Human papillomavirus and gene mutations in head and neck squamous carcinomas

• Published in: ANZ journal of surgery Vol. 82; no. 5; pp. 362 - 366
• Main Authors: Friedland, Peter, Thomas, Anitha, Naran, Anupam, Amanuel, Benhur, Grieu-Iacopetta, Fabienne, Carrello, Amerigo, Harnett, Gerald, Meyer, Christine, Phillips, Michael
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-05-2012; Blackwell Publishing Ltd
• Subjects: Age; alcohols; Alphapapillomavirus; Carcinoma; Carcinoma, Squamous Cell - genetics; Carcinoma, Squamous Cell - virology; Data processing; Demography; DNA, Viral; Epidermal growth factor receptors; ErbB Receptors - genetics; gene mutations; Genes; Genes, p16; Genes, p53; genomics; Head & neck cancer; Head and neck cancer; Head and Neck Neoplasms - genetics; Head and Neck Neoplasms - virology; histopathology; HPV 16; Human papillomavirus; Humans; Immunochemistry; Infection; K-Ras protein; Mutation; p16; p53 protein; Papillomavirus Infections - complications; Papillomavirus Infections - genetics; Papillomavirus Infections - virology; Point mutation; Polymerase chain reaction; Protein kinase; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins B-raf - genetics; Proto-Oncogene Proteins p21(ras); Proto-oncogenes; ras Proteins - genetics; Retrospective Studies; RNA; Sarcoma; Serine; Smoking; Squamous Cell Carcinoma of Head and Neck; Statistical analysis; Survival; Threonine; Tonsil; tonsillar carcinoma; tonsillar neoplasm; Western Australia; Western Australia
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/j.1445-2197.2011.05791.x

Background:  Human papillomavirus (HPV) infection is implicated as an aetiological factor in head and neck squamous carcinomas (HNSCC), especially in the tonsils of the oropharyngeal region. This study investigates the frequency of HPV infection, p16 and p53 tumour profile and mutations in epidermal growth factor receptor (EGFR), Kirsten RNA Associated Rat Sarcoma 2 Virus (KRAS) and B‐Raf proto‐oncogene serine/threonine protein kinase (BRAF) genes in tonsillar and non‐tonsillar HNSCCs and correlates with clinical outcome and histopathological parameters in previously unstudied cohort of patients.
Methods:  A retrospective clinical study was performed utilising the demographic data and pathological specimens from 60 out of 726 head and neck cancer patients. Smoking and alcohol history, tumour staging, treatment and outcomes were recorded. Histopathology and immunochemistry for p16 and p53 was performed and HPV DNA was detected with polymerase chain reaction. Genomic DNA from all cancers were analysed for somatic mutations of EGFR, BRAF and KRAS genes.
Results:  20 (33%) of 60 cases were tonsillar squamous carcinomas and 38 (66%) were non‐tonsillar. 19 (95%) of the 20 tonsillar cancers and three (8%) of 38 non‐tonsillar patients were patients who were HPV 16‐positive. Nine (47%) of the 19 HPV 16‐positive tonsillar cases were p16 positive. Gene mutations were rare. There was a statistically significant (P < 0.05) improved survival of patients with HPV positive tonsillar tumours, younger age and non‐smokers.
Conclusion:  Although limited in numbers, this study reinforces the role of HPV infection in HNSCC and its association with a more favourable clinical course in younger non‐smokers worldwide. Gene mutation frequencies were low in all cancers tested and routine testing not recommended.