title: p16 immunohistochemistry alone is a better prognosticator in tonsil cancer than human papillomavirus in situ hybridization with or without p16 immunohistochemistry.
abstract: CONCLUSIONS
  p16 immunohistochemistry (IHC) status correlated with less exposure to smoking and/or alcohol in Korean patients with locally advanced tonsillar squamous cell carcinoma (TSCC), and was an independent prognostic factor for survival.
  
  
  OBJECTIVE
  TSCC is more likely to be human papillomavirus (HPV)-positive than other head and neck squamous cell carcinoma (HNSCC) subtypes. The objective of this study was to ascertain the HPV status of TSCC in Korean patients and to determine its relationship with clinical parameters and prognosis.
  
  
  METHODS
  The locally advanced TSCCs of 79 patients who were treated between 2000 and 2008 were tested by p16 IHC and HPV in situ hybridization (ISH) with a tissue microarray.
  
  
  RESULTS
  Sixty-three patients (80%) were positive for p16 IHC, while 54 (68%) were positive by HPV ISH. p16 IHC status correlated significantly with lower exposure to smoking and alcohol (p < 0.05) but did not correlate with T and N stage classification, histological differentiation, age, or gender. The p16-positive group had a significantly higher 5-year overall survival rate in comparison with the p16-negative group (78% vs 63%, hazard ratio (HR) = 0.347, 95% CI = 0.14, 95% Cp = 0.025). p16 IHC was a favorable independent prognostic factor for overall survival, even after adjustment for age and T stage (HR = 0.283, 95% CI = 0.103, 95% p = 0.015).
authors.affiliation: Departments of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kwonoh
authors.initials: K
authors.lastname: Park
authors.forename: Kyung Ja
authors.initials: KJ
authors.lastname: Cho
authors.forename: Miji
authors.initials: M
authors.lastname: Lee
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.forename: Jiyoun
authors.initials: J
authors.lastname: Kim
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jonh-Lyel
authors.initials: JL
authors.lastname: Roh
authors.forename: Myung Woul
authors.initials: MW
authors.lastname: Han
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Si Yeol
authors.initials: SY
authors.lastname: Song
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Back
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D019941:Cyclin-Dependent Kinase Inhibitor p16; D005260:Female; D052162:Human papillomavirus 16; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate; D046888:Tissue Array Analysis; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins