Selvam Thavaraj1, Angela Stokes2, Kazuya Mazuno3, Rhonda Henley-Smith4, Yae-Eun Suh4, Vinidh Paleri5, Mahvash Tavassoli6, Edward Odell2, Max Robinson7. 1. Oral Pathology, King's College London Dental Institute, London, United Kingdom. Electronic address: selvam.thavaraj@kcl.ac.uk. 2. Oral Pathology, King's College London Dental Institute, London, United Kingdom. 3. Department of Oral Pathology, Osaka Dental University, Osaka, Japan. 4. Oral Pathology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom. 5. Otolaryngology-Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, United Kingdom. 6. Molecular Oncology, King's College London Dental Institute, London, United Kingdom. 7. Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Abstract
OBJECTIVES: Patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) have a reduced risk of developing second primary upper aerodigestive tract (UADT) tumours compared to patients with HPV-negative primary tumours at the same site. To determine whether this finding might be explained by a lack of viral-induced field cancerisation or multifocal infection, we investigated whether there was epithelial dysplasia and/or evidence of HPV infection at other pharyngeal mucosal sites in patients presenting with the disease. MATERIALS AND METHODS: Sixty-three patients with primary tonsil SCC and 108 pharyngeal endoscopic biopsies, representing at least one pharyngeal subsite from each patient, were included in this study. Tissue samples were tested using HPV PCR (GP5+/6+), p16 immunohistochemistry (IHC) and high risk HPV DNA in situ hybridisation (ISH). RESULTS: There were 46 patients with HPV-related SCC and 17 patients with HPV-negative disease. PCR detected HPV DNA in a fifth of pharyngeal endoscopic biopsies and was equally likely to be from a patient with HPV-related SCC as from a patient with HPV negative disease. All PCR positive cases were tested using p16 IHC and high risk HPV ISH and only three biopsies were positive. Significantly, these three biopsies all showed evidence of epithelial dysplasia and were from patients with an HPV positive index tumour. CONCLUSION: Our data suggest that virus-induced field cancerisation and/or multifocal oncogenic HPV infection of the pharynx is uncommon in OPSCC and supports the concept that these patients have a lower risk of developing second primary tumours of the UADT.
OBJECTIVES:Patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) have a reduced risk of developing second primary upper aerodigestive tract (UADT) tumours compared to patients with HPV-negative primary tumours at the same site. To determine whether this finding might be explained by a lack of viral-induced field cancerisation or multifocal infection, we investigated whether there was epithelial dysplasia and/or evidence of HPV infection at other pharyngeal mucosal sites in patients presenting with the disease. MATERIALS AND METHODS: Sixty-three patients with primary tonsil SCC and 108 pharyngeal endoscopic biopsies, representing at least one pharyngeal subsite from each patient, were included in this study. Tissue samples were tested using HPV PCR (GP5+/6+), p16 immunohistochemistry (IHC) and high risk HPV DNA in situ hybridisation (ISH). RESULTS: There were 46 patients with HPV-related SCC and 17 patients with HPV-negative disease. PCR detected HPV DNA in a fifth of pharyngeal endoscopic biopsies and was equally likely to be from a patient with HPV-related SCC as from a patient with HPV negative disease. All PCR positive cases were tested using p16 IHC and high risk HPV ISH and only three biopsies were positive. Significantly, these three biopsies all showed evidence of epithelial dysplasia and were from patients with an HPV positive index tumour. CONCLUSION: Our data suggest that virus-induced field cancerisation and/or multifocal oncogenic HPV infection of the pharynx is uncommon in OPSCC and supports the concept that these patients have a lower risk of developing second primary tumours of the UADT.
Authors: Vittoria Guarda; Lea Schroeder; Michael Pawlita; Kristian Ikenberg; Niels J Rupp; Wolfram Jochum; Sandro J Stoeckli; Dana Holzinger; Martina A Broglie Journal: Front Oncol Date: 2022-04-22 Impact factor: 5.738
Authors: Samir S Khariwala; Michael G Moore; Kelly M Malloy; Benoit Gosselin; Richard V Smith Journal: Otolaryngol Head Neck Surg Date: 2015-07-28 Impact factor: 3.497
Authors: Robbie Woods; Esther M O'Regan; Susan Kennedy; Cara Martin; John J O'Leary; Conrad Timon Journal: World J Clin Cases Date: 2014-06-16 Impact factor: 1.337
Authors: Brenen W Papenberg; Jessica L Allen; Steven M Markwell; Erik T Interval; Phillip A Montague; Christopher J Johnson; Scott A Weed Journal: Sci Rep Date: 2020-07-15 Impact factor: 4.379