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1.
J Med Primatol ; 53(3): e12717, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38853391

ABSTRACT

BACKGROUND: Oral cavity squamous cell carcinomas (OCSCCs) are relatively common in multiple non-human primate species but are poorly documented in Goeldi's monkeys. METHODS: Four Goeldi's monkeys with OCSCC, from three zoological collections, underwent necropsy with cytology, histopathology, immunohistochemistry, and pan-herpesvirus PCR analysis. RESULTS: All animals were euthanised and exhibited poor-to-emaciated body condition. Three OCSCCs arose from the maxillary oral mucosa and a single OCSCC was primarily mandibular, with bone invasion evident in three cases. Histologically, one OCSCC in situ was diagnosed, whilst the rest were typically invasive OCSCCs. Neoplastic cells were immunopositive for pancytokeratin and E-cadherin. All examined cases were negative for regional lymph node (RLN) and/or distant metastases, cyclooxygenase-2 (COX-2) immunoexpression, and panherpesvirus PCR expression. CONCLUSIONS: OCSCCs in Goeldi's monkeys may be deeply invasive, but not readily metastatic. No herpesvirus-association or COX-2 expression was evident; the latter suggesting that NSAIDs are unlikely to be a viable chemotherapeutic treatment.


Subject(s)
Animals, Zoo , Carcinoma, Squamous Cell , Monkey Diseases , Mouth Neoplasms , Animals , Carcinoma, Squamous Cell/veterinary , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/virology , Mouth Neoplasms/veterinary , Mouth Neoplasms/pathology , Mouth Neoplasms/etiology , Monkey Diseases/pathology , Monkey Diseases/virology , Male , Female
2.
Head Neck Pathol ; 18(1): 36, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38709462

ABSTRACT

BACKGROUND: To determine the prevalence of HR-HPV in a series of lip SCC from South African patients, using currently accepted HPV-testing methodologies and to define the clinical and histomorphologic features of HPV-associated lip SCC. METHODS: Fifty SCC of lip and 50 control cases were tested for HR-HPV using p16 and HR-HPV DNA PCR. p16-equivocal/positive and HPV DNA PCR-positive SCC were further evaluated for the expression of HPV-16 and HPV-18 mRNA transcripts using reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) to confirm transcriptionally active HPV. RESULTS: p16 was positive in 22% (n = 11) and equivocal in 4% (n = 2) of the SCC. One p16-positive case showed positivity for both HPV-16 DNA and HPV-16 E6/E7 mRNA transcripts (HPV prevalence rate of 2%). The HPV-positive case was non-keratinizing and occurred in an 80-year-old female. The two p16-equivocal cases were HR-HPV DNA positive and mRNA PCR negative. p16 was found to have a positive predictive value of 9%. CONCLUSION: Findings from our cohort of lip SCC suggest that HR-HPV may have an insignificant role in the pathogenesis of SCC at this site. Due to its low ppv, p16 is insufficient to establish HR-HPV infection in SCC of the lip. The combination of p16 and DNA PCR appears to correlate with the presence of transcriptionally active virus. HPV E6/E7 mRNA detection is the gold standard for identifying HR-HPV. mRNA testing is not widely available in sub-Saharan Africa due to technical and financial constraints; however, the test appears to be of great value in p16-equivocal lip SCC.


Subject(s)
Carcinoma, Squamous Cell , Lip Neoplasms , Papillomavirus Infections , Humans , Female , Papillomavirus Infections/complications , South Africa , Lip Neoplasms/virology , Lip Neoplasms/pathology , Aged , Middle Aged , Aged, 80 and over , Male , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/pathology , Adult , Cohort Studies , Squamous Cell Carcinoma of Head and Neck/virology , Squamous Cell Carcinoma of Head and Neck/pathology , Human papillomavirus 16/genetics
3.
PLoS One ; 19(5): e0300354, 2024.
Article in English | MEDLINE | ID: mdl-38691559

