High Association of Human Papillomavirus Infection with Oral Cancer: A Case-Control Study

Universidad Autónoma Metropolitana, Mexico, D.F., Mexico.
Archives of Medical Research (Impact Factor: 2.65). 03/2008; 39(2):189-97. DOI: 10.1016/j.arcmed.2007.08.003
Source: PubMed


The aim of the present study was to determine the association of high-risk human papillomavirus (HR-HPV) in Mexican individuals with oral squamous cell carcinoma (OSCC) and their association with various risk factors.
We designed a matched case-control study. Cases were individuals with newly diagnosed OSCC, age- and sex-matched with controls (1:4). Demographic and clinical data were obtained; also a self-administered questionnaire about sexual behavior was included. DNA from oral brushing was purified to amplify HPV-DNA through MY09/MY11 and GP5+/GP6+ primers and subsequently subjected to sequencing. Conditional regression models were built to calculate odds ratios (ORs) and 95% confidence intervals (CI).
Sixty two cases and 248 controls (53.2% males), median age 62 years (Q1-Q3=54-72 years) were included. HPV prevalence was 43.5% in cases and 17.3% in controls (HR-HPV: 37.1% cases, 9.7% controls). The most frequent types in cases were HPV-16 and HPV-18 (55.6 and 18.5%). The presence of HR-HPV was associated with OSCC (OR=6.2; 95% CI: 2.98-12.97) controlling for the most common risk factors. An interaction between smoking and drinking was detected, and family history of cancer was also significant (OR: 3.61; 95% CI=1.44-8.99). Early age at first sexual intercourse and large number of lifetime sexual partners showed an association with HR-HPV (p=0.019 and p=0.033, respectively).
Oral HR-HPV was strongly associated with OSCC, suggesting that HPV-16 and -18 are risk factors for oral cancer in Mexican patients. A significant association of tobacco and alcohol was confirmed. In addition, family history of cancer was associated with OSCC. The results underline the role of HPV in OSCC and its multifactorial etiology.

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Available from: Alejandro M García-Carrancá, Jul 23, 2014
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    • "El carcinoma oral y orofaríngeo son los tipos más comunes de cáncer de cabeza y cuello, y más del 90% de éstos son carcinomas de células escamosas; ha sido asociado a factores de riesgo como el tabaco y el alcohol entre otros (Ibieta-Zarco et al., 2012). Los sitios afectados con mayor frecuencia son la lengua, seguido por la encía y piso de cavidad oral (Anaya-Saavedra et al., 2008). "

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    • "Furthermore, during much of the same period accumulating reports from many Western countries conveyed both a general increase of OPSCC as well as an increase in the proportion of HPV-positive OPSCC (6–17). The main explanation for this development was attributed to changes in sexual habits with a significant correlation between HPV-positive OPSCC, early sex debut as well as number of oral or vaginal partners (42). Nonetheless, oral- to-oral contact (open-mouth kissing) and oral HPV-transmission at birth could also account for oral HPV infection (43,44). "
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    ABSTRACT: In 2007, the International Agency for Research against Cancer (IARC) recognized human papillomavirus (HPV), especially HPV16, besides smoking and alcohol, as a risk factor for oropharyngeal squamous cell carcinoma (OPSCC), where tonsillar and base of tongue cancer dominate. Moreover, during the past decade, in many Western countries, a sharp rise in the incidence of OPSCC, more specifically of HPV-positive OPSCC has been observed. Notably, patients with HPV-positive OPSCC, where the majority are men, particularly never-smokers have a better clinical outcome than patients with HPV-negative OPSCC and other head neck cancer (roughly 80 vs. 40% disease-free survival with conventional radiotherapy and surgery). This suggests that many patients with HPV-positive OPSCC may not require the more aggressive intensified chemo-radiotherapy given to head neck cancer patients today, and could with somewhat tapered treatment maintain excellent survival, avoiding some of the severe side effects along with intensified treatment. However, before de-intensified treatment is administered additional biomarkers are necessary in combination with HPV-positive status in order to predict and select patients that will respond favorably to therapy. In conclusion, noteworthy issues within this field with an increasing cohort of patients with HPV-positive OPSCC are better-tailored therapy and prevention. Patients with HPV-positive OPSCC, with biomarkers for good response to therapy e.g., low MHC class I, or CD44 expression or high numbers of CD8+ tumor infiltrating lymphocytes, could be included in randomized trials with less severe therapy. Furthermore, possibilities to screen for HPV-positive OPSCC and to vaccinate boys against HPV infection should be further investigated.
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    • "A Canadian study has reported that 73% of cancers of the base of the tongue and tonsils were HPV-positive [10]. Oral Squamous cell carcinomas are strongly associated with HPV 16 and HPV 18 [11]. Reviews have concluded that existing evidence points towards a clinically significant [12] and causal relationship [13] between HPV and oropharyngeal squamous cell carcinoma. "
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    ABSTRACT: A 53 year-old male gynecologist presented with human papillomavirus (HPV) 16 positive tonsillar squamous cell carcinoma. He had no identifiable risk factors with the exception of long term occupational exposure to laser plumes, having performed laser ablations and loop electrosurgical excision procedures (LEEP) on greater than 3000 dysplastic cervical and vulvar lesions over 20 years of practice. The second patient is a 62 year old male gynecologist with a 30 year history of laser ablation and LEEP who subsequently developed HPV 16 positive base of tongue cancer. He also had very few other risk factors for oropharyngeal cancer or HPV infection. HPV is a probable causative agent for oropharyngeal squamous cell carcinoma and has been reported as being transmittable through laser plume. This paper suggests that HPV transmitted through laser plume can result in subsequent squamous cell carcinoma.
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