Human papillomavirus in early laryngeal carcinoma.

Baumann JL, Cohen S, Evjen AN, Law JH, Vadivelu S, Attia A, Schindler JS, Chung CH, Wirth PS, Meijer CJ, Snijders PJ, Yarbrough WG, Slebos RJ
Laryngoscope. 2009 119 (8): 1531-7

PMID: 19489068 · DOI:10.1002/lary.20509

OBJECTIVES/HYPOTHESIS - To examine the role of HPV status in the etiology, prognosis, and treatment of head and neck squamous cell carcinoma in early larynx malignancies.

STUDY DESIGN - Retrospective.

METHODS - Thirty-eight cases of T1 or carcinoma in situ (CIS) laryngeal lesions were examined for the presence of human papilloma virus (HPV) using an inclusive polymerase chain reaction (PCR)/hybridization technique capable of identifying 37 HPV subtypes.

RESULTS - HPV DNA was detected in 6 (16%) of the 38 lesions, representing HPV types 16, 26, 31, 39, and 52, and p16 tumor suppressor protein expression was confirmed in 10 representative cases. This HPV prevalence is higher than that noted in many previous laryngeal cancer studies, possibly due to the relatively large panel of subtypes screened for in this study. Identification of HPV-26, which has been associated with uterine cervical cancer, in an early laryngeal cancer specimen represents the first evidence of this subtype in a laryngeal carcinoma. Consistent with reports focusing on head and neck squamous cell carcinoma (HNSCC) arising from other subsites within the upper aerodigestive tract, patients with HPV-positive laryngeal carcinomas were of younger age and were somewhat less likely to have a history of tobacco use, although the latter of the two findings did not reach statistical significance.

CONCLUSIONS - Our findings emphasize the presence of a broad spectrum of HPV types in a relevant proportion of early laryngeal cancers, and together with evidence of an association of HPV tumor status with a more favorable clinical course, provide a rationale for the routine HPV testing of small larynx lesions.

MeSH Terms (27)

Adult Aged Aged, 80 and over Age Factors Biopsy, Needle Carcinoma in Situ Case-Control Studies DNA, Viral Early Detection of Cancer Female Humans Immunohistochemistry Laryngeal Neoplasms Male Middle Aged Neoplasm Staging Papillomaviridae Papillomavirus Infections Polymerase Chain Reaction Probability Prognosis Reference Values Retrospective Studies Risk Assessment Sex Factors Statistics, Nonparametric Tumor Virus Infections

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