感染状况的测定;同时采用半定量免疫组化检测HPV(+)组和HPV(-)组中VEGF、CD31(MVD标志)蛋白表达情况.结果:口咽鳞癌中HPV感染率36.7％(22/60),HPV-16型占所有感染者的比例86.4％ (19/22),明显高于其他型别;VEGF高度表达者出现MVD＞ 15个/高倍视野的几率较VEGF低度表达者高(P =0.001);MVD＞ 15个/高倍视野的肿瘤为低分化的可能性较高(P =0.004);VEGF和MVD表达与患者年龄、性别、TNM分期、HPV感染状况之间无相关性.结论:HPV感染与口咽鳞癌的发生存在相关性.口咽鳞癌中HPV感染状况和VEGF之间无相关性.     

口腔、口咽鳞状细胞癌中HPV感染与EGFR之间的相关性研究

目的：通过检测人乳头状病毒 (human papilloma virus, HPV)感染相关蛋白P16与表皮生长因子受体（epidermal growth factor receptor, EGFR）在口腔、口咽鳞癌中的表达，探索HPV感染与EGFR之间的关系，以及探讨P16、EGFR蛋白在口腔、口咽鳞癌中的表达差异及其临床病理意义。方法：收集53例口腔鳞癌和35例口咽鳞癌组织标本及其临床资料，采用免疫组化法检测P16、EGFR蛋白的表达情况，并结合临床资料分析临床意义。同时采用t检验、2检验和分类变量的关联性分析法分析数据。结果：本组88例患者中P16阳性率为40.9%，EGFR阳性率为69.3%，P16与EGFR在口腔、口咽鳞癌中具有相关性（P<0.05，2=14.77，r=0.379）。口腔鳞癌患者P16阳性率为22.6%(12/53)，口咽鳞癌患者阳性率为68.6%(24/35)，两者差异有统计学意义（P<0.000），口腔鳞癌患者EGFR阳性率为56.6 %(30/53)，口咽鳞癌患者阳性率为88.6%(31/35)，两者差异有统计学意义（P<0.001）。P16阳性组患者的吸烟情况、肿瘤分化程度、复发情况和患者性别与阴性组患者比较，差异均有统计学意义（均P<0.05）。EGFR阳性组和阴性组仅在患者性别情况比较上，有统计学差异（P<0.05）。结论：在口腔、口咽鳞癌中P16的表达与EGFR呈正相关，说明HPV感染状态可能影响EGFR的表达，P16、EGFR在口腔与口咽上的表达分布存在差异。P16表达与肿瘤复发、分化程度、患者性别及吸烟情况有关。     

不同方法检测口咽鳞癌中高危型HPV的感染情况分析

摘 要：［目的］分析不同方法检测口咽鳞癌中高危型HPV在河南地区人群中的感染情况。［方法］ 采用二代杂交捕获、p16免疫组化、bDNA三种方法对89例口咽鳞癌石蜡包埋标本进行检测,并分析其HPV阳性率与患者临床病理参数的相关性及其临床意义。［结果］ 二代杂交捕获、p16免疫组化、bDNA三种检测方法结果具有较好的一致性,HPV阳性率分别为27.0%,22.5%,16.9%。三种方法检出的HPV阳性结果与患者性别、年龄、原发灶部位、肿瘤分化程度、T分期等临床病理参数均无关（P＞0.05）。经p16免疫组化法检测的结果与患者淋巴结转移（P=0.049）、TNM分期（P=0.026）存在相关性,而二代杂交捕获、bDNA结果与患者淋巴结转移、TNM分期（P＞0.05）均无关。［结论］ 在充分考虑临床实用性及可靠性的前提下,p16蛋白免疫组化法是最简单实用的HPV感染检测方法。     