ABSTRACT

Oral cancer (OC) is the most common cancer in Pakistani males and the second most common in females. Major risk factors include peculiar chewing habits, human papillomavirus (HPV) infection and molecular pathways. However, less data is available for this avertible cancer regarding its association with high-risk HPV (HR-HPV) and chewing habits in this region. Therefore, this study was done to determine the prevalence of HR-HPV in oral squamous cell carcinoma (OSCC) and its correlation with p16 and chewing habits. Formalin-fixed paraffin-embedded (FFPE) biopsy specimens of 186 samples were tested for HR-HPV type 16/18 by PCR, followed by p16 immunostaining (IHC) in a subset of cases (n = 50). Appropriate statistical tests were applied to find the association between HR-HPV/p16 and peculiar chewing habits with significance criteria of p<0.05 with 95% CI. HR-HPV (type 16 &18) was present in seven out of 186 cases (3.8%). Of these seven cases, five were positive for HPV16, whereas two were positive for HPV16/18. The overall expression of p16 protein in 50 samples was 38% (n = 19), and among these 19-IHC positive samples, 26% were positive for HR-HPV DNA. No significant association was found between HR-HPV positivity and p16 and chewing habits (p>0.05). It was concluded that HR-HPV prevalence in OSCC was very low in our population, with no statistically significant correlation with p16 and chewing habits. These results suggest the role of HR-HPV as an independent risk factor in OSCC in the local setting.


Subject(s)
Carcinoma, Squamous Cell , Human papillomavirus 16 , Mouth Neoplasms , Papillomavirus Infections , Humans , Mouth Neoplasms/virology , Mouth Neoplasms/epidemiology , Male , Female , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/epidemiology , Middle Aged , Prevalence , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Adult , Human papillomavirus 16/genetics , Human papillomavirus 16/isolation & purification , Cyclin-Dependent Kinase Inhibitor p16/metabolism , Risk Factors , Aged , Human papillomavirus 18/isolation & purification , Human papillomavirus 18/genetics , Mastication , Pakistan/epidemiology , Human Papillomavirus Viruses
4.
PLoS One ; 19(5): e0300729, 2024.
Article in English | MEDLINE | ID: mdl-38691575

ABSTRACT

Penile squamous cell carcinoma (PSCC) occurs more frequently in some developing countries compared to developed countries. Infection with HIV and/or high-risk human papillomavirus (hrHPV) are risk factors for penile cancer development. The tumor microenvironment of PSCC may predict prognosis and may inform on the best targets for immunotherapy. We evaluated the immune microenvironment of penile tumors histologically, and determined whether and/or how HIV and/or hrHPV infections affect this tumor microenvironment. We conducted a prospective analytical cross-sectional study in which penile cancer tumors from 35 patients presenting at the University Teaching Hospital in Lusaka, Zambia were histologically staged and assessed for presence of tumor infiltrating immune cells and expression of immune checkpoints. Immunohistochemistry was used to evaluate immune checkpoints and infiltrating immune cells, while multiplex real-time polymerase chain reaction was used for hrHPV genotyping. The median age of all participants was 55 years. About 24% had advanced histological stage, 83% were HIV+, and 63% had hrHPV detected in their tumors using multiplex real-time polymerase chain reaction. PDL1 expression was significantly higher in HIV- participants than HIV+ participants (p = 0.02). Tumors with multiple hrHPV infections had a significantly higher number of cells expressing TIM3 than those with one hrHPV (p = 0.04). High grade tumors had a significantly higher infiltrate of FoxP3+ cells (p = 0.02), CD68+ cells (p = 0.01), CD163+ cells (p = 0.01), LAG3+ cells (p = 0.01), PD1+ cells (p = 0.01) and TIM3+ cells (p = 0.03) when compared with low grade tumours. There was significant moderate to strong positive correlation of cells expressing PD1 and LAG3 (⍴ = 0.69; p = 0.0001), PD1 and TIM3 (⍴ = 0.49; p = 0.017) and TIM3 and LAG3 PDL1 (⍴ = 0.61; p = 0.001). In conclusion, the tumor microenvironment of penile squamous cell carcinoma seems to be affected by both HIV and HPV infections. TIM3 appears to be a potential therapeutic target in PSCC patients with hrHPV infections.


Subject(s)
Carcinoma, Squamous Cell , HIV Infections , Papillomavirus Infections , Penile Neoplasms , Tumor Microenvironment , Humans , Male , Tumor Microenvironment/immunology , Penile Neoplasms/virology , Penile Neoplasms/pathology , Penile Neoplasms/immunology , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/pathology , Middle Aged , HIV Infections/immunology , HIV Infections/complications , HIV Infections/virology , HIV Infections/pathology , Papillomavirus Infections/immunology , Papillomavirus Infections/virology , Papillomavirus Infections/complications , Papillomavirus Infections/pathology , Cross-Sectional Studies , B7-H1 Antigen/metabolism , B7-H1 Antigen/genetics , Aged , Papillomaviridae , Adult , Prospective Studies , Lymphocytes, Tumor-Infiltrating/immunology , Human Papillomavirus Viruses
7.
Medicine (Baltimore) ; 103(21): e38202, 2024 May 24.
Article in English | MEDLINE | ID: mdl-38787972

