Biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral and oropharyngeal squamous cell carcinoma, with emphasis on smoking, protein p16INK4a expression, and HPV status
Abstract
The aim of the study is to evaluate biologic importance and prognostic significance of selected clinicopathological parameters in patients with oral (OSCC) and oropharyngeal (OPSCC) squamous cell carcinoma, with emphasis on smoking, protein p16 expression and HPV status. The study sample consisted of 48 patients with OSCC and 44 patients with OPSCC.
Half of the patients were nonsmokers. p16 expression was detected in 17/48 OSCCs and in 36/44 OPSCCs and HPV DNA was present in 7/48 OSCCs and in 35/44 OPSCCs. OPSCCs were more frequently basaloid (p < 0.001) while OSCCs were more frequently conventional (p < 0.000001).
OSCCs were more likely to recur locally and to be the cause of death (p = 0.009). HPV-positive tumors were more frequently localized in oropharynx, were basaloid SCCs and were p16- and HPV-positive (p < 0.000001).
HPV-negative tumors were more frequently localized in oral cavity (p < 0.000001), more frequently associated with locoregional recurrence (p = 0.030) and with tumor-related death (p = 0.003). The survival of patients with HPV-positive tumors was significantly longer (median 112 months) than that of patients with HPV-negative tumors (median 17 months) (p < 0.001).
HPV status of OSCC/OPSCC is an important biological and prognostic parameter and should be examined in all cases, using PCR or immunohistochemical detection of surrogate marker p16. Smoking itself does not seem to be an important prognostic factor.