title: Human papillomavirus prevalence is high in oral samples of patients with tonsillar and base of tongue cancer.
abstract: METHODS
  Presence of HPV DNA was analyzed in mouthwash and tonsillar swab samples, if indicative of HPV-positive tonsillar or base of tongue cancer in 76 patients, with suspected head neck cancer, undergoing diagnostic endoscopy at Karolinska University Hospital. The diagnosis and tumor HPV status was later obtained from patients' records. As controls, 37 tumor-free dental visitors were included.
  
  
  RESULTS
  Of the 76 patients, 22/29 (76%) and 16/18 (89%) had an HPV-positive tonsillar and base of tongue cancer respectively, with 18/22 (82%) and 8/16 (50%) respectively having tumor concordant HPV-type positive oral samples. Two other HPV-positive oral samples in the base of tongue cancer group did not correlate to the tumor HPV status. Among the remaining patients, 19 with other head neck cancer and 10 with benign conditions, 4/29 (14%) had HPV-positive oral samples. Consequently, of the HPV-positive oral samples, dominated by HPV16 and high signals, 27/32 (84%) were derived from 26 patients with concordant HPV-type positive tonsillar or base of tongue cancer and one patient with an unknown primary head and neck cancer. The other five HPV-positive oral samples, with mainly low signals were derived from two patients with non-concordant HPV-type positive tumor biopsies, two patients with HPV-negative tumor biopsies and a patient with a benign condition. Of the dental patients, 3/37 (8%) had HPV-positive tonsillar swabs with weak signals.
  
  
  CONCLUSIONS
  In patients with suspected head neck cancer, HPV-positive oral samples, especially HPV16 with high signals, could be indicative of HPV-positive tonsillar or base of tongue cancer.
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Nordfors
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Oto-Rhino-Laryngology, Head and Neck Surgery, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Sweden.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vlastos
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ahrlund-Richter
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tertipis
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Grün
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Audiology and Neurotology CLINTEC, Karolinska Institutet, Karolinska University Hospital, Sweden.
authors.forename: Mircea
authors.initials: M
authors.lastname: Romanitan
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linnea
authors.initials: L
authors.lastname: Haeggblom
authors.affiliation: Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Roosaar
authors.affiliation: Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Dahllöf
authors.affiliation: STI Unit, San Gallicano, Dermatological Institute, Rome, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Donà
authors.affiliation: Pathology Department, Regina Elena National Cancer Institute, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Benevolo
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Ramqvist
authors.affiliation: Department of Oto-Rhino-Laryngology, Head and Neck Surgery, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Munck-Wikland
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. Electronic address: Tina.Dalianis@ki.se.
authors.forename: Tina
authors.initials: T
authors.lastname: Dalianis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction; D014062:Tongue Neoplasms / Q000821:virology*; D014067:Tonsillar Neoplasms / Q000821:virology*
chemical_list: D004279:DNA, Viral
keywords: Human papillomavirus (HPV); Mouthwash samples, tonsillar swabs; Oral HPV infection; Oropharyngeal squamous cell carcinoma; Tonsillar cancer base of tongue cancer