ABSTRACT

The human papillomavirus (HPV) belongs to the Papillomaviridae family of viruses which includes small, double-stranded DNA viral agents. Approximately 90% of HPV infections occur asymptomatically and resolve spontaneously. However, infection with high-risk viral strains can lead to the development of preneoplastic lesions, with an increased propensity to become cancerous. The location of these malignancies includes the oral cavity, cervix, vagina, anus, and vulva, among others. The role of HPV in carcinogenesis has already been demonstrated for the aforementioned neoplasia. However, regarding skin malignancies, the mechanisms that pinpoint the role played by HPV in their initiation and progression still elude our sight. Until now, the only fully understood mechanism of viral cutaneous oncogenesis is that of human herpes virus 8 infection in Kaposi sarcoma. In the case of HPV infection, however, most data focus on the role that beta strains exhibit in the oncogenesis of cutaneous squamous cell carcinoma (cSCC), along with ultraviolet radiation (UVR) and other environmental or genetic factors. However, recent epidemiological investigations have highlighted that HPV could also trigger the onset of other non-melanocytic, for example, basal cell carcinoma (BCC), and/or melanocytic skin cancers, for example, melanoma. Herein, we provide an overview of the role played by HPV in benign and malignant skin lesions with a particular focus on the main epidemiological, pathophysiological, and molecular aspects delineating the involvement of HPV in skin cancers.


Subject(s)
Papillomaviridae , Papillomavirus Infections , Skin Neoplasms , Humans , Skin Neoplasms/virology , Papillomavirus Infections/complications , Papillomavirus Infections/virology , Papillomaviridae/pathogenicity , Papillomaviridae/genetics , Carcinoma, Squamous Cell/virology , Carcinoma, Basal Cell/virology , Melanoma/virology , Human Papillomavirus Viruses
8.
Hum Pathol ; 148: 81-86, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38782101

ABSTRACT

The staging for pT2/pT3 penile squamous cell carcinoma (pSCC) has undergone major changes. Some authors proposed criteria wherein the distinction between pT2/pT3 was made using the same histopathological variables that are currently utilized to differentiate pT1a/pT1b. In this single-institution, North American study, we focused on (HPV-negative) pT2/3 pSCCs (i.e., tumors invading corpus spongiosum/corpus cavernosum), and compared the prognostic ability of the following systems: (i) AJCC (8th edition) criteria; (ii) modified staging criteria proposed by Sali et al. (Am J Surg Pathol. 2020; 44:1112-7). In the proposed system, pT2 tumors were defined as those devoid of lymphovascular invasion (LVI) or perineural invasion (PNI), and were not poorly differentiated; whereas pT3 showed one or more of the following: LVI, PNI, and/or grade 3. 48 pT2/pT3 cases were included (AJCC, pT2: 27 and pT3: 21; Proposed, pT2: 22 and pT3: 26). The disease-free survival (DFS) and progression-free survival (PFS) did not differ between pT2 and pT3, following the current AJCC definitions (p = 0.19 and p = 0.10, respectively). When the pT2/3 stages were reconstructed using the modified criteria, however, a statistically significant difference was present in both DFS and PFS between pT2 and pT3 (p = 0.004 and p = 0.003, respectively). The proposed staging system has the potential to improve the prognostication of pT2/pT3 tumors in pSCC. Each of these histopathologic variables has been shown to have a significant association with outcomes in pSCC, which is an advantage. Further studies are needed to demonstrate the utility of this modified staging system in patient populations from other geographic regions.


Subject(s)
Carcinoma, Squamous Cell , Neoplasm Staging , Penile Neoplasms , Humans , Penile Neoplasms/pathology , Penile Neoplasms/virology , Male , Neoplasm Staging/methods , Neoplasm Staging/standards , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/virology , Middle Aged , Aged , Adult , Prognosis , North America , Aged, 80 and over
9.
Oral Oncol ; 154: 106855, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38788337

