Role of mucosal high-risk human papillomavirus types in head and neck cancers in central India

Abstract

Mucosal high-risk (HR) human papillomaviruses (HPV) cause a subset of head and neck cancers (HNC). The HPV-attributable fraction of HNC varies substantially between countries. Although HNC has a very high incidence in the Indian sub-continent, information on the contribution of HPV infection is limited. Here, we evaluated the HPV-attributable fraction in HNC (N=364) collected in a central region of India. HNC from three different anatomical subsites were included, namely oral cavity (n=252), oropharynx (n=53) and hypopharynx/larynx (n=59).

In this retrospective study, HPV-driven HNC were defined by presence of both viral DNA and RNA. Overexpression of p16^INK4a was also evaluated. HR-HPV DNA was detected in 13.7% of the cases; however only 2.7% were positive for both HPV DNA and RNA. The highest percentage of HPV DNA/RNA double positivity was found in oropharynx (9.4%), followed by larynx (1.7%) and oral cavity (1.6%) (p=0.02). More than half of HPV DNA/RNA-positive cases were p16^INK4a-negative, while a considerable number of HPV RNA-negative cases were p16^INK4a-positive (17.9%). HPV16 was the major type associated with HNC (60.0%), although cases positive for HPV18, 35 and 56 were also detected.

Our data indicate that the proportion and types of mucosal HR-HPV associated with HNC in this central Indian region differ from those in other (developed) parts of the world. This may be explained by differences in smoking and/or sexual behaviour compared with North America and northern Europe. Moreover, we show that p16^INK4a staining appeared not to be a good surrogate marker of HPV transformation in the Indian HNC cases. This article is protected by copyright. All rights reserved.

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