Investigating the Prevalence of Human Papilloma Virus in Squamous Cell Carcinoma of the Larynx and Its Correlation with Disease Prognosis

Document Type: Original

Authors

Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Introduction:
The human papilloma virus (HPV) can play a role in the development of head and neck squamous cell carcinoma (SCC). Our aim was to assess the prevalence of HPV DNA in SCC of the larynx. The impact of HPV infection on patient survival was also evaluated.
 Materials and Methods:
This case-control study was performed in 44 patients with SCC of the larynx (case group), while the control group comprised samples obtained from cadavers with no previous history of malignancy. A preliminary pathologic evaluation was performed on all samples in the control group (36 samples) to ensure the absence of dysplasia or malignancy. Polymerase chain reaction (PCR) was used to detect HPV DNA. After completing the treatment protocol, patients were followed to assess the impact of HPV infection on overall survival (OS).
 Results:
PCR evaluation in the case group showed that HPV DNA was successfully isolated from 11 (25%) samples, while only two (5.6%) HPV DNA-positive were obtained from cadavers. According to these results, a significant difference was obtained in the prevalence of HPV DNA and laryngeal SCC between cases and controls (P=0.031). No statistically significant difference was observed in the OS of patients with or without HPV infection in the case group (P=0.235).
 Conclusion:
Based on these results, we suggest that the prevalence of HPV infection is higher in laryngeal SCC subjects compared with healthy individuals. Although a longer OS was seen in HPV-positive patients, survival analysis did not show a significant difference in the comparison of HPV-positive and negative findings in SCC patients.
 

Keywords

Main Subjects


1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA: a cancer journal for clinicians. 2007;57(1):43-66.

2. Vigneswaran N, Williams MD. Epidemiologic trends in head and neck cancer and aids in diagnosis. Oral and maxillofacial surgery clinics of North America. 2014;26(2):123-41.

3. Kreimer AR, Clifford GM, Boyle P, Franceschi S. Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiology Biomarkers & Prevention. 2005;14(2):467-75.

4. Gillison ML, Koch WM, Capone RB, Spafford M, Westra WH, Wu L, et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. Journal of the National Cancer Institute. 2000;92(9):709-20.

5. Syrjänen K, Syrjänen S, Lamberg M, Pyrhönen S, Nuutinen J. Morphological and immunohistochemical evidence suggesting human papillomavirus (HPV) involvement in oral squamous cell carcinogenesis. International journal of oral surgery. 1983;12(6):       418-24.

6. Mehanna H, Beech T, Nicholson T, El‐Hariry I, McConkey C, Paleri V, et al. Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer-systematic review and meta‐analysis of trends by time and region. Head & neck. 2013;35(5):747-55.

7. Hobbs C, Sterne J, Bailey M, Heyderman R, Birchall M, Thomas S. Human papillomavirus and head and neck cancer: a systematic review and meta‐analysis. Clinical Otolaryngology. 2006; 31(4): 259-66.

8. O’rorke M, Ellison M, Murray L, Moran M, James J, Anderson L. Human papillomavirus related head and neck cancer survival: a systematic review and meta-analysis. Oral oncology. 2012;48(12):1191-201.

9. Gillison M, Lowy D. A causal role for human papillomavirus in head and neck cancer. The Lancet. 2004;363(9420):1488-9.

10. .Klussmann JP, Weissenborn SJ, Wieland U, Dries V, Eckel HE, Pfister HJ, et al. Human papillomavirus-positive tonsillar carcinomas: a different tumor entity? Medical microbiology and immunology. 2003;192(3):129-32.

11. Gillison ML. Human papillomavirus-associated head and neck cancer is a distinct epidemiologic, clinical, and molecular entity. Seminars in oncology 2004;31(6):744-54.

12. Cattani P, Hohaus S, Bellacosa A, Genuardi M, Cavallo S, Rovella V, et al. Association between cyclin D1 (CCND1) gene amplification and human papillomavirus infection in human laryngeal squamous cell carcinoma. Clinical cancer research. 1998;4(11):2585-9.

13. Flaitz C, Hicks M. Molecular piracy: the viral link to carcinogenesis. Oral oncology. 1998;34(6):448-53.

14. Dahlstrand H, Näsman A, Romanitan M, Lindquist D, Ramqvist T, Dalianis T. Human papillomavirus accounts both for increased incidence and better prognosis in tonsillar cancer. Anticancer research. 2008;28(2B):1133-8.

15. Näsman A, Attner P, Hammarstedt L, Du J, Eriksson M, Giraud G, et al. Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: An epidemic of viral‐induced carcinoma? International Journal of Cancer. 2009; 125(2):362-6.

16. Ryerson AB, Peters ES, Coughlin SS, Chen VW, Gillison ML, Reichman ME, et al. Burden of potentially human papillomavirus‐associated cancers of the oropharynx and oral cavity in the US, 1998–2003. Cancer. 2008;113(S10):2901-9.

17. Klussmann JP, Weissenborn SJ, Wieland U, Dries V, Kolligs J, Jungehuelsing M, et al. Prevalence, distribution, and viral load of human papillomavirus 16 DNA in tonsillar carcinomas. Cancer. 2001; 92(11):2875-84.

18. Strome SE, Savva A, Brissett AE, Gostout BS, Lewis J, Clayton AC, et al. Squamous Cell Carcinoma of the Tonsils A Molecular Analysis of
HPV Associations. Clinical Cancer Research. 2002; 8(4):1093-100.

19. Herrero R, Castellsagué X, Pawlita M, Lissowska J, Kee F, Balaram P, et al. Human papillomavirus and oral cancer: the International Agency for Research on Cancer multicenter study. Journal of the National Cancer Institute. 2003;95(23):1772-83.

20. Zhang ZY, Sdek P, Cao J, Chen WT. Human papillomavirus type 16 and 18 DNA in oral squamous cell carcinoma and normal mucosa. International journal of oral and maxillofacial surgery. 2004; 33(1):71-4.

21. Rees L, Birchall M, Bailey M, Thomas S. A systematic review of case–control studies of human papillomavirus infection in laryngeal squamous cell carcinoma. Clinical Otolaryngology & Allied Sciences. 2004;29(4):301-6.

22. Laskaris S, Sengas I, Maragoudakis P, Tsimplaki E, Argyri E, Manolopoulos L, et al. Prevalence of Human Papillomavirus Infection in Greek Patients with Squamous Cell Carcinoma of the Larynx. Anticancer research. 2014;34(10):5749-53.

23. Roshan NM, Jafarian A, Ayatollahi H, Ghazvini K, Tabatabaee SA. Correlation of laryngeal squamous cell carcinoma and infections with either HHV-8 or HPV-16/18. Pathology Research and Practice. 2014;210(4):205-9.

24. Rodrigo JP, Hermsen MA, Fresno MF, Brakenhoff RH, García-Velasco F, Snijders PJ, et al. Prevalence of human papillomavirus in laryngeal and hypopharyngeal squamous cell carcinomas in northern Spain. Cancer epidemiology. 2015;39(1):        37-41.

25. Hoffmann M, Görögh T, Gottschlich S, Lohrey C, Rittgen W, Ambrosch P, et al. Human papillomaviruses in head and neck cancer: 8 year-survival-analysis of 73 patients. Cancer letters. 2005; 218(2):199-206.