Analysis of prevalence of human papillomavirus in laryngeal carcinomas. Study of 40 cases using polymerase chain reaction and consensus primers.

In this study we determined the frequency of association of human papillomavirus (HPV) and laryngeal carcinomas and investigated the possibility that HPV may be associated with larger or more aggressive tumors. Laryngeal squamous cell carcinomas from 40 patients who did not have preexisting papillomas by clinical history were retrieved from formalin-fixed, paraffin-embedded blocks and analyzed for HPV. Twenty-two cases were tumors of the true vocal folds, and 18 were supraglottic. Clinical follow-up was available for 25 patients. We used the polymerase chain reaction (PCR) with the "hot start" modification and consensus primers that can detect over 30 distinct HPV types. Three of the 40 patients (8%) had detectable HPV DNA. These 3 patients did not have unusual age demographics and were smokers. All but 1 of the 22 HPV-negative patients who were questioned were also smokers. We compared the outcomes for large (4 cm or greater) HPV-positive and -negative tumors. Six of the 40 tumors were 4 cm or greater and involved contiguous structures. Two of these 6 were HPV-positive, and these patients died of disease after 3 and 16 months, respectively. Of the 4 HPV-negative patients with tumors greater than 4 cm, 3 are disease-free at 41, 42, and 3 months, respectively, and 1 was lost to follow-up. The third HPV-positive patient had a tumor less than 1 cm, and is disease-free after 38 months. While the number of HPV-positive cases is too small for definitive conclusions, it is possible that for large tumors the presence of HPV DNA may portend a worse prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)