ABSTRACT

OBJECTIVES: Human papillomavirus (HPV) has emerged as a potential etiological factor in sinonasal squamous cell carcinoma (SNSCC), but a clear understanding of HPV prevalence and its temporal patterns in SNSCC remains elusive. This study aimed to investigate temporal trends in HPV testing and positivity rates, and explore demographic and geographic factors associated with these trends. METHODS: A retrospective cohort study included patients diagnosed with invasive SNSCC between 2011 and 2017 from the US National Cancer Database (NCDB). Prevalence ratios (PR) of HPV positivity and testing rates were estimated with the corresponding 95% confidence interval (95% CI). RESULTS: The overall HPV testing rate was 45.4 % (N = 1762/3880), and the prevalence of HPV testing significantly decreased during the study period (adjusted PR: 0.97, 95 % CI: 0.95 - 0.99, p < 0.001). Overall HPV positivity frequency was 37.3 % (N = 650/1741), and the overall prevalence of HPV positive tumors significantly increased during the study period (adjusted PR: 1.04, 95 % CI: 1.02 - 1.05, p < 0.001). The increase in HPV positivity rate was observed solely in the white population (unadjusted PR: 1.10, 95 % CI: 1.06 - 1.14; p < 0.001). A significant geographical variation was observed for both HPV testing (range: 28.6 % - 61.7 %) and positivity (range: 28.3 % - 44.7 %). CONCLUSIONS: This study provides novel insights into the temporal trends and demographic factors associated with HPV testing and positivity in SNSCC. Despite increasing HPV positivity rates, disparities in testing rates persist, highlighting the need for standardized testing protocols and targeted interventions.


Subject(s)
Papillomavirus Infections , Humans , Male , Female , United States/epidemiology , Middle Aged , Aged , Retrospective Studies , Papillomavirus Infections/epidemiology , Papillomavirus Infections/virology , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/virology , Prevalence , Paranasal Sinus Neoplasms/epidemiology , Paranasal Sinus Neoplasms/virology , Papillomaviridae , Adult , Aged, 80 and over
10.
J Robot Surg ; 18(1): 226, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38806847

ABSTRACT

We present a cohort review of TORS resection for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) and its associated oncological outcomes spanning a 10-year period. A retrospective case series review was performed of patients undergoing primary surgical treatment for HPV-associated OPSCC through the St. Vincent's Head and Neck Cancer service from 2011 to 2022. The primary outcomes were to investigate complete resection of the primary tumour, rates of recurrence, and survival analysis. Secondary outcomes included complications, rates of adjuvant therapy, sites of recurrence and rates of percutaneous endoscopic gastrostomy (PEG). 184 patients underwent TORS-based therapy with neck dissection, and guideline-directed adjuvant therapy for HPV-associated OPSCC. Our median follow-up was 46 months. The positive margin rate on final histopathology analysis was 10.9%. Adjuvant therapy was indicated in 85 patients (46%). The local recurrence rate was 10.9% with the majority (80%) of patients recurring in the first 3 years since treatment. The disease-specific survival at 3 years was 98.6% and at 5 years was 94.4%. The 3-year and 5-year OS for the cohort was 96.7% and 92.5%, respectively. The presence of extranodal extension and positive margins were associated with increased risk of recurrence, whereas adjuvant therapy was found to be a protective factor for both overall recurrence and survival. Major complications occurred in 12 patients (6.5%), resulting in one death. This study has demonstrated that primary surgical therapy for HPV-associated OPSCC is a safe and effective treatment modality with low local recurrence and complication rates, and overall survival benefits.


Subject(s)
Oropharyngeal Neoplasms , Robotic Surgical Procedures , Humans , Robotic Surgical Procedures/methods , Retrospective Studies , Oropharyngeal Neoplasms/surgery , Oropharyngeal Neoplasms/virology , Oropharyngeal Neoplasms/pathology , Male , Female , Middle Aged , Aged , Treatment Outcome , Neoplasm Recurrence, Local , Australia/epidemiology , Adult , Papillomavirus Infections/complications , Papillomavirus Infections/surgery , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/pathology , Margins of Excision , Squamous Cell Carcinoma of Head and Neck/surgery , Squamous Cell Carcinoma of Head and Neck/virology , Squamous Cell Carcinoma of Head and Neck/pathology , Neck Dissection/methods , Aged, 80 and over
12.
Clin Exp Pharmacol Physiol ; 51(6): e13864, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38679464

