title: [Relationship between human papilloma virus infection and expression of p16 and EGFR in head and neck squamous cell carcinoma and their prognostic significance].
abstract: OBJECTIVE
  To detect the infection of human papillomavirus (HPV) 6/11, 16/18, 31/33 in patients with head and neck squamous cell carcinoma and explore the relationship between HPV infection and expression of p16 and EGFR in the tumor tissue and their clinical significance.
  
  
  METHODS
  The infection of HPV6/11, 16/18, 31/33 was detected by in situ hybridization (ISH), and expression of p16 and EGFR was assessed by immunohistochemistry in biopsy or surgical specimens of 43 cases of head and neck squamous cell carcinoma, and analyzed its impact on the prognosis. Spearman rank correlation method was used for analysis of the relationship. Overall survival rate of the patients was estimated by Kaplan-Meier analysis. Cox regression model was used for multivariate analysis.
  
  
  RESULTS
  HPV6/11, 16/18, 31/33 were detected in 25.6% (11/43) of this group of patients, among them, HPV16/18 accounted for 63.6%, HPV31/33 accounted for 27.3%, and HPV6/11 accounted for 0. EGFR was expressed in 69.8% and p16 was expressed in 53.5% of the patients. The difference was statistically significant between the HPV-positive and HPV-negative groups in ethnicity, smoking, alcohol consumption (P = 0.045, 0.040, 0.011, respectively). HPV infection was found to be positively correlated with p16 expression and inversely correlated with EGFR expression (P = 0.029, P = 0.009). The expression of p16 protein was negatively correlated with EGFR protein expression (r = -0.447, P = 0.003). The 3-year overall survival rate was 60.0% in the HPV-positive group and 59.7% in the negative group (P = 0.789); 72.2% in the p16-positive patients and 43.9% in the p16-negative patients (P = 0.012); 48.8% in the EGFR-positive patients and 81.8% in the EGFR-negative patients (P = 0.037).
  
  
  CONCLUSIONS
  The results of our study suggest that the HPV infection rate, HPV subtypes and clinicopathological features of HPV-positive SCCHN are in accordance with those reported in Western literatures. There may be differences between the HPV infections in Uygur and Han nationalities. HPV infection is positively correlated with p16 and negatively correlated with EGFR expressions. The prognosis of p16-positive patients is significantly better than that of negative cases, and p16 is an independent prognostic factor for head and neck squamous cell carcinoma.
authors.affiliation: Department of Radiation Oncology, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi 830011, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Ma
authors.forename: Duoming
authors.initials: D
authors.lastname: Wang
authors.forename: Aikemu
authors.initials: A
authors.lastname: Wufuer
authors.forename: Ran
authors.initials: R
authors.lastname: Wu
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Email: wrz8526@163.com.
authors.forename: Ruozheng
authors.initials: R
authors.lastname: Wang
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000821:virology*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D066246:ErbB Receptors / Q000378:metabolism; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000821:virology*; D052162:Human papillomavirus 16; D006801:Humans; D030361:Papillomavirus Infections / Q000378:metabolism*; D011379:Prognosis; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16; C512478:EGFR protein, human; D066246:ErbB Receptors