Association of HIV Status With Outcomes of Anal Squamous Cell Carcinoma in the Era of Highly Active Antiretroviral Therapy

Human papillomavirus (HPV) can infect oral mucosa, causing asymptomatic infection or warty lesions. Several case-control studies have confirmed HPV as an independent risk factor for squamous cell carcinoma. HPV-related cancers seem to have better prognoses and different risk factors than do HPV-negative ones. HIV-infected patients are known to be at increased risk for persistent genital and anal high-risk HPV infections and intraepithelial neoplasm. Since the era of highly active antiretroviral therapy, the prevalence and persistence of warty lesions in oral mucosa have increased. Oral squamous cell carcinoma was recently added in the case definitions for common HIV-related oral mucosa lesions. The increased risk of HPV infection in HIV patients has been associated with impaired immune response to HPV, highly active antiretroviral therapy, aging of the HIV-infected patients, and direct interaction between the 2 viruses. HPV32 seems to be much more prevalent in asymptomatic HPV infections and warts among those infected with HIV than among those in the general population. Regarding HIV genes, there is evidence of an interaction between HPV and tat, rev, and vpr. HIV might play a role in HPV-associated pathogenesis by exhorting oncogenic stimuli via tat and rev or visa versa.

Download Full-text

Association of HIV Status With Local Immune Response to Anal Squamous Cell Carcinoma

JAMA Oncology ◽

10.1001/jamaoncol.2017.0115 ◽

2017 ◽

Vol 3 (7) ◽

pp. 974 ◽

Cited By ~ 36

Author(s):

Elizabeth L. Yanik ◽

Genevieve J. Kaunitz ◽

Tricia R. Cottrell ◽

Farah Succaria ◽

Tracee L. McMiller ◽

...

Keyword(s):

Immune Response ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Local Immune Response ◽

Hiv Status ◽

Anal Squamous Cell Carcinoma

Download Full-text

PD-L1 Expression is Associated with Poorer Survival in Anal Squamous Cell Carcinoma: Analysis from an Urban Public Hospital

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa161.145 ◽

2020 ◽

Vol 154 (Supplement_1) ◽

pp. S66-S67

Author(s):

A Monsrud ◽

V Avadhani ◽

M Mosunjac ◽

U Krishnamurti

Keyword(s):

Squamous Cell Carcinoma ◽

Viral Load ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cd4 Count ◽

Hiv Status ◽

Hiv Viral Load ◽

Cancer Specific Survival ◽

Anal Squamous Cell Carcinoma ◽

Cox Regression Analysis

Abstract Introduction/Objective Upregulation of programmed death-ligand 1 (PD-L1), an immunoregulatory protein is associated with adverse outcome in several malignancies. Very few studies have evaluated PD-L1 expression in anal squamous cell carcinoma. This study aims to correlate PD-L1 expression with clinicopathologic factors and clinical outcomes. Methods After IRB approval, formalin-fixed, paraffin embedded sections of 58 cases of anal invasive squamous cell carcinoma from 2010–2018 were immunostained for PD-L1 (Dako 22C3 monoclonal antibody). Of these, 51 cases could be evaluated for PD-L1 expression. Greater than 1% of tumor cells with partial or complete membrane staining was interpreted as PD-L1 positive (PD-L1 +). PD-L1 expression was correlated with age, sex, stage, HIV status, HIV viral load, CD4 count, disease progression, and cancer specific survival. Kaplan-Meier curves for overall survival (OS) were plotted and compared using the log rank test. Cox regression analysis was performed to identify significant prognostic factors (Two-tailed p< 0.05 was considered statistically significant). Results Of the 51 cases evaluated, PD-L1 was positive in 18/51 (35%) and negative in 33/51 (65%) cases. The median cancer specific survival (MCSS) was lower in PD-L1 positive cases (22 months) compared with PD-L1 negative cases (48 months), p=0.008. The number of cancer specific deaths was higher in the PD-L1 + group (50% vs. 30%), but not statistically significant (p= 0.23). Other factors that were not significantly different between the two groups were age, sex, stage, HIV status, HIV viral load, and number of patients with cancer progression. Patients with positive PD-L1 had worse OS (5yr OS: 41% for PD-L1 positive vs 64% for PD-L1 negative; p=0.02). On multivariate analysis, PD-L1 positive status remained statistically significant for worse OS, HR = 6.5 (95% CI 1.2–33.9), p=0.027. Conclusion The median cancer specific survival and 5-yr OS is significantly lower in the PD-L1 positive group. PD-L1 positive status is associated with a worse prognosis independent of stage, HIV status, HIV viral load, and CD4 count. The study highlights the potential of PD-L1 targeted therapy in better management of anal squamous cell carcinoma.