ABSTRACT

Human papillomavirus (HPV) infection has been reported to be associated with N6-methyladenosine (m6A) modification in cancers. However, the underlying mechanism by which m6A methylation participates in HPV-related cervical squamous cell carcinoma (CSCC) remains largely unclear. In this study, we observed that m6A regulators methyltransferase like protein (METTL14) and insulin like growth factor 2 mRNA binding protein 3 (IGF2BP3) were upregulated in HPV-positive CSCC tissues and cell lines, and their high expression predicted poor prognosis for HPV-infected CSCC patients. Cellular functional experiments verified that HPV16 oncogenes E6/E7 upregulated the expression of METTL14 and IGF2BP3 to promote cell proliferation and epithelial mesenchymal transition of CSCC cells. Next, we found that E6/E7 stabilized fascin actin-bundling protein 1 (FSCN1) mRNA and elevated FSCN1 expression in CSCC cells through upregulating METTL14/IGF2BP3-mediated m6A modification, and FSCN1 expression was also validated to be positively associated with worse outcomes of HPV-positive CSCC patients. Finally, HPV16-positive CSCC cell lines SiHa and CaSki were transfected with knockdown vector for E6/E7 or METTL14/IGF2BP3 and overexpressing vector for FSCN1, and functional verification experiments were performed through using MTT assay, flow cytometry, wound healing assay and tumour formation assay. Results indicated that knockdown of E6/E7 or METTL14/IGF2BP3 suppressed cell proliferation, migration and tumorigenesis, and accelerated cell apoptosis of HPV-positive CSCC cells. Their tumour-suppressive effects were abolished through overexpressing FSCN1. Overall, HPV E6/E7 advanced CSCC development through upregulating METTL14/IGF2BP3-mediated FSCN1 m6A modification.


Subject(s)
Carcinoma, Squamous Cell , Human papillomavirus 16 , Methyltransferases , Microfilament Proteins , Papillomavirus Infections , RNA-Binding Proteins , Uterine Cervical Neoplasms , Female , Humans , Adenosine/analogs & derivatives , Adenosine/metabolism , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/metabolism , Carrier Proteins/genetics , Carrier Proteins/metabolism , Cell Line, Tumor , Cell Proliferation , Epithelial-Mesenchymal Transition , Gene Expression Regulation, Neoplastic , Human papillomavirus 16/genetics , Human papillomavirus 16/metabolism , Methylation , Methyltransferases/metabolism , Methyltransferases/genetics , Microfilament Proteins/genetics , Microfilament Proteins/metabolism , Oncogene Proteins, Viral/genetics , Oncogene Proteins, Viral/metabolism , Papillomavirus E7 Proteins/genetics , Papillomavirus E7 Proteins/metabolism , Papillomavirus Infections/genetics , Papillomavirus Infections/virology , Papillomavirus Infections/metabolism , Papillomavirus Infections/pathology , Repressor Proteins , RNA-Binding Proteins/genetics , RNA-Binding Proteins/metabolism , Uterine Cervical Neoplasms/virology , Uterine Cervical Neoplasms/genetics , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/metabolism
13.
Viruses ; 16(4)2024 03 25.
Article in English | MEDLINE | ID: mdl-38675844

ABSTRACT

Chromosomal instability (CIN) and aneuploidy are hallmarks of cancer. CIN is defined as a continuous rate of chromosome missegregation events over the course of multiple cell divisions. CIN causes aneuploidy, a state of abnormal chromosome content differing from a multiple of the haploid. Human papillomavirus (HPV) is a well-known cause of squamous cancers of the oropharynx, cervix, and anus. The HPV E6 and E7 oncogenes have well-known roles in carcinogenesis, but additional genomic events, such as CIN and aneuploidy, are often required for tumor formation. HPV+ squamous cancers have an increased frequency of specific types of CIN, including polar chromosomes. CIN leads to chromosome gains and losses (aneuploidies) specific to HPV+ cancers, which are distinct from HPV- cancers. HPV-specific CIN and aneuploidy may have implications for prognosis and therapeutic response and may provide insight into novel therapeutic vulnerabilities. Here, we review HPV-specific types of CIN and patterns of aneuploidy in squamous cancers, as well as how this impacts patient prognosis and treatment.


