engleski

Impact of Hhuman papillomavirus on clinicopathological characteristics of oropharyngeal carcinomas

Purpose/Objective(s): Recent data demonstrate important role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinomas (OPSCC). At least 90% HPV-positive OPSCC are associated with HPV type 16. The p16-positive OPSCC have better prognosis. Relation between p16 and epidermal growth factor receptor (EGFR) expression is ambiguous. Materials/Methods: In this retrospective study, it has been performed immunohistochemical analysis of p16 and EGFR expression on tumor tissues embedded on paraffin blocks. p16 immunohistochemistry was used as a surrogate for HPV status. It was analyzed histopathological samples of 108 patients with oropharyngeal carcinomas who were diagnosed and treated in the period from January 2002. to June 2007. All patients were treated with 2D external-beam radiation therapy exclusively, postoperatively or concurrent with chemotherapy, in dose of 60-70 Gy. Results: Overexpression of p16 was detected in 40 of 108 examined samples (37.0%). p16 overexpression statistically significantly correlates with higher levels of tumor grade (pZ0.0016), while subsite of primary tumor, T stage , N stage and clinical stage of disease were not in correlation with p16 overexpression. Overall 5 year survival (OS) of p16 positive patients with oropharyngeal carcinomas were 45% (median survival 3.18 years), and 34% in p16 negative (median survival 1, 29 years), respectively (pZ0.0652). In multivariate analysis, p16 overexpression (HR 0.329 ; pZ0.002), T stage (HR 2.374 ; pZ0.0002), and age of patients (HR 1.088 ; pZ0.0001), had statistically significant impact on overall survival of analyzed group of patients, while EGFR overexpression did not have significant impact on survival of observed patients. Conclusions: The p16 expression is a reliable surrogate marker of HPV status. The study showed that p16 positive patients have a better OS compared to p16 negative. Defining p16 expression is necessary as a routine procedure in all OPSCC due to better stratification of patients, making therapeutic algorithms and successful treatment of this heterogeneous group of tumors. Correlation between p16 and EGFR expression has to be investigated.

Oropharyngeal carcinoma; HPV

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