食管鳞癌中HPV-16/18感染与c-erbB-2、p53和Rb表达及其意义

目的 :探讨食管鳞癌组织中人乳头瘤病毒HPV 16 / 18感染与c erbB 2、p5 3和Rb表达及其意义。方法 :采用聚合酶链反应 (PCR)法检测 90例活检存档的食管鳞癌蜡块中HPV 16 / 18的感染情况 ,从中随机选择 2 0例 ,采用免疫组化法检测单独的HPV 16感染及c erbB 2、p5 3和Rb表达。结果 :PCR检测食管癌组织HPV 16 / 18的感染率为 31 1% (2 8/ 90 ) ;免疫组化法检测食管癌组织中单独的HPV 16的感染率为 5 5 % (11/ 2 0 )。食管癌组织表达c erbB 2、Rb和p5 3和Rb的阳性率分别为 75 % (15 / 2 0 )、6 5 % (13/ 2 0 )和 80 % (16 / 2 0 )。HPV 16感染与c erbB 2、Rb和p5 3表达之间未见相关性。HPV 16感染以及c erbB 2、p5 3和Rb表达与淋巴结转移之间差异无显著性 (P >0 0 5 )。p5 3表达与食管癌组织学分级之间差异有显著性 (P <0 0 5 ) ,而HPV 16感染以及Rb和c erbB 2表达与食管癌组织学分级之间差异无显著性 (P >0 0 5 )。结论 :食管癌组织中HPV 16 / 18感染与c erbB 2、p5 3和Rb表达之间的关系是复杂的 ,尚有待于进一步研究。     

HSP70、p53和c—myc在宫颈鳞癌中的表达及与HPV16／18感染的关系

目的探讨热休克蛋白70(heat shock protein 70,HSP70)、抑癌基因p53、原癌基因c-myc在宫颈鳞癌中的表达及其与人乳头瘤病毒(HPV)感染的关系。方法采用免疫组化技术检测45例宫颈鳞癌、12例宫颈原位癌和20例正常宫颈组织中HSP70、p53、c-myc蛋白的表达,同时采用聚合酶链反应(PCR)技术检测HPV16/18的感染情况。结果①宫颈原位癌和宫颈癌中HSP70、p53、c-myc蛋白表达均显著高于正常宫颈组织。②HPV16/18阳性组HSP70表达明显高于HPV16/18阴性组,HPV16/18阴性组p53表达明显高于HPV16/18阳性组,但c-myc表达差异无显著性。结论在HPV感染的应激状态下,HSP70在宫颈鳞癌中过表达,p53则表达降低,c-myc蛋白的表达与HPV感染无相关性。     

食管鳞癌中HPV—16／18感染与c—erbB—2、p53和Rb表达及其意义

目的：探讨食管鳞癌组织中人乳头瘤病毒HPV－16／18感染与c-erbB-2，p53和Rb表达及其意义。方法：采用聚合酶链反应（PCR）法检测90例活检存档的食管鳞癌蜡块中HPV－16／18的感染情况。从中随机选择20例，采用免疫组化法检测单独的HPV－16感染及c-erbB-2，p53和Rb表达。结果：PCR检测食管癌组织HPV－16／18的感染率为31．1％（28／90）；免疫组化法检测食管癌组织中单独的HPV－16的感染率为55％（11／20）。食管癌组织表达c-erbB-2，Rb和p53和Rb的阳性率分别为75％（15／20），65％（13／20）和80％（16／20）。HPV－16感染与c-erbB-2，Rb和p53表达之间未见相关性。HPV－16感染以及c-erbB-2，p53和Rb表达与淋巴结转移之间差异无显著性（P＞0．05）。p53表达与食管癌组织学分级之间差异有显著性（P＜0．05），而PV－16感染以及Rb和c-erbB-2表达与食管癌组织学分级之间差异无显著性（P＞0．05）。结论：食管癌组织中HPV－16／18感染与c-erbB-2，p53和Rb表达之间的关系是复杂的，尚有待于进一步研究。     

