title: Human papillomavirus & WHO type I nasopharyngeal carcinoma.
abstract: OBJECTIVE
  Nasopharyngeal carcinoma (NPC) is a rare cancer in the U.S. that has a well-established association with Epstein-Barr virus(EBV) for WHO types II/III but less so for WHO type I. Given the rise in oropharyngeal tumors positive for high risk human papillomavirus (HPV) and the unique biology of WHO type INPC, we chose to examine the relationship between HPV and WHO type I NPC.
  
  
  METHODS
  Retrospective case comparison study.
  
  
  METHODS
  A search of a large multidisciplinary cancer center tumor registry identified 183 patients seen from January 1999 to December 2008 with incident NPC and no history of prior cancer. Available paraffin embedded tumor specimens (N=30) were analyzed for HPV status by in situ hybridization (ISH) and polymerase chain reaction (PCR) for HPV 16 and 18, EBV status by ISH, and p16 expression by immunohistochemistry. Demographic parameters, including race, smoking, and alcohol exposure were obtained from the medical records.
  
  
  RESULTS
  Patients with incident WHO-I NPC (N=18) tended to be smokers (66%) and only 17% were Asian, while for patients with incident WHO-II/III NPC (N=165), 44% were smokers and 24% were Asian. For WHO-I NPC patients with available paraffin blocks (N=8), 5 of 6 were HPV 16+ by PCR and 4 of 8 had HPV identified by ISH, while only 2 of 8 were EBV+. Of patients with WHO II/III NPC and available archival tissue (N=22), 60% were EBV+ and only one was HPV positive by ISH.
  
  
  CONCLUSIONS
  These results suggest that WHO type I NPC may be associated with oncogenic HPV, though larger studies are needed to verify these findings.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Lo
authors.forename: Diana
authors.initials: D
authors.lastname: Bell
authors.forename: Jason
authors.initials: J
authors.lastname: Woo
authors.forename: Guojun
authors.initials: G
authors.lastname: Li
authors.forename: Ehab Y
authors.initials: EY
authors.lastname: Hanna
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Erich M
authors.initials: EM
authors.lastname: Sturgis
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000145:classification / Q000453:epidemiology / Q000208:ethnology / Q000821:virology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000145:classification / Q000453:epidemiology / Q000208:ethnology / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D016133:Polymerase Chain Reaction; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D014944:World Health Organization