title: E1 detection as prognosticator in human papillomavirus-positive head and neck cancers.
abstract: OBJECTIVE
  HPV-related locally advanced head and neck cancers (LA-HNCs) show a good prognosis. This study aimed to investigate the HPV prevalence in LA-HNCs and compare the prognostic value of E1, E6 and L1 genomic viral fragments and p16, individually and in combination, in order to find the best prognosticator in terms of overall survival (OS) and progression-free survival (PFS).
  
  
  METHODS
  HPV16 was searched in 255 LA-HNC formalin-fixed paraffin-embedded tumor tissues, 89 oropharyngeal cancers (OPCs), and 166 non-OPCs by DNA-PCR with 3 primer pairs. p16 was analyzed by immunohistochemistry in 235 patients.
  
  
  RESULTS
  The prevalence of positive samples decreased constantly from E6 to L1 and E1 in both OPCs and non-OPCs. Each LA-HNC patient highlighted variable positivity for each fragment. OPCs showed a higher prevalence of positive samples compared to non-OPCs.Positive coexistence of all the fragments was more common in OPCs (31.5%) than non-OPCs (4.2%), and E1 detection was always associated with E6 and L1. E1-positive OPCs showed improved OS (p = 0.012) and PFS (p = 0.036), while L1- or E6-positive ones did not. p16-positive patients were more prevalent in the OPC (29.8%) than the non-OPC group (7.3%) (p&lt;0.0001) and its prognostic value was not superior to that of E1. However, the multivariate Cox analysis which included E1, L1, E6 status and p16 expression did not show a significant p value.
  
  
  CONCLUSIONS
  Though HPV16 positivity measured by DNA-PCR was higher for L1 and E6, they performed weakly as prognosticators; E1 might become a strong prognostic marker for OS and PFS in OPCs.
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Vivenza
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Lo Nigro
authors.affiliation: Medical Oncology, Oncology Department, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Nerina
authors.initials: N
authors.lastname: Denaro
authors.affiliation: Anatomic Pathology Department, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Mirella
authors.initials: M
authors.lastname: Fortunato
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Monteverde
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Tonissi
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Lattanzio
authors.affiliation: Laboratory of Cancer Genetics and Translational Oncology, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Astesana
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Gloghini
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
authors.forename: Chiara C
authors.initials: CC
authors.lastname: Volpi
authors.affiliation: Radiotherapy Department, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Elvio
authors.initials: E
authors.lastname: Russi
authors.affiliation: Medical Oncology, Oncology Department, S. Croce & Carle Teaching Hospital, Cuneo - Italy.
authors.forename: Marco C
authors.initials: MC
authors.lastname: Merlano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000032:analysis*; D009959:Oropharyngeal Neoplasms / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C093478:E1 protein, Human papillomavirus 16; D009856:Oncogene Proteins, Viral