Subject(s)
Aneuploidy , Chromosomal Instability , Papillomavirus Infections , Humans , Papillomavirus Infections/virology , Papillomavirus Infections/complications , Papillomavirus Infections/genetics , Papillomaviridae/genetics , Papillomaviridae/pathogenicity , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/genetics , Neoplasms, Squamous Cell/virology , Neoplasms, Squamous Cell/genetics , Neoplasms, Squamous Cell/pathology , Female , Alphapapillomavirus/genetics , Alphapapillomavirus/pathogenicity , Human Papillomavirus Viruses
14.
J Dent Hyg ; 98(2): 39-46, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38649286

ABSTRACT

Oral squamous cell carcinomas (OSCC) signs and symptoms may be first identified by dental hygienists during routine extra and intra-oral examinations. A comprehensive extra-oral and intra-oral examination during regular dental hygiene assessment is paramount to identifying oral potentially malignant disorders (OPMD) and cancerous lesions for timely referral and treatment. Integrating a systematic list of questions during the medical and dental assessment along with careful visual and tactile examinations is critical to identifying OPMDs and cancerous lesions. Understanding the relationship between oropharyngeal squamous cell carcinomas (OPSCC) and Human Papilloma Virus (HPV) and how vaccination can prevent HPV-related OPSCC is critical to providing evidence-based recommendations and care. The purpose of this report is to provide an update on current epidemiological trends of OSCC and OPSCC rates in the United States (US) and provide the latest evidence on what dental hygienists must know to improve health outcomes and mitigate the consequences of undiagnosed cancer. This report considers enduring challenges with the annual rise in OPSCC rates and the public health burden of HPV-related cancers in the US. Emphasis on regular, quality continuing education about OSCC and OPSCC is emphasized along with recommendations for evidence-based training.


Subject(s)
Carcinoma, Squamous Cell , Dental Hygienists , Mouth Neoplasms , Oropharyngeal Neoplasms , Papillomavirus Infections , Humans , Oropharyngeal Neoplasms/virology , Oropharyngeal Neoplasms/diagnosis , Oropharyngeal Neoplasms/prevention & control , Mouth Neoplasms/diagnosis , Mouth Neoplasms/prevention & control , Mouth Neoplasms/virology , Papillomavirus Infections/diagnosis , Papillomavirus Infections/prevention & control , United States/epidemiology , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/prevention & control , Carcinoma, Squamous Cell/epidemiology , Dental Hygienists/education
15.
JAMA Otolaryngol Head Neck Surg ; 150(5): 429-435, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38573597

ABSTRACT

Importance: Despite interest in therapy de-escalation for survivors of human papillomavirus-mediated oropharyngeal squamous cell carcinoma (HPV-positive OPSCC), the association of de-escalated therapy with patient-reported quality of life (QoL) outcomes and burden of depressive symptoms remains unclear. Objective: To identify associations between clinicopathologic and therapeutic variables with patient-reported QoL outcomes and depression symptom burden in patients with HPV-positive OPSCC, who were enrolled in a therapy de-escalation trial. Design, Setting, and Participants: In this nonrandomized controlled, open-label, curative-intent therapy de-escalation clinical trial in adults with stage I, II, and III HPV-positive OPSCC, patients were recruited from a high-volume head and neck oncology practice. Main Outcomes and Measures: The main outcomes of this study included quantitative, patient-reported QoL and depression symptoms per well-validated inventories. Patient-reported QoL was based on Functional Assessment of Cancer Therapy-Head & Neck (FACT-HN) scores (range, 0-148; lower score indicates inferior QoL). Patient-reported depression-related symptom burden was based on Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR) scores (range, 0-27; a higher score indicates a higher burden of depression symptoms). Baseline clinicopathologic and treatment variables were paired with FACT-HN and QIDS-SR scores at baseline, 3, 6, 12, 24, and 36 months. Linear mixed-effect models with a random intercept were used for each participant and fixed effects for other measures. Regression coefficients are reported with 95% CIs. Results: A total of 95 patients were followed up for a median (IQR) of 2.2 (1.6-3.2) years. Of these, 93 patients (98%) were male with a mean (SD) age of 60.5 (8.2) years. Overall, 54 participants (57%) had a history of current or former smoking, 47 (50%) underwent curative-intent surgery (with or without adjuvant therapy), and 48 (50%) underwent primary radiotherapy (with or without chemotherapy). The median (IQR) radiotherapy dose was 60 (60-70) Gy. Five deaths and 2 recurrence events were observed (mean [SD] recurrence interval, 1.4 [1.5] years). A higher radiotherapy dose was the only modifiable factor associated with inferior patient-reported QoL (lower FACT-HN) (coefficient, -0.66 [95% CI, -1.09 to -0.23]) and greater burden of depression-related symptoms (higher QIDS-SR) (coefficient, 0.11 [95% CI, 0.04-0.19]). With the 70-Gy dose as reference, improvements in FACT-HN and QIDS-SR scores were identified when patients received 51 to 60 Gy (coefficient, 12.75 [95% CI, 4.58-20.92] and -2.17 [-3.49 to -0.85], respectively) and 50 Gy or lower (coefficient, 15.03 [4.36-25.69] and -2.80 [-4.55 to -1.04]). Conclusions and Relevance: In this nonrandomized controlled, open-label, curative-intent therapy de-escalation trial, a higher radiotherapy dose was associated with inferior patient-reported QoL and a greater burden of depression-related symptoms. This suggests opportunities for improved QoL outcomes and reduced depression symptom burden with a reduction in radiotherapy dose. Trial Registration: ClinicalTrials.gov Identifier: NCT04638465.


