title: Human papillomavirus type 16 oropharyngeal cancers in lymph nodes as a marker of metastases.
abstract: BACKGROUND
  Oropharyngeal squamous cell carcinomas (OSCCs) are associated with high-grade human papillomavirus (HPV) infection in 20% to 30% of cases. HPV-16 DNA has been detected in cervical lymph node metastases of HPV-16(+) OSCC. However, the meaning of HPV-16 DNA detection in lymph nodes remains controversial. Does the presence of HPV-16 DNA in lymph nodes correlate with their metastatic involvement, or is it just a consequence of the filter function of lymph nodes?
  
  
  METHODS
  Viral load quantification using reverse transcriptase-polymerase chain reaction was retrospectively performed in primary tumors and in cervical lymph nodes, originating from levels IIa, IIb, and III, in 11 patients with HPV-16(+) OSCC and in 3 control patients with HPV-16(-) OSCC.
  
  
  RESULTS
  A total of 45 lymph node levels were analyzed. HPV-16 DNA was not detected in HPV-16(-) OSCC lymph nodes. No statistically significant difference was found between primary tumors and metastatic lymph nodes viral load (P > .01). The viral load value was significantly higher in metastatic lymph nodes than in tumor-free lymph nodes (P < .01). Among 27 tumor-free lymph node levels, the viral load value was undetectable in 16, low or medium (<10(5) copies per million cells) in 8, and high (>10(5) copies per million cells) in 3.
  
  
  CONCLUSIONS
  HPV-16 DNA detection in lymph nodes of patients affected with HPV-16(+) oropharyngeal cancer is indicative of metastatic involvement. Tumor-free lymph nodes with a high viral load value would suggest the presence of occult lymph nodes metastasis and the opportunity to use HPV-16 DNA as a metastatic marker. Further investigations are needed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University Pierre et Marie Curie Paris VI, France. mirghani_fr@yahoo.fr
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Frederique
authors.initials: F
authors.lastname: Moreau
authors.forename: Marine
authors.initials: M
authors.lastname: Lefèvre
authors.forename: Chong
authors.initials: C
authors.lastname: Tam
authors.forename: Sophie
authors.initials: S
authors.lastname: Périé
authors.forename: Patrick
authors.initials: P
authors.lastname: Soussan
authors.forename: Jean Lacau
authors.initials: JL
authors.lastname: St Guily
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D030361:Papillomavirus Infections / Q000473:pathology* / Q000601:surgery / Q000821:virology*; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D047368:Tumor Burden; D019562:Viral Load
chemical_list: D004279:DNA, Viral