Download Full-text

Squamous Cell Carcinoma of the Lower Lip Complicating a Recurrent Labial Herpes During HIV Infection: a Case Report

International Journal of Clinical & Experimental Dermatology ◽

10.33140/ijced.05.01.01 ◽

2020 ◽

Vol 5 (1) ◽

Keyword(s):

Squamous Cell Carcinoma ◽

Hiv Infection ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Surgical Excision ◽

Hiv Positive ◽

Epithelial Tumor ◽

Lower Lip ◽

Highly Active

Introduction: Squamous cell carcinoma (SCC) is the main cancer of lips; it is increasingly diagnosed in HIV-positive patients. In most cases, there are factors that promote his occurrence. We report a case of an HIV-positive woman with SCC of the lower lip complicating recurrent labial herpes. Medical observation: It was a case of a 40-year-old female received in consultation for a painful and ulcerous lesion of her lip lasting 5 months. She was a HIV-positive patient diagnose since 2007 and on Highly Active Antiretroviral Therapy since that time. She was taking alcohol, was exposed to sunlight regularly, and had presented many episodes of labial herpes in the past. On clinical examination she had a painful ulcero-crustal medallion measuring 2.5 centimeters in diameter, with a papular edge of pearlescent appearance of the lower lip. Given this clinical picture, the diagnosis of chronic decaying herpes labialis with in differential an epithelial tumor (in particular a squamous cell carcinoma of the lower lip) was mentioned. After surgical excision, an anatomopathological analysis of the part confirmed the diagnosis of squamous cell carcinoma. At the time of diagnosis, the patient had a respective CD4 and CD8 level of 939 and 964 cells / mm3 . The evolution was marked 6 weeks later by the scarring with complete epithelialization of the site of the lesion. Conclusion: SCC of the lips is a frequent cancer occurring during HIV infection; there are many risk factors which promote his occurrence. Earlier the treatment is instituted, better is the prognosis.

Download Full-text

Oral squamous cell carcinoma in human immunodeficiency virus positive patients: clinicopathological audit

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002647 ◽

2011 ◽

Vol 126 (3) ◽

pp. 276-278 ◽

Cited By ~ 6

Author(s):

F M A Butt ◽

M L Chindia ◽

F Rana

Keyword(s):

Human Immunodeficiency Virus ◽

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Highly Active Antiretroviral Therapy ◽

Histopathological Classification ◽

Highly Active ◽

Increased Risk ◽

Immunodeficiency Virus

AbstractBackground:Most human immunodeficiency virus positive patients now have a longer life expectancy, with the advent of highly active antiretroviral therapy. However, they are now at increased risk of developing a malignancy during their lives.Aim:To investigate the age at which oral squamous cell carcinoma presents in patients infected with human immunodeficiency virus.Study design:Prospective, clinicohistopathological audit of patients infected with human immunodeficiency virus.Results:Of 200 human immunodeficiency virus positive patients, 16 (8 per cent) presented with oral squamous cell carcinoma (nine women and seven men; age range 18–43 years, mean age 31.7 years). The majority of patients (62.5 per cent) had stage III and IV disease (tumour-node-metastasis staging). There was a predilection for poorly differentiated oral squamous cell carcinoma (using Broder's histopathological classification).Conclusion:Oral squamous cell carcinoma associated with human immunodeficiency virus infection appears to present at a relatively young age.

