Evidence for a Causal Association Between Human Papillomavirus and a subset of Head and Neck Cancers

Reviewers: Li Liu, MD
Source: Journal of the National cancer Institute, Vol. 92, No 9, 709-720, (May) 2000

Précis: Association of human papillomaviruses with some head and neck squamous cell cancers.

Introduction

Human papillomaviruses (HPVs) are associated with a large spectrum of diseases. Most of these are benign hyperplasias (warts) that only very rarely progress to cancer. Some HPVs, i.e., the "high-risk" HPVs, however, are associated with lesions that have a propensity to become cancers. Most notably, almost all human cervical cancers are associated with HPV infection. The mucosal lining of the oral cavity and the upper digestive tract is also susceptible to HPV infections. However, the link of high-risk HPV infections and the development of cancer at these sites has been unclear. Dr. Gillison and colleagues retrospectively studied the association between HPV infections and squamous cell cancer of head and neck region.

Method

Cancer tissues from 253 patients with head and neck squamous cell cancers were analyzed for the presence of HPV by several methods.

Results

• HPV infection was found in 25% of patients. Of them, 90% were due to infection with HPV 16 (one of the subtypes of high risk HPVs).
• HPV-positive tumors occurred less often among moderate to heavy drinkers and smokers, and were less likely to contain p53 oncogenes.
• HPV-positive tumors occurred mostly at oropharyngeal sites.
• Patients with HPV-positive tumors had much less chance of dying from their head and neck cancers compared with patients who had HPV-negative tumors.

Discussion

In this study, oropharyngeal cancer that tested positive for infection with HPVs appeared to be distinct from HPV-negative head and neck cancers and were associated with a significantly better prognosis. These findings may open the door for the development and use of vaccines in the management of some patients with head and neck squamous cell cancers, especially oropharyngeal cancers.