title: Human papillomavirus and Epstein-Barr virus in nasopharyngeal carcinoma in a low-incidence population.
abstract: BACKGROUND
  The significance of human papillomavirus (HPV) in nasopharyngeal carcinomas (NPCs) in a low-incidence population remains unknown.
  
  
  METHODS
  Samples from 90 patients with NPC (years, 1957-2012) were analyzed for Epstein-Barr virus (EBV). Clinical data, EBV, HPV, and p16 status were correlated with overall survival (OS; 63 cases; years, 1981-2012).
  
  
  RESULTS
  Of 9 HPV-positive cases, 3 extended from extra-nasopharyngeal sites. Nasopharyngeal origin was confirmed in 6 cases. HPV-positive NPC had OS similar to EBV-positive NPC (85 vs 141 months; p > .05). The OS of patients with EBV/HPV-negative NPC was worse (34 months; p = .004). Nonkeratinizing histology was associated with better outcome than keratinizing (115 vs 25 months; p = .001). Over the last several decades, the proportion of keratinizing NPC decreased from 34.5% to 14.3% (p = .026).
  
  
  CONCLUSIONS
  The etiologic role of HPV in NPC is confirmed. The favorable prognostic significance of HPV positivity is similar to that of EBV positivity.
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Dogan
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Hedberg
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.forename: Tanya J
authors.initials: TJ
authors.lastname: Rath
authors.forename: Adel M
authors.initials: AM
authors.lastname: Assaad
authors.forename: Simion I
authors.initials: SI
authors.lastname: Chiosea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000821:virology*; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D014861:Washington / Q000453:epidemiology; D055815:Young Adult
keywords: Epstein-Barr virus; human papillomavirus; nasopharyngeal carcinoma