肺鳞癌中人乳头瘤病毒与p53和Rb积聚的关系

目的探讨肺鳞癌组织中人乳头瘤病毒(humanpapillomavirus,HPV)感染与p53蛋白和Rb蛋白表达的关系并分析作用机理。方法采用地高辛标记的HPV-DNA探针,用原位杂交法检测84例肺鳞癌49例支气管黏膜慢性炎标本,组织中的HPV-DNA存在情况,并用免疫组化SABC法检测肺鳞癌组织中p53及Rb蛋白。结果HPV原位杂交阳性信号位于细胞核内,肺鳞癌HPV检出率为48.81%(41/84)、对照组黏膜慢性炎HPV检出率为6.12%(3/49),两组比较差异有统计学意义(P=0)。84例肺鳞癌中31例检出Rb蛋白表达,其中18例HPV阳性,13例HPV阴性,HPV阳性组与阴性组差异无统计学意义(P=0.2588)。84例肺鳞癌中30例检出p53蛋白表达,其中17例HPV阳性,13例HPV阴性,HPV阳性组与阴性组差异无统计学意义(P=0.3634)。结论肺鳞癌与HPV感染关系密切,肺鳞癌组织中也存在p53蛋白积聚,p53蛋白积聚与HPV感染无明显相关性,Rb蛋白积聚与HPV感染无明显相关性。     

人乳头瘤状病毒感染与抑癌基因p16突变在食管鳞癌中的研究

目的本研究旨在应用聚合酶链反应技术(PCR)联合DNA探针技术对河北省中南部地区食管鳞癌患者人乳头瘤病毒(HPV)感染情况进行研究,以明确二者之间的关系;同时应用单链构象多态性(SSCP)技术对标本p16基因第二外显子突变进行初筛,以明确其在食管癌发病过程中的变化以及HPV感染与p16基因突变的关系。方法对47名河北省中南部地区食管鳞癌切除术患者的癌组织(实验组)以及37名相同地域健康志愿者食管黏膜组织(对照组)进行取材,提取DNA进行HPV分型检测,同时以HPV E6基因引物对标本DNA HPV感染情况进行复检;除试剂盒阳性、阴性对照外,同时采用HPV阳性宫颈癌组织做阳性对照,DEPC水做阴性对照。HPV感染检测完成之后,以p16基因第二外显子引物对组织DNA进行SSCP分析,判断HPV感染时是否伴有p16基因突变。统计学分析采用SPSS13.0软件完成,其中以病理分期为标记分组,采用K个独立样本的非参数检验方法检验不同病理分期的p16基因是否呈现差异;采用pearson相关分析检验p16基因第二外显子在食管鳞癌中与性别、年龄、吸烟史、饮酒史、家族史及淋巴结转移的关系。结果食管鳞癌患者中HPV感染率0%,正常对照组HPV感染率为0%,试剂盒阳性对照呈现阳性,宫颈癌标本HPV感染呈现阳性;复检食管癌患者中HPV E6基因为0%,正常对照组HPV E6基因为0%,宫颈癌标本HPV E6基因为阳性,此结果和试剂盒检测结果一致。食管鳞癌患者中p16第二外显子基因缺失率为0%,基因突变率为44.7%;正常对照组p16第二外显子基因缺失率为0%,基因突变率为0%。p16基因突变与不同病理分期的食管鳞癌的关系中,渐近显著性P值为0.035,卡方值为6.691,认为病理分期越晚,p16第二外显子基因突变率越高;Pearson相关分析中,p16基因第二外显子在食管鳞癌中与性别、年龄、吸烟史、饮酒史、家族史及淋巴结转移的渐进显著性P值分别为0.496、0.143、0.000、0.547、0.113、0.005;以HPV感染为标记分组,检验HPV感染与p16基因变异(Fisher确切概率法)P0.05,无统计学意义。结论 (1)河北省中南部地区HPV感染与食管鳞癌无关,HPV感染可能不是食管鳞癌的病因。(2)p16基因第二外显子基因变异与食管鳞癌有关。食管鳞癌病理分期越晚,p16基因第二外显子突变越明显。(3)p16基因第二外显子突变与患者吸烟史及淋巴结转移情况有关。(4)HPV感染可能并非食管鳞癌中p16基因第二外显子突变的原因。     

Human Papillomavirus 16 and 18 Infection in Oral Cancer in Thailand: A Multicenter Study

