Human papillomavirus (HPV) status of non-tobacco related squamous cell carcinomas of the lateral tongue.
OBJECTIVE
The human papillomavirus (HPV) is an important cause of some head and neck squamous cell carcinomas (HNSCCs), but its role in cancer of the lateral tongue is debatable. Suspicion of HPV causation is heightened when these lateral tongue carcinomas arise in patients that are young and/or have never smoked. The purpose of this study was to determine the incidence of transcriptionally active high risk HPV in these tumors, with a particular emphasis on non-smoking patients who are often presumed to have HPV-positive tumors.


METHODS
We evaluated 78 HNSCCs of the lateral tongue for the presence of HPV using p16 immunohistochemistry and an RNA in situ hybridization assay targeting HPV E6/E7 mRNA. The study population was enriched for patients without traditional risk factors such as smoking and drinking.


RESULTS
P16 overexpression was detected in 9 (11.5%) of 78 cases, but HPV E6/E7 mRNA transcripts were detected in only 1 (1.3%) case (positive predictive value of p16 staining for the presence of transcriptionally active HPV=0.12). HPV mRNA transcripts were not detected in any patient under 40 (n=11), or in patients who had never smoked (n=44), had quit smoking (n=15), and/or were only light consumers of alcohol (n=57).


CONCLUSIONS
HPV is not detected in the vast majority of lateral tongue carcinomas. In light of the observation that HPV plays little if any role in the development of these cancers, routine HPV testing is unwarranted , even for patients without traditional risk factors. P16 staining is not a reliable marker for the presence of transcriptionally active HPV at this particular anatomic site.
Departments of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
J S
JS
Poling
Advanced Cell Diagnostics, Hayward, CA, USA.
X-J
XJ
Ma
Advanced Cell Diagnostics, Hayward, CA, USA.
S
S
Bui
Advanced Cell Diagnostics, Hayward, CA, USA.
Y
Y
Luo
Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
R
R
Li
Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
W M
WM
Koch
Departments of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA. Electronic address: wwestra@jhmi.edu.
W H
WH
Westra
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D005260:Female; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D012333:RNA, Messenger / Q000235:genetics; D014062:Tongue Neoplasms / Q000821:virology*
D012333:RNA, Messenger
Head and neck cancer; Oral cancer; P16; RNA in situ hybridization; Smoking; Tobacco