Human papillomavirus status and p16(INK4A) expression in patients with mucosal squamous cell carcinoma of the head and neck in Queensland, Australia

Annika Antonsson; Rachel E Neale; Samuel Boros; Guy Lampe; William B Coman; David I Pryor; Sandro V Porceddu; David C Whiteman

doi:10.1016/j.canep.2015.01.010

Human papillomavirus status and p16(INK4A) expression in patients with mucosal squamous cell carcinoma of the head and neck in Queensland, Australia

Cancer Epidemiol. 2015 Apr;39(2):174-81. doi: 10.1016/j.canep.2015.01.010. Epub 2015 Feb 9.

Authors

Annika Antonsson¹, Rachel E Neale², Samuel Boros³, Guy Lampe³, William B Coman³, David I Pryor³, Sandro V Porceddu³, David C Whiteman²

Affiliations

¹ Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia. Electronic address: Annika.Antonsson@qimrberghofer.edu.au.
² Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
³ Princess Alexandra Hospital, Brisbane, Australia.

PMID: 25677091
DOI: 10.1016/j.canep.2015.01.010

Abstract

Background: The last decade has seen changes in the epidemiology of mucosal squamous cell carcinomas of the head and neck (HNSCCs), with increasing numbers of cases attributable to human papillomavirus (HPV) infection. We sought to determine the prevalence of HPV and p16(INK4a) expression in Australian HNSCC patients and to identify predictors of HPV-positivity.

Methods: We recruited 248 HNSCC patients with histologically confirmed primary SCC of the oropharynx, oral cavity, hypopharynx or larynx diagnosed between 2004 and 2010. All patients completed a questionnaire. Clinical data were abstracted from medical records. HPV presence in paraffin-embedded tumours was determined by PCR, and expression of p16(INK4a), p21(WAF1), p53, pRB, cyclin D1, and Ki67 by immunohistochemistry.

Results: Fifty (20%) patients were HPV-positive, 63 (28%) overexpressed p16(INK4a), and 44 (19%) were positive for HPV and p16(INK4a) (high concordance between HPV-positivity and p16(INK4a) status, κ=0.72). HPV-16 was most common (84%), followed by HPV-18 (10%), HPV-33 (4%) and HPV-69 (2%). HPV and p16(INK4a) prevalence was highest for SCCs of the oropharynx, followed by hypopharynx, larynx and oral cavity (HPV and p16(INK4a)p<0.0001). HPV prevalence and p16(INK4a)-overexpression were significantly higher in younger than older patients (HPV p=0.001; p16 (INK4a)p=0.003). Heavy smokers had lower HPV prevalence than non- or moderate smokers (p=0.017). Gender and alcohol consumption were not associated with HPV or p16(INK4a) status. HPV-positive tumours had significantly lower cyclin D1 and higher p21(WAF1) expression than HPV-negative tumours.

Conclusion: HPV prevalence and p16(INK4a)-overexpression were highest in oropharyngeal tumours, younger patients, and non-smokers.

Keywords: Cyclin D1; Human papillomavirus DNA tests; Immunohistochemistry; Papillomavirus infections; Risk factors; Smoking; Squamous cell carcinoma of the head and neck; p16(INK4A).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia
Carcinoma, Squamous Cell / immunology*
Female
Head and Neck Neoplasms / immunology*
Human papillomavirus 16 / metabolism*
Humans
Male
Queensland
Risk Factors
Smoking
Squamous Cell Carcinoma of Head and Neck