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No evidence for active human papillomavirus ( HPV ) in fields surrounding HPV ‐positive oropharyngeal tumors
Author(s) -
Rietbergen Michelle M.,
Braakhuis Boudewijn J. M.,
Moukhtari Nadia,
Bloemena Elisabeth,
Brink Arjen,
Sie Daoud,
Ylstra Bauke,
Baatenburg de Jong Robert J.,
Snijders Peter J. F.,
Brakenhoff Ruud H.,
Leemans C. René
Publication year - 2014
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/jop.12123
Subject(s) - field cancerization , medicine , human papillomavirus , oncology , carcinogenesis , hpv infection , papillomaviridae , pathology , cancer research , gastroenterology , cancer , cervical cancer
Background Patients with human papillomavirus ( HPV )‐positive oropharyngeal squamous cell carcinomas ( OPSCC s) have a better prognosis than patients with HPV ‐negative OPSCC s. Important factors contributing to this better prognosis are relatively low numbers of local/regional recurrences ( LRR s) and second primary tumors ( SPT s) in patients with HPV ‐positive OPSCC. These low numbers may be explained in addition by the absence of a ‘field cancerization’ effect, which is a cause of LRR s and SPT s in patients with HPV ‐negative OPSCC. We aimed to detect a possible ‘field effect’ in patients with HPV ‐positive OPSCC. As HPV is involved in the early stage of carcinogenesis in OPSCC s, its presence is considered a reliable marker for the detection of such a field effect. Therefore, the presence of transcriptionally active HPV was analyzed in the mucosa surrounding HPV ‐positive OPSCC s. Methods We included 20 patients who were surgically treated for an HPV ‐positive OPSCC in the period 2000–2006. Of each patient, the formalin‐fixed paraffin‐embedded tumor sample and all available resection margins were collected. In total, 97 resection margins were investigated with an average of five resection margins per tumor. All samples were analyzed for the presence of tumor and the presence of transcriptionally active HPV by HPV 16‐ E 6‐m RNA detection. Results All tumors were HPV 16‐ E 6‐m RNA positive. HPV 16‐ E 6‐m RNA could be detected in the resection margins that contained tumor ( n = 6). All tumor‐negative resection margins ( n = 91) scored negative for HPV 16‐ E 6‐m RNA . Conclusions In conclusion, transcriptional active HPV could not be detected in the mucosa surrounding an HPV ‐positive OPSCC , which suggests the absence of field effect. This observation may explain the lower number of LRR s and SPT s in HPV ‐positive patients.