Timo Carpén1, Anni Sjöblom2, Marie Lundberg1, Caj Haglund3, Antti Markkola4, Stina Syrjänen5, Jussi Tarkkanen2, Antti Mäkitie1,6, Jaana Hagström2, Petri Mattila1. 1. a Department of Otorhinolaryngology - Head and Neck Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 2. b Department of Pathology , Haartman Institute and HUSLAB, University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 3. c Department of Surgery , University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 4. d Department of Radiology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 5. e Department of Oral Pathology and Oral Radiology , University of Turku and Turku University Hospital , Turku , Finland. 6. f Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences , Intervention and Technology, Karolinska Institutet and Karolinska Hospital , Stockholm , Sweden.
Abstract
OBJECTIVES: Oropharyngeal squamous cell carcinoma (OPSCC) is divided in two different disease entities depending on HPV involvement. We investigated differences in presenting symptoms and clinical findings in patients with HPV-positive and -negative OPSCC tumors. METHODS: Altogether 118 consecutive patients diagnosed with primary OPSCC between 2012 and 2014 at the Helsinki University Hospital were included. HPV-status of the tumors was assessed by PCR detection of HPV DNA and immunostaining with p16-INK4a antibody. RESULTS: Fifty-one (47.7%) of the patients had HPV-positive and 56 (52.3%) HPV-negative tumors. Forty-nine (49/51, 96.1%) of the HPV+ tumors were also p16+ showing high concordance. The most common presenting symptom among HPV+/p16+ patients was a neck mass (53.1%), whereas any sort of pain in the head and neck area was more frequently related to the HPV-/p16- (60.0%) group. HPV+/p16+ tumors had a tendency to locate in the tonsillar complex and more likely had already spread into regional lymph nodes compared with HPV-/p16- tumors. Smoking and heavy alcohol consumption were significantly more common among HPV−/p16− patients but also rather common among HPV+/p16+ patients [corrected]. CONCLUSIONS: This analysis of symptoms and signs confirm that OPSCC can be dichotomized in two distinct disease entities as defined by HPV status.
OBJECTIVES: Oropharyngeal squamous cell carcinoma (OPSCC) is divided in two different disease entities depending on HPV involvement. We investigated differences in presenting symptoms and clinical findings in patients with HPV-positive and -negative OPSCC tumors. METHODS: Altogether 118 consecutive patients diagnosed with primary OPSCC between 2012 and 2014 at the Helsinki University Hospital were included. HPV-status of the tumors was assessed by PCR detection of HPV DNA and immunostaining with p16-INK4a antibody. RESULTS: Fifty-one (47.7%) of the patients had HPV-positive and 56 (52.3%) HPV-negative tumors. Forty-nine (49/51, 96.1%) of the HPV+ tumors were also p16+ showing high concordance. The most common presenting symptom among HPV+/p16+ patients was a neck mass (53.1%), whereas any sort of pain in the head and neck area was more frequently related to the HPV-/p16- (60.0%) group. HPV+/p16+ tumors had a tendency to locate in the tonsillar complex and more likely had already spread into regional lymph nodes compared with HPV-/p16- tumors. Smoking and heavy alcohol consumption were significantly more common among HPV−/p16− patients but also rather common among HPV+/p16+ patients [corrected]. CONCLUSIONS: This analysis of symptoms and signs confirm that OPSCC can be dichotomized in two distinct disease entities as defined by HPV status.
Entities:
Keywords:
Human papillomavirus; cancer; etiology; oropharynx; p16; symptom
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