title: Human papillomavirus positivity predicts favourable outcome for squamous carcinoma of the tonsil.
abstract: Mutations in the p53 and retinoblastoma (pRb) pathways associated with the use of tobacco and alcohol are common in squamous cell carcinoma (SCC) of the head and neck. Cell cycle proteins are also affected by human papillomavirus (HPV), which may also have an aetiological role in cancers at particular sites, most notably the tonsil. Attempts to identify prognostic molecular markers in head and neck cancers have met with conflicting results, but few studies have been undertaken with tumours of known HPV status at a single anatomic site. In our study 86 tonsil cancers were analysed for HPV status by sequence analysis of polymerase chain reaction products and for the expression of cell cycle proteins (p53, p21(CIP1/WAF1), pRb, p16(INK4A), cyclin D1 and p27(KIP1)) by immunohistochemistry. The HPV status could be established in 67 of the tumours. Thirty-one (46%) of these were HPV-positive, predominantly (28/31) for HPV16. Findings were related to tumour recurrence and patient survival. None of the cell cycle proteins independently predicted recurrence or survival. Patients with HPV-positive tumours, however, were significantly less likely (p < 0.05) to have recurrence or to die of disease than those with HPV-negative tumours, after adjusting for the effects of the cell cycle proteins, clinical stage, pathological node status, tumour grade, age, gender and treatment. These findings support the concept that HPV-positive tonsil cancers may be a distinct biological group with less aggressive characteristics. Screening of tonsil cancers for HPV DNA may help optimise treatment and provide more accurate prognostic information.
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia.|Department of Infectious Diseases, University of Sydney, Sydney, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Infectious Diseases, University of Sydney, Sydney, Australia.
authors.forename: Carol H
authors.initials: CH
authors.lastname: Thompson
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Brien
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Edward B
authors.initials: EB
authors.lastname: McNeil
authors.affiliation: Department of Anatomical Pathology, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Scolyer
authors.affiliation: Department of Infectious Diseases, University of Sydney, Sydney, Australia.
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Cossart
authors.affiliation: Head and Neck Unit, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Veness
authors.affiliation: Department of Oral Pathology, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: D Murray
authors.initials: DM
authors.lastname: Walker
authors.affiliation: Head and Neck Unit, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Morgan
authors.affiliation: Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, Australia.|Department of Infectious Diseases, University of Sydney, Sydney, Australia.
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Rose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D018797:Cell Cycle Proteins / Q000378:metabolism; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000502:physiology*; D030361:Papillomavirus Infections / Q000378:metabolism / Q000821:virology*; D011379:Prognosis; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D014412:Tumor Virus Infections / Q000378:metabolism / Q000821:virology*
chemical_list: D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; D004279:DNA, Viral