Objectives: To identify the prevalence of high-risk human papillomavirus (HPV) genotypes 16 and 18 among patients with oral squamous cell carcinoma (OSCC) in Thailand and investigate the associations of p16 expression and HPV16/18 with the demographic, clinicopathologic, and risk parameters. Materials and Methods: A total of 403 formalin-fixed paraffin-embedded OSCC specimens from four centers in four regions were obtained. p16 expression was evaluated by immunohistochemistry. The detection of HPV16/18 DNA was performed by polymerase chain reaction.  Results: Of all, 172 specimens (42.7%) were presented with amplifiable extracted DNA. Among these, 62.8% were positive for p16, 8.1% were positive for HPV16/18, and 5.8% were positive for both methods. Of all HPV-positive specimens, HPV18 was detected in 57.1%; HPV16 in 14.3%; and HPV16 and 18 (co-infection) in 28.6%. The prevalence of HPV16/18 varied between centers, with the highest rate in the northern center (20.0%). There was no significant correlation between p16 expression and HPV16/18. There were no significant associations of p16 expression and/or HPV16/18 with all variables. Conclusions: The prevalence of HPV16/18 infection in OSCC geographically varied in Thailand, with the highest rate in the northern region. Poor correlation between p16 and HPV16/18 suggests p16 not be used as a surrogate marker for HPV-positive OSCC.     

Nuclear survivin expression is associated with HPV-independent carcinogenesis and is an indicator of poor prognosis in oropharyngeal cancer

The relationship between expression of the inhibitor of apoptosis protein survivin and the presence of high-risk human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OSCC) remains unclear. This also accounts for its role as a predictor of survival. Therefore, we conducted a multicentre retrospective study on 106 consecutive oropharyngeal cancer patients. Human papillomavirus sequences were detected by nested PCR protocols. Survivin and p16 expression as a surrogate marker for HPV status were analysed by immunohistochemistry. Sequences of high-risk HPV were detected in 29% of cases. Prominent cytoplasmatic expression of survivin was found in 58% of cases and nuclear expression of survivin was found in 19% of the survivin-positive tumours. Nuclear expression of survivin was significantly correlated with HPV-negative tumours (P=0.023) and with a poor disease-free survival rate with an estimated 3-year disease-free survival probability of 35% for tumours with nuclear expression of survivin vs 78% for tumours with non-nuclear expression of survivin (hazard ratio=8.264; 95% confidence interval (95% CI)=2.510-27.210; P<0.001). In multivariate analysis, p16 expression status as well as nuclear expression of survivin were strong independent and opposing prognostic indicators of disease-free survival (hazard ratio=0.068; 95% CI=0.005-0.892; P=0.041 and hazard ratio=15.975; 95% CI=2.377-107.360; P=0.004, respectively). Our data show that nuclear accumulation of survivin correlates with HPV-independent carcinogenesis and is an independent predictor of poor survival in patients with OSCC.     

Lack of Association between High-risk Human Papillomaviruses and Oral Squamous Cell Carcinoma in Young Japanese Patients

Background: Human papillomaviruses (HPV) may play an important role as one of the possible etiologiesof oral squamous cell carcinoma (OSCC). The present study aimed to investigate the association between HPVand OSCC in young Japanese patients by examining the presence of HPV DNA and surrogate markers in OSCCtissues. Materials and Methods: Forty young patients with OSCC whose surgical specimens were available wereanalyzed and compared with 40 patients randomly recruited from a pool of patients aged >40 years. HPV DNAwas detected using the polymerase chain reaction-based AMPLICOR® HPV test, and surrogate markers ofHPV infection were analyzed using immunohistochemical techniques to detect p16INK4a and p53. Results: Onlytwo (5%) young patients and one (2.5%) older patient were positive for HPV DNA. p16INK4a overexpressionwas identified in six (15%) young patients. p53 staining levels were not high in tissues of most young patients(27 patients, 67.5%). HPV DNA status did not significantly correlate with p16INK4a expression levels. Profiles ofincreased levels of p16INK4a expression with diminished levels of p53 staining were not associated with the presenceof HPV DNA. The combined p53 with p16INK4a profiles were significantly correlated with alcohol consumptionin younger patients (p=0.006). Conclusions: Results of the present study indicate that HPV is less likely to causeOSCC in young Japanese patients, and the p16INK4a expression level is not an appropriate surrogate marker forHPV infection in OSCC.     

