title: High level of Tregs is a positive prognostic marker in patients with HPV-positive oral and oropharyngeal squamous cell carcinomas.
abstract: BACKGROUND
  Human papillomaviruses (HPVs) have been proved as one of the etiological factors of oropharyngeal squamous cell carcinoma (OPSCC). Patients with tumors of viral etiology have a lower recurrence rate and better prognosis. OPSCC is linked to an alteration in the immune system. Only a limited number of studies have correlated both the immunological parameters and HPV status with patient prognosis. The aim of this study was to determine whether HPV infection and the immunological status influence patient prognosis individually or in concurrence.
  
  
  METHODS
  Sixty patients with oral and oropharyngeal carcinomas were enrolled. They were divided into HPV-positive and HPV-negative groups based on the expression of HPV 16 E6 mRNA. Basic lymphocyte subpopulations were determined in the peripheral blood by means of flow cytometry.
  
  
  RESULTS
  Significantly better disease-specific survival (DSS) was observed in patients with HPV-positive tumors. Nodal status, tumor grade, recurrence, and CD8+/Tregs ratio were identified as factors influencing DSS. A higher level of Tregs and a lower ratio of CD8/Tregs influenced overall survival (OS) independently of HPV status and age. Patients with HPV-positive tumors and high levels of Tregs survived significantly better than patients from the other groups.
  
  
  CONCLUSIONS
  Better survival is associated with HPV positivity and elevated Tregs levels. Our data suggest that HPV infection and Tregs do not influence patient prognosis in concurrence.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic ; Department of Experimental Virology, Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Lukesova
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic ; Institute of Microbiology Academy of Sciences of the Czech Republic, Public Research Institution, 142 20 Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Boucek
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Rotnaglova
authors.affiliation: Department of Experimental Virology, Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Salakova
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic ; Department of Experimental Virology, Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic.
authors.forename: E
authors.initials: E
authors.lastname: Koslabova
authors.affiliation: Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Grega
authors.affiliation: Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University in Prague, 150 06 Prague, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Eckschlager
authors.affiliation: Institute of Microbiology Academy of Sciences of the Czech Republic, Public Research Institution, 142 20 Prague, Czech Republic.
authors.forename: B
authors.initials: B
authors.lastname: Rihova
authors.affiliation: Department of Experimental Virology, Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic.
authors.forename: B
authors.initials: B
authors.lastname: Prochazka
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, 150 06 Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Klozar
authors.affiliation: Department of Experimental Virology, Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic.
authors.forename: R
authors.initials: R
authors.lastname: Tachezy
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D003710:Demography; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009959:Oropharyngeal Neoplasms / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D027383:Papillomaviridae / Q000502:physiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D016019:Survival Analysis; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*
chemical_list: D015415:Biomarkers; D019941:Cyclin-Dependent Kinase Inhibitor p16