Previous retrospective studies have elucidated a correlation between secretory leucocyte
protease inhibitor (SLPI) and Annexin A2 (AnxA2), patient smoking status andtonsillar
human papilloma virus (HPV) status. The current study assessed these parameters prospectively
and to the best of our knowledge, analyzed SLPI-/AnxA2-expression for the first time
in tonsillar swabs and sputum. Samples were obtained from 52 patients with tonsillar
squamous cell carcinoma and 163 patients with tonsillar hyperplasia (H; n=56) and
chronic or recurrent tonsillitis (CRT; n=107). HPV-DNA, SLPI and AnxA2 gene expression
was analysed in sputum, tonsillar swabs and tissue by performing reverse transcription-quantitative
PCR. Results were compared with smoking status, revealing that smoking resulted in
significantly increased SLPI gene expression in all biomaterials of all cases. SLPI-gene
expression was significantly decreased in all HPV-DNA-positive samples (tissue/swab/sputum),
while AnxA2 was significantly increased in all HPV-DNA-positive samples. Results from
swabs and sputum were able to predict SLPI- and AnxA2 gene expression of the corresponding
tonsil. The current prospective study confirmed previous retrospective results underlining
this hypothesis: Smoking enhances SLPI-expression, preventing HPV-binding to AnxA2.
HPV-binding to AnxA2 appears essential for successful cell-entry. SLPI/AnxA2-gene
expression in swabs and sputum reflect their expression in tonsillar tissue. Accordingly,
a positive AnxA2/SLPI-ratio in sputum/swabs could possibly be used to reduce HPV-associated
carcinogenesis, by performing tonsillectomy or HPV-vaccination in patients with positive
AnxA2/SLPI-ratios.
Deutsche Krebshilfe, Fördernummer 111777
