title: Expression of human papillomavirus-related proteins and its clinical implication in tonsillar squamous cell carcinoma.
abstract: BACKGROUND
  Human papillomavirus (HPV) is known to cause of oropharyngeal squamous cell carcinoma (SqCC). HPV positive SqCCs overexpress p16 and are associated with better survival. Several markers of cell cycles and apoptosis have been reported as a prognostic value. We examined the prognostic value of HPV status, p16, cyclin D1, and Bcl-2 in patients with tonsillar SqCC.
  
  
  METHODS
  Tissue microarrays were constructed in 56 cases of tonsillar SqCC for which we performed an immunohistochemistry and an in situ hybridization (ISH) of the HPV.
  
  
  RESULTS
  Of the 56 cases, 31 (55.3%) were positive for p16 and 20 (35.7%) were positive for HPV ISH. The expressions of p16, cyclin D1, and Bcl-2 were not correlated with the clinicopathologic variables including smoking status, differentiation and pT- and pN-stages. The HPV ISH positive group showed a better overall survival than the HPV negative group (p=0.04), and the p16 positive group showed a better disease free survival (DFS) than the negative group (p=0.016). Cox regression analysis showed that only p16 positivity was an independent prognostic factor for DFS (p=0.03; hazard ratio, 10.1).
  
  
  CONCLUSIONS
  Our results indicate that both p16 expression and HPV status are useful indicators for risk stratification in patients with tonsillar SqCC.
authors.affiliation: Department of Hospital Pathology, The Catholic University of Korea School of Medicine, Seoul, Korea. ; Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Joon Seon
authors.initials: JS
authors.lastname: Song
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
authors.forename: Joon Wook
authors.initials: JW
authors.lastname: Park
authors.forename: Youn Soo
authors.initials: YS
authors.lastname: Lee
authors.forename: Chang Suk
authors.initials: CS
authors.lastname: Kang
keywords: Bcl-2; Carcinoma, squamous cell carcinoma; Cyclin D1; Human papillomavirus; Palatine tonsil; p16