title: HPV-positive/p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans.
abstract: BACKGROUND
  Human papillomavirus (HPV) has been detected in keratinizing nasopharyngeal carcinomas (NPCs); however, the relationship between HPV and Epstein-Barr virus (EBV) among whites with nonkeratinizing NPCs remains unclear. The HPV, p16, and EBV status was examined in current University of Michigan patients with NPC.
  
  
  METHODS
  From 2003 to 2007, 89 patients, 84 with oropharyngeal cancer (OPC) and 5 with NPC, were enrolled in an organ-sparing trial. Biopsy tissues from all 89 patients were evaluated for HPV and p16 expression. A separate HPV analysis of the 84 OPC patients is in progress. Among the patients with NPC, tumor tissue was also analyzed for EBV-encoded RNA (EBER).
  
  
  RESULTS
  Five of 89 patients (5.6%) had NPC, all with nonkeratinizing histology. The 4 white patients with NPC were HPV(+) (subtype-16, subtype-18 [2 patients], and subtype-59)/p16(+)/EBER(-). One Asian patient with NPC had an HPV(-)/p16(-)/EBER(+) NPC tumor that developed distant metastases.
  
  
  CONCLUSIONS
  We postulate that HPV may be the etiologic factor in some EBV-negative, nonkeratinizing NPCs among whites.
authors.affiliation: University of Michigan Medical School, The University of Michigan Health System and Comprehensive Cancer Center, Ann Arbor, MI, USA.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Maxwell
authors.forename: Bhavna
authors.initials: B
authors.lastname: Kumar
authors.forename: Felix Y
authors.initials: FY
authors.lastname: Feng
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.forename: Kitrina G
authors.initials: KG
authors.lastname: Cordell
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
authors.forename: Francis P
authors.initials: FP
authors.lastname: Worden
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.forename: Mark E
authors.initials: ME
authors.lastname: Prince
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Moyer
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Teknos
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
authors.forename: Jay
authors.initials: J
authors.lastname: Stoerker
authors.forename: Heather
authors.initials: H
authors.lastname: Walline
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Carey
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
mesh_terms: D000368:Aged; D044466:Asian People; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000821:virology*; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D004854:Herpesvirus 4, Human; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D044465:White People