Download Full-text

Non-AIDS Defining Malignancies Become an Emerging Problem in HIV-Infected Patients

10.31219/osf.io/9br84 ◽

2016 ◽

Author(s):

Khin Soe ◽

Zaw Moe Thein

Keyword(s):

Squamous Cell Carcinoma ◽

Retrospective Study ◽

Antiretroviral Therapy ◽

Oral Squamous Cell Carcinoma ◽

Hiv Infection ◽

Cell Carcinoma ◽

Highly Active Antiretroviral Therapy ◽

Oral Pathology ◽

Highly Active ◽

Screening Procedures

The introduction of HAART (Highly Active Antiretroviral Therapy) caused significant decrease in the incidence of AIDS-defining illnesses among individuals undergoing antiretroviral therapy. In the resent years, the research observed a worrying increase in the incidence of non-AIDS-defining illnesses and increases mortality related to these cases. In this retrospective study, we observed surgical pathology cases with HIV infection those sent to Oral Pathology Unit, University of Dental Medicine, Yangon, from January 2013 to November 2015. Twelve cases were analyzed in relation with their request forms and biopsy results. In general, there were noticeably larger numbers of non-AIDS-defining malignancies (for instance, oral squamous cell carcinoma). According to this study, non-AIDS-defining malignancy is found to be an emerging problem in HIV-infected patients. Further epidemiological and clinico-pathological studies as well as screening procedures should be warranted to solve this problem.

Download Full-text

Expert Commentary on Diagnosis and Treatment of Anal Squamous Cell Carcinoma

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001801 ◽

2020 ◽

Vol 63 (10) ◽

pp. 1361-1362

Author(s):

Alexander G. Heriot

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Diagnosis And Treatment ◽

Anal Squamous Cell Carcinoma ◽

Expert Commentary

Download Full-text

Description of the genetic variants identified in a cohort of patients diagnosed with localized anal squamous cell carcinoma and treated with panitumumab

Scientific Reports ◽

10.1038/s41598-021-86966-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lucía Trilla-Fuertes ◽

Angelo Gámez-Pozo ◽

Joan Maurel ◽

Rocio Garcia-Carbonero ◽

Jaume Capdevila ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Clinical Practice ◽

Cell Carcinoma ◽

Squamous Cell ◽

Genetic Variants ◽

Anal Carcinoma ◽

Genetic Alterations ◽

Daily Clinical Practice ◽

Complete Regression ◽

Anal Squamous Cell Carcinoma

AbstractSquamous cell carcinoma is the most frequent histologic type of anal carcinoma. The standard of care since the 1970s has been a combination of 5-fluorouracil, mitomycin C, and radiotherapy. This treatment is very effective in T1/T2 tumors (achieving complete regression in 80–90% of tumors). However, in T3/T4 tumors, the 3-year relapse free survival rate is only 50%. The VITAL trial aimed to assess the efficacy and safety of panitumumab in combination with this standard treatment. In this study, 27 paraffin-embedded samples from the VITAL trial and 18 samples from patients from daily clinical practice were analyzed by whole-exome sequencing and the influence of the presence of genetic variants in the response to panitumumab was studied. Having a moderate- or high-impact genetic variant in PIK3CA seemed to be related to the response to panitumumab. Furthermore, copy number variants in FGFR3, GRB2 and JAK1 were also related to the response to panitumumab. These genetic alterations have also been studied in the cohort of patients from daily clinical practice (not treated with panitumumab) and they did not have a predictive value. Therefore, in this study, a collection of genetic alterations related to the response with panitumumab was described. These results could be useful for patient stratification in new anti-EGFR clinical trials.

Download Full-text