Combined analysis of HPV-DNA, p16 and EGFR expression to predict prognosis in oropharyngeal cancer

Molecular prognostic indicators for oropharyngeal squamous cell carcinoma (OSCC), including HPV-DNA detection, epidermal growth factor receptor (EGFR) and p16 expression, have been suggested in the literature, but none of these are currently used in clinical practice. To compare these predictors, 106 newly diagnosed OSCC for the presence of HPV-DNA and expression of p16 and EGFR were analyzed. The 5-year disease-free survival (DFS) and overall survival (OS) were calculated in relation to these markers and a multivariate Cox analysis was performed. Twenty-eight percent of the cases contained oncogenic HPV-DNA and 30% were positive for p16. The p16 expression was highly correlated with the presence of HPV-DNA (p < 0.001). Univariate analysis of the 5-year DFS revealed a significantly better outcome for patients with p16-positive tumors (84% vs. 49%, p = 0.009). EGFR-negative tumors showed a tendency toward a better prognosis in DFS (74% vs. 47%, p = 0.084) and OS (70% vs. 45%, p = 0.100). Remarkable and highly significant was the combination of p16 and EGFR expression status, leading to 5-year DFS of 93% for p16+/EGFR- tumors vs. 39% for p16-/EGFR+ tumors (p = 0.003) and to a 5-year OS of 79% vs. 38%, respectively (p = 0.010). In multivariate analysis p16 remained a highly significant prognostic marker for DFS (p = 0.030) showing a 7.5-fold increased risk for relapse in patients with p16-negative tumors. Our data indicate that p16 expression is the most reliable prognostic marker for OSCC and further might be a surrogate marker for HPV-positive OSCC. HPV+/p16+ tumors tended to have decreased EGFR expression, but using both immunohistological markers has significant prognostic implications.     

Human papillomavirus infection and prognostic predictors in patients with oropharyngeal squamous cell carcinoma

This study focused on infection rates and subtypes of human papillomavirus (HPV) in patients with oropharyngeal squamous cell carcinoma (OSCC), and the relationship between HPV status and prognosis of the disease. We evaluated sixty-six OSCC patients who met the enrollment criteria during the period from January 1999 to December 2009. The presence or absence of oncogenic HPV types in tumors was determined using the SPF10 LiPA25 assay. Overall survival (OS) and disease specific survival (DSS) for HPV positive and HPV negative patients were estimated using Kaplan-Meier analysis. The Cox regression model was applied for multivariate analysis. HPV-DNA was detected in 11(16.7%) of all specimens. Among them, 7 were type HPV-16, while other types were HPV-16/11, HPV-35, HPV-58/52, and HPV-33/52/54. Patients with HPV positive tumors were more likely to be female, non-smokers and non-drinkers (p=0.002, 0.001 and 0.001, respectively). After a median follow-up of 24.5 months, patients with HPV positive tumors had significantly better overall survival (HR=0.106[95%CI=0.014-0.787], p=0.016,) and disease specific survival (HR=0.121[95%CI=0.016-0.906], p=0.030). Patients with HPV positive OSCC have significantly better prognosis than patients with HPV negative tumors. HPV infection is an independent prognostic factor.     

