Lars Sivars1, David Landin2, Nathalie Grün3, Andrea Vlastos3,2, Linda Marklund2, Sushma Nordemar2, Torbjörn Ramqvist2, Eva Munck-Wikland2, Anders Näsman3,4, Tina Dalianis5. 1. Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden Lars.Sivars@ki.se Tina.Dalianis@ki.se. 2. Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden. 3. Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden. 4. Department of Clinical Pathology, Karolinska University Hospital, Stockholm, Sweden. 5. Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden Lars.Sivars@ki.se Tina.Dalianis@ki.se.
Abstract
BACKGROUND: Human papillomavirus (HPV) is a favourable prognostic factor in oropharyngeal cancer. Moreover, we and others reported that HPV-positive cancer of unknown primary in the head and neck region (HNCUP) has better outcome than HPV-negative HNCUP. However, not all studies concord. Here, our previous finding was investigated in a new cohort and additional biomarkers were analyzed. MATERIALS AND METHODS: A total of 19 HNCUPs diagnosed 2008-2013 were analyzed for HPV DNA by polymerase chain reaction assay (PCR) and p16 by immunohistochemistry (IHC). Thereafter, 69 HNCUPs diagnosed between 2000-2013 were analyzed for HPV16 mRNA by PCR (if HPV16DNA-positive) and cluster of differentiation 8 positive (CD8+) tumour-infiltrating lymphocytes (TILs) and human leukocyte antigen (HLA) class I-expression using IHC. RESULTS: HPV DNA, alone and in combination with p16 overexpression, was validated as a favourable prognostic factor in HNCUP. HPV16 mRNA was present in most HPV16 DNA-positive cases, confirming HPV-driven carcinogenesis in HNCUP. High CD8+ TIL counts indicated favourable prognosis. CONCLUSION: HPV status is useful for the management of patients with HNCUP and the role of CD8+ TILs should be further explored. Copyright
BACKGROUND:Human papillomavirus (HPV) is a favourable prognostic factor in oropharyngeal cancer. Moreover, we and others reported that HPV-positive cancer of unknown primary in the head and neck region (HNCUP) has better outcome than HPV-negative HNCUP. However, not all studies concord. Here, our previous finding was investigated in a new cohort and additional biomarkers were analyzed. MATERIALS AND METHODS: A total of 19 HNCUPs diagnosed 2008-2013 were analyzed for HPV DNA by polymerase chain reaction assay (PCR) and p16 by immunohistochemistry (IHC). Thereafter, 69 HNCUPs diagnosed between 2000-2013 were analyzed for HPV16 mRNA by PCR (if HPV16DNA-positive) and cluster of differentiation 8 positive (CD8+) tumour-infiltrating lymphocytes (TILs) and human leukocyte antigen (HLA) class I-expression using IHC. RESULTS:HPV DNA, alone and in combination with p16 overexpression, was validated as a favourable prognostic factor in HNCUP. HPV16 mRNA was present in most HPV16 DNA-positive cases, confirming HPV-driven carcinogenesis in HNCUP. High CD8+ TIL counts indicated favourable prognosis. CONCLUSION:HPV status is useful for the management of patients with HNCUP and the role of CD8+ TILs should be further explored. Copyright
Authors: Mona Kamal; Abdallah S R Mohamed; Clifton David Fuller; Erich M Sturgis; Faye M Johnson; William H Morrison; G Brandon Gunn; Katherine A Hutcheson; Jack Phan; Stefania Volpe; Sweet Ping Ng; Jae Phan; Carlos Cardenas; Renata Ferrarotto; Steven J Frank; David I Rosenthal; Adam S Garden Journal: Adv Radiat Oncol Date: 2020-05-15