Assessment of the incidence of squamous cell papilloma of the esophagus and the presence of high-risk human papilloma virus

Background: Oral cancer is a major problem globally. The strong causal association with tobacco, prevalent in Pakistan makes it imperative to know the role of molecular events in oral oncogenesis. We aim to evaluate high risk HPV 16/18 and p16 in oral premalignant lesions (OPL) and oral squamous cell carcinoma (OSCC). We further analyze the association between high risk human papilloma virus (HR-HPV16/18) and p16 in OPL and OSCC. Methods: A total of 100 OSCC and 50 OPL cases were included. Demographic data along with habitual exposure to smoked and chewable tobacco, betel and gutka etc., was noted. We evaluated p16 in OPL and OSCC by immunohistochemistry, HPV was detected by polymerase chain reaction. Data was entered and analyzed using SPSS 21. Chi square and Fisher exact were applied to determine the association of HPV and p16 with different variables. Results: Out of 50 OPL, 14% were positive and 86% were negative for p16 whereas out of 100 OSCC, 18% were positive and 82% were negative. Out of 50 OPL, HPV was detected in 6% whereas out of 100 OSCC, 15% were positive. Highly significant co expression of HPV with p16 was observed in all 15 (100%) HPV positive OSCC cases (p = 0.001). However, 3 out of 18 cases, which showed p16 expression, did not show HPV infection. Conclusion: Role of p16 as a surrogate marker for HPV in OSCC can be supported in the present study. Moreover a Chemical carcinogen like tobacco is considered as major associative risk factor with p16 and HPV in concert.

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High-risk human papilloma virus testing in oropharyngeal squamous cell carcinoma at a university-based cancer center: A quality improvement project.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.21 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 21-21

Author(s):

Deepthi Kodali ◽

Melinda Sanders ◽

Robert James Dowsett ◽

Jeffrey Spiro ◽

Upendra P. Hegde

Keyword(s):

Quality Improvement ◽

High Risk ◽

Human Papilloma Virus ◽

Squamous Cell ◽

Strong Association ◽

Quality Improvement Project ◽

Cancer Center ◽

Hpv Testing ◽

Improvement Project ◽

Papilloma Virus

21 Background: Although traditionally linked to smoking and alcohol, high-risk (HR) human papilloma virus (HPV) associated head and neck cancers are becoming increasingly common in non-smokers. HR HPV causes approx. 70% of all oropharyngeal squamous cell carcinomas (OPSCC) and they have better outcomes when compared with smoking associated OPSCC. An accurate HPV assessment in OPSCC is important due to its relevance in treatment and follow up. This Quality Improvement project was designed to evaluate frequency of HPV testing with p16 immunochemistry (IHC) staining in patients with OPSCC at a University-based cancer center. Methods: All cases diagnosed with OPSCC or those with high suspicion for OPSCC between 2008 and 2017 were obtained from Department of Pathology. Patients with biopsies from sites other than oropharynx as well as those with biopsies performed at outside hospitals were excluded. All pathology reports were reviewed to identifyfrequency of p16 IHC staining. Results: A list of 127 cases was obtained from Pathology. Of these, 26 non-OPSCC and external hospital slides were excluded, making sample size (n) 101. HR HPV testing by p16 IHC staining was performed in 42 of 101 patients (41.5%) and not performed in 59 (58.5%). 38 of 42 patients tested were positive for HR HPV (90.5%). There was an overall upward trend in the frequency of HPV testing over the 10 years. Conclusions: HR HPV testing was done only in 41.5% of eligible patients suggesting a deficiency in testing for this biomarker. Various causes for this lack of testing were identified, most common one being inadequacy of tissue specimen. 90.5% of eligible patients tested were positive for HR-HPV, highlighting the strong association between HPV and OPSCC. Based on importance of testing HR HPV in OPSCC and need for aligning with American Society of Clinical Pathology guidelines, corrective actions were proposed by meeting with pathologists and otolaryngologists.

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