Subject(s)
Depression , Oropharyngeal Neoplasms , Papillomavirus Infections , Quality of Life , Humans , Male , Oropharyngeal Neoplasms/therapy , Oropharyngeal Neoplasms/virology , Oropharyngeal Neoplasms/psychology , Oropharyngeal Neoplasms/pathology , Female , Middle Aged , Depression/etiology , Papillomavirus Infections/complications , Papillomavirus Infections/psychology , Aged , Carcinoma, Squamous Cell/therapy , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/psychology , Carcinoma, Squamous Cell/pathology , Patient Reported Outcome Measures , Neoplasm Staging
18.
Int J Cancer ; 155(1): 61-70, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38418719

ABSTRACT

High-risk human papillomavirus (hrHPV) is the cause of virtually all cervical cancers, most vaginal and anal cancers, and some vulvar cancer cases. With HPV testing becoming the primary screening method for cervical cancer, understanding the link between cervical hrHPV infection and the risk of other anogenital cancers is crucial. We assessed the risk of vulvar, vaginal and anal cancer and precancer (VIN2+, VaIN2+ and AIN2+) in a prospective cohort study including 455,349 women who underwent cervical hrHPV testing in Denmark from 2005 to 2020. We employed Cox proportional hazard models, adjusting for age, calendar year and HPV vaccination status, and estimated hazard ratios (HRs) and 95% confidence intervals (CI). We used the Aalen Johansen estimator to calculate the absolute risks of VIN2+, VaIN2+ and AIN2+. In total, 15% of the women were hrHPV positive at baseline. A positive cervical hrHPV test was associated with increased incidence of vulvar, vaginal and anal squamous cell carcinoma (SCC). Five-year risk estimates of VIN2+, VaIN2+ and AIN2+ among hrHPV-positive women (0.45%, 0.14% and 0.12%) were higher than among hrHPV-negative women (0.14%, 0.01% and 0.05%). Particularly high risk was observed among the hrHPV-positive women of the oldest age, with a history of anogenital precancer and those not HPV vaccinated. In conclusion, our study confirms the association between cervical hrHPV infection and non-cervical anogenital precancers and cancers. Currently, no established risk threshold or guidelines for follow-up. As HPV testing becomes the primary method for cervical cancer screening, future data will help define high-risk groups and acceptable risk thresholds.


Subject(s)
Anus Neoplasms , Papillomavirus Infections , Precancerous Conditions , Vaginal Neoplasms , Vulvar Neoplasms , Humans , Female , Papillomavirus Infections/virology , Papillomavirus Infections/epidemiology , Papillomavirus Infections/complications , Anus Neoplasms/virology , Anus Neoplasms/epidemiology , Vulvar Neoplasms/virology , Vulvar Neoplasms/epidemiology , Middle Aged , Prospective Studies , Adult , Precancerous Conditions/virology , Precancerous Conditions/epidemiology , Precancerous Conditions/pathology , Vaginal Neoplasms/virology , Vaginal Neoplasms/epidemiology , Vaginal Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Uterine Cervical Neoplasms/epidemiology , Uterine Cervical Neoplasms/pathology , Denmark/epidemiology , Aged , Incidence , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/epidemiology , Carcinoma, Squamous Cell/pathology , Papillomaviridae/isolation & purification , Early Detection of Cancer , Risk Factors , Cytology
19.
Am J Clin Pathol ; 161(6): 570-578, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38349613