Human papillomavirus (HPV) DNA in tonsillar cancer: clinical correlates, risk of relapse, and survival

Human papillomavirus (HPV) is more commonly found in tonsillar cancer than in other head and neck cancers. The importance of HPV status in tonsillar cancer for prognosis remains unclear. The aim of the present study was to investigate the frequency of HPV in tonsillar cancer and to correlate the presence of HPV with tumor stage, nodal status, grade of differentiation, risk of relapse, and survival. HPV DNA and HPV type were determined, using PCR, in pre-treatment biopsies from 60 cases of primary tonsillar cancer. All patients had undergone full-dose radiotherapy, 45% as the only treatment modality, and 55% in combination with surgery. HPV 16 was detected in 43% (26/60) of the cancers including 1 double infection of both HPV 16 and HPV 33. Patients with HPV(+) tonsillar cancer showed less risk of relapse within 3 years after diagnosis, with a better odds ratio of 4.18 as compared with HPV(-) patients (p = 0. 025). Furthermore, cause specific survival was significantly (p = 0. 047) better in patients with HPV(+) tonsillar carcinomas. At 3 years after diagnosis the survival rate was 65.3% in the HPV(+) group and 31.5% in the HPV(-) group, and at 5 years the survival rate was 53. 5% and 31.5%, respectively. The better outcome for patients with HPV(+) tonsillar cancer was independent of TNM stage, nodal status, gender and age. These results indicate that HPV status is a significantly favorable prognostic factor in tonsillar cancer and may be used as a marker in order to optimize the treatment of patients with this type of cancer.     

Do Human Papilloma Viruses Play Any Role in Oral Squamous Cell Carcinoma in North Indians?

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among males inIndia. While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence hassurprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but itsfrequency in OSCCS is still uncertain. We aim to explore the frequency of HPV and its major genotypes in NorthIndian patients and their association with clinicopathological and histopathological features and p16 expressionpattern. Materials and Methods: The study group comprised 250 histologically proven cases of OSCC. HPVwas detected by real time PCR in tumor biopsy specimens and confirmed by conventional PCR with PGMY09/PGMY11 primers. Genotyping for high-risk types 16/ 18 was conducted by type specific PCR. p16 expressionwas assessed by immunohistochemsitry. Results: HPV presence was confirmed in 23/250 (9.2%) OSCC cases, ofwhich 30.4% had HPV 16 infection, 17.4%were positive for HPV 18 and 26.1% had co-infections. HPV presencewas significantly associated with male gender (p=0.02) and habit of pan masala chewing (p=0.01). HPV positivecases also had a history of tobacco consumption in 91.3% cases. p16 over expression was observed in 39.1%of HPV positive cases but this was not significantly different from negative cases (p=0.54). Conclusions: Thefrequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit.It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliablemarker to assess the potential etiological role of HPV in OSCC in our population is not suggested.     

Prognostic Significance of Human Papilloma Virus and p16 Expression in Patients with Vulvar Squamous Cell Carcinoma who Received Radiotherapy

AimsHuman papilloma virus (HPV) has been identified as an aetiological agent in a subset of patients with vulvar squamous cell carcinoma (VSCC). The prognostic role of HPV status in VSCC patients treated with radiotherapy has not yet been determined. We investigated the associations between HPV, p16 and clinical outcome in these women.Materials and methodsPatients undergoing potentially curative radiation treatment for VSCC at a single institution from 2000 to 2009 were retrospectively identified. Those who received definitive or peri-operative radiotherapy as part of treatment, and who had available pathological specimens, were included for analysis. HPV infection was detected using Roche Linear array hybridisation and p16 by immunohistochemistry. The locoregional relapse (LRR) rate was estimated using a cumulative incidence function to account for competing risks. Disease-free survival (DFS) and overall survival were analysed using the Kaplan–Meier method. The median follow-up was 4.9 years.ResultsForty patients were suitable for analysis, with a median age of 69.5 years. HPV was detected in 14/40 (35%) patients, HPV16 being the most common serotype (79%). Patients with HPV-positive tumours had lower 5 year LRR compared with those with HPV-negative tumours (14.3% versus 79.3%, Gray test P = 0.003). Tumour p16 positivity was also associated with lower 5 year LRR (15.4% versus 81.2%, Gray test P = 0.002). Patients with p16-positive tumours had higher 5 year DFS compared with those with p16-negative tumours (62% versus 7%, Log-rank test P = 0.02).ConclusionsWe have identified a favourable prognostic group in VSCC, with p16-positive patients showing improved outcomes. p16 has the potential to be a predictive marker allowing the identification of women more likely to have a favourable response to radiotherapy.