Prevalence and Prognostic Significance of HPV in Laryngeal Squamous Cell Carcinoma in Egyptians

Introduction:

Human papillomavirus (HPV) is an etiological risk factor for a subset of head and neck squamous cell carcinomas. HPV has been proven to be a powerful prognostic biomarker for oropharyngeal cancer, but its role in the larynx has not been explored in depth. Here, we sought to evaluate the prevalence and genotype distribution of HPV in patients with laryngeal squamous cell carcinoma (LSCC) in Egyptian population

Patients and Methods:

In Mansoura University Hospitals; HPV DNA in specimens from 30 patients diagnosed with LSCC and 20 patients with benign non neoplastic laryngeal lesions were analyzed by the polymerase chain reaction (PCR) and in situ hybridization, and p16 overexpression was evaluated by immunohistochemistry. Due to variations in p16-INK4a immunostaining outcome, the German semi-quantitative scoring system was applied. The result was calculated by multiplying the scores of intensity by the scores of percentage areas of stained cell; with the minimum score is zero and the maximum is 12. The score of four or higher is considered positive.

Results:

Among LSCC patients, 13 (43.3%) were positive for HPV DNA (HPV+), while all of the benign laryngeal lesions were HPV- and the difference was statistically significant (p = 0.003). The HPV+ cases included 7 cases of genotype HPV16 and 6 cases of HPV18. p16 expression was observed in 8 of 13 (61.5%) cases previously determined to be HPV DNA positive (n = 3 for genotype 16; n = 5 for genotype 18). All benign laryngeal lesions were negative for p16 expression.

Conclusion:

Our findings support a possible role of HPV in laryngeal carcinogenesis. This study indicates that HPV DNA is a more reliable surrogate marker than p16 for the prediction of outcomes in patients with LSCC.

Publication History

Publication Date:
23 April 2019 (online)