ABSTRACT

OBJECTIVES: In this feasibility study, we explored the combined use of circulating tumor human papillomavirus (HPV) DNA (ctHPVDNA) and HPV serology as diagnostic tests for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). METHODS: Among patients with research-banked serum or plasma at diagnosis, IgG antibodies to oncoproteins from HPV types 16, 18, 31, 33, 35, 45, 52, and 58 were detected with multiplex serology. Positivity for HPV 16 was defined based on detection of combinations of anti-E6, E1, E2, and E7 and for other high-risk types on detection of anti-E6 and anti-E7. Circulating tumor HPV DNA was detected by custom digital droplet polymerase chain reaction (ddPCR) assays for HPV types 16, 18, 33, 35, and 45. p16 immunohistochemistry and high-risk HPV RNA in situ hybridization (ISH) using a cocktail of 18 high-risk HPV types were performed on tissue. RESULTS: Of 75 patients, 67 (89.3%) were HPV-associated (p16 and HPV RNA ISH positive) and 8 (10.7%) were HPV-independent. All 8 HPV-independent patients were seronegative and negative for ctHPVDNA (100% specificity). Serology was positive in 53 (79.1%) of 67 HPV-associated patients, while ddPCR was positive for ctHPVDNA in 59 (88.6%) of 67 HPV-associated patients. Requiring both tests to be positive resulted in a sensitivity of 50 (74.6%) of 67 while combining assays (either positive) improved sensitivity to 62 (92.6%) of 67. CONCLUSIONS: Compared to HPV RNA ISH, HPV serology and ctHPVDNA are sensitive and highly specific biomarkers for HPV-associated OPSCC at the time of presentation.


Subject(s)
DNA, Viral , Feasibility Studies , Oropharyngeal Neoplasms , Papillomavirus Infections , Humans , Female , Papillomavirus Infections/diagnosis , Papillomavirus Infections/virology , Male , Oropharyngeal Neoplasms/virology , Oropharyngeal Neoplasms/diagnosis , Middle Aged , Liquid Biopsy/methods , Aged , DNA, Viral/analysis , Squamous Cell Carcinoma of Head and Neck/virology , Squamous Cell Carcinoma of Head and Neck/diagnosis , Adult , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Carcinoma, Squamous Cell/virology , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/pathology , Aged, 80 and over , In Situ Hybridization/methods , Sensitivity and Specificity
20.
Monoclon Antib Immunodiagn Immunother ; 42(4): 125-131, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37624608

ABSTRACT

Cervical cancer is the fourth most commonly identified cancer and the third important reason for cancer-related death among women in less developed nations. Aside from the human papillomavirus (HPV), the host genetic factors, especially some polymorphisms in the interleukin 6 (IL-6) gene, might relate to the risk of cervical cancer. This study aims to investigate the molecular investigation of HPV infection and its association with the common polymorphism of IL-6 in cervical carcinoma in Iran. This case-control study collected 62 precancerous and cancerous lesions and 62 healthy samples from cancer-free women, subsequent negative colposcopy, and cervical cytology. The frequency of HPV genotypes and the genotyping of IL-6 rs1800795 and rs1800796 were done by different PCR techniques. Results were analyzed using the Epi Info version 7, 2012, with the χ2 test. Compared with cervical intraepithelial neoplasia grade 1 (CINI), the HPV positivity rate is saliently higher in CINII/III and squamous cell carcinoma (SCC) (56.25%, 66.66%, and 73.63%, respectively, p < 0.001). The HPV positivity rate is also higher in SCC in comparison with CINII/III (p < 0.01). Furthermore, the most detected HPV genotypes were HPV16 and 33 in CINI; HPV16, 31, and 35 in CINII/III; and HPV16 and 18 in SCC groups. HPV16 was the most commonly detected genotype in CINI, CINII/III, and SCC, accounting for 44.44%, 50%, and 71.42%, respectively. In addition, the frequency of GG, CG, and CC genotypes from rs1800795 polymorphism was 0.58, 0.32, and 0.10, respectively (p = 0.033), but in the control group, it was 0.70, 0.27, and 0.03, respectively. The findings suggest that HPV16 plays an important role in the emergence of cervical lesions in Iranian patients. As a result, rs1800795 CC genotype and HPV might increase cervical cancer risk in Iranian women.


Subject(s)
Carcinoma, Squamous Cell , Interleukin-6 , Papillomavirus Infections , Uterine Cervical Neoplasms , Female , Humans , Antibodies, Monoclonal , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/virology , Case-Control Studies , Genotype , Human Papillomavirus Viruses , Interleukin-6/genetics , Iran , Papillomaviridae/genetics , Papillomavirus Infections/genetics , Uterine Cervical Neoplasms/genetics , Uterine Cervical Neoplasms/virology
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