HPV-related oropharyngeal carcinoma remains infrequent over 25 years in a Brazilian Oral Pathology Center: A cross-sectional study with literature review

• Published in: Medicina oral, patología oral y cirugía bucal Vol. 29; no. 4; pp. e498 - e508
• Main Authors: da Costa, A-A, Guieiro, R-S, Oliveira, I-G, Tavares, T-S, Meirelles, D-P, Silva, E-V, Silva, A-T, León, J-E, Aguiar, M-C, Caldeira, P-C
• Format: Journal Article
• Language: English
• Published: Spain Medicina Oral S.L 01-07-2024
• Subjects: Adult; Aged; Brazil - epidemiology; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Oropharyngeal Neoplasms - epidemiology; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - virology; Papillomavirus Infections - epidemiology; Squamous Cell Carcinoma of Head and Neck - epidemiology; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - virology; Time Factors; Brazil
• ISSN: 1698-6946; 1698-4447; 1698-6946
• DOI: 10.4317/medoral.26462

The aim was to evaluate the frequency, clinicopathological features, and HPV status of oropharyngeal squamous cell carcinoma (OP-SCC) and benign HPV-related epithelial lesions of the oropharynx over the last 25 years. Moreover, a literature review was performed to investigate HPV frequency in OP-SCC samples diagnosed in Brazilian Centers.
A cross-sectional study analyzed OP-SCC, squamous papilloma, verruca vulgaris, and condyloma accuminatum, diagnosed from 1997 to 2021. HPV status of OP-SCC was determined by immunohistochemistry and "in situ" hybridization. Bivariate statistics were performed (p≤0.05). For the literature review, MEDLINE/PubMed, Web of Science, EMBASE, and Scopus were searched. Two independent reviewers assessed the studies for eligibility.
Cross-sectional: 211 OP-SCC (63.0%) and 124 benign lesions (37.0%) were included. OP-SCC frequency increased gradually over time, whereas benign lesions had steady trends. OP-SCC affected more males (n= 171; 81.0%), though the relative frequency in females rose over time. Smoking (n= 127; 60.2%) was common in OP-SCC. Nineteen OP-SCC (13.0%) were positive for HPV. HPV-positive and HPV-negative tumors had similar clinicopathological features (p>0.05). Benign lesions predominated in middle-aged (n= 32; 26.7%) women (n= 71; 57.3%), in the soft palate (n=101; 81.5%).
32 studies were included, and in 60% of them, HPV frequency in OP-SCC was less than 25%.
OP-SCC prevalence has been increasing, and it was mostly associated with smoking and alcohol rather than with HPV infection in Brazil. Benign lesions had a stationary frequency over the evaluated period.