Comparison of HPV prevalence in HNSCC patients with regard to regional and socioeconomic factors.
HPV infection is considered as an independent risk factor for head and neck squamous cell carcinomas (HNSCC). Due to highly variable prevalence results in numerous studies, it is, however, difficult to estimate the relevance of HPV infection as risk factor for a specific patient collective. This study aimed to elucidate the disparities of HPV prevalence by analyzing socioeconomically and regionally different patient collectives. Two age, gender, stage and tumor location matched cohorts of 18 private health insured (PHIP) and 16 statutory health insured patients (SIP) suffering from an oropharyngeal squamous cell carcinoma (OSCC) and treated at a university hospital were screened for p16 overexpression and HPV infection by immunohistochemistry and PCR. In addition 85 HNSCC patients of an otolaryngology private practice (PPP) in a rural area were screened for p16 overexpression and positive cases were tested for HPV infection. HPV prevalence was 72.2% in the PHIP collective in comparison to 25.0% (p = 0.015) in the SIP collective with a significantly improved 5-year overall survival (p = 0.003) of the PHIP collective. The total HPV prevalence of PPP group was 7.1% with the highest infection rate in tonsillar carcinomas (33.3%) and a larger percentage of female patients in the HPV positive group (p = 0.037). This study shows that variable HPV infection rates in HNSCC can be caused by the selection of particular patient collectives, which suggest taking socioeconomic and regional factors into account for a decision on HPV testing, if it is not performed on a routine basis.
Institute of Pathology, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany, rosemarie.krupar@ukr.de.
Rosemarie
R
Krupar
Michael
M
Hartl
Kornelia
K
Wirsching
Wolfgang
W
Dietmaier
Juergen
J
Strutz
Ferdinand
F
Hofstaedter
D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16; D005260:Female; D019942:Genes, p16; D005843:Geography; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D052162:Human papillomavirus 16 / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009363:Neoplasm Proteins / Q000378:metabolism; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000821:virology; D014067:Tonsillar Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000821:virology
C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins