title: Human papillomavirus and oropharyngeal squamous cell carcinoma: a New Zealand cohort study.
abstract: BACKGROUND
  Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) are clinically, epidemiologically and prognostically distinct from other OPSCCs. The incidence of HPV-related OPSCCs has increased significantly worldwide over the past few decades. However, no studies of OPSCC with direct molecular HPV testing has been conducted in New Zealand.
  
  
  OBJECTIVE
  To estimate the proportion of OPSCCs attributable to HPV infections in a New Zealand population with a validated HPV testing algorithm.
  
  
  METHODS
  HPV-status was determined by p16 immunohistochemistry and polymerase chain reaction (PCR) of both L1 and E6/7 genes on 55 OPSCCs diagnosed in 2010 and 2011 in Central and South Auckland. Baseline and survival analyses were performed according to HPV status.
  
  
  RESULTS
  Forty-one (75%) of OPSCC tumours had HPV infections. There was 98% concordance between p16 immunohistochemistry and real-time E6/E7 PCR. After a median follow-up period of 2.6 years, patients with OPSCC of HPV aetiology had more favourable outcomes compared to patients with HPV-negative OPSCC (hazard ratio 0.14, P = 0.02) after adjustment for other variables.
  
  
  CONCLUSIONS
  This study highlights the significant role that HPV plays in the aetiology of OPSCC in New Zealand, and confirms the high rate of accuracy of p16 immunostaining.
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Ou
authors.affiliation: Department of Oto-rhinolaryngology, Head and Neck Surgery, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Kim
authors.initials: K
authors.lastname: Gear
authors.affiliation: Department of Virology and Anatomical Pathology, LabPLUS, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Fahimeh
authors.initials: F
authors.lastname: Rahnama
authors.affiliation: Department of Virology and Anatomical Pathology, LabPLUS, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Stephen
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Department of Virology and Anatomical Pathology, LabPLUS, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Radhika
authors.initials: R
authors.lastname: Nagappan
authors.affiliation: Department of Virology and Anatomical Pathology, LabPLUS, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Dennis
authors.initials: D
authors.lastname: Kee
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand.
authors.forename: Sharon
authors.initials: S
authors.lastname: Waldvogel-Thurlow
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand.
authors.forename: Ravi
authors.initials: R
authors.lastname: Jain
authors.affiliation: Department of Oto-rhinolaryngology, Head and Neck Surgery, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Nick
authors.initials: N
authors.lastname: McIvor
authors.affiliation: Department of Oto-rhinolaryngology, Head and Neck Surgery, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Mark
authors.initials: M
authors.lastname: Izzard
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Douglas
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000175:diagnosis; D015996:Survival Rate
chemical_list: D015415:Biomarkers; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: 
  HPV
  ; 
  PCR
  ; New Zealand; oropharyngeal squamous cell carcinoma; p16