| 1. |
- Du, Juan, et al.
(författare)
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Prevalence of Oral Human Papillomavirus Infection among Youth, Sweden
- 2012
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention. - 1080-6040 .- 1080-6059. ; 18:9, s. 1468-1471
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Tidskriftsartikel (refereegranskat)abstract
- Human papillomavirus (HPV) causes cervical, head, and neck cancers. We studied 483 patients at a youth clinic in Stockholm, Sweden, and found oral HPV prevalence was 9.3% and significantly higher for female youth with than without cervical HPV infection (p = 0.043). Most oral HPV types matched the co-occurring cervical types.
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| 2. |
- Nordfors, Cecilia, et al.
(författare)
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Oral human papillomavirus prevalence in high school students of one municipality in Sweden
- 2013
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Ingår i: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 45:11, s. 878-881
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Tidskriftsartikel (refereegranskat)abstract
- The rise in human papillomavirus (HPV) infection has been suggested to be responsible for the increased incidence of oropharyngeal cancer in the Western world. This has boosted interest in oral HPV prevalence and whether HPV vaccines can prevent oral HPV infection. In a previous study we showed oral HPV prevalenceto be almost 10% in youth aged 15-23 y attending a youth clinic in Stockholm, Sweden. However, this may not be a generalizable sample within the Swedish population. Therefore, mouthwashes were used to investigate oral HPV prevalence in 335 Swedish high school students aged 17-21 y (median age 18 y), from 1municipality with 140,000 inhabitants. The presence of HPV DNA in the oral samples, as examined by a Luminex-based assay, was significantly lower in this cohort, only 1.8% (3.1% in females and 0.6% in males), as compared to our previous study.
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| 3. |
- Nordfors, Cecilia
(författare)
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Studies on human papillomavirus and molecular markers in head-neck cancer
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Oropharyngeal squamous cell carcinoma (OSCC), where tonsillar and base of tongue cancer (TSCC and BOTSCC) dominate, is associated with smoking and alcohol as well as human papillomavirus (HPV) infection. The incidence of TSCC and BOTSCC, has increased lately, mainly due to HPV infection. In addition, patients with HPV-positive TSCC and BOTSCC have a better clinical outcome compared to those with the corresponding HPV-negative tumors (80% vs. 40% 5 year disease free survival (DFS)). Recently, head and neck cancer treatment has been intensified with chemotherapy and more intensive radiotherapy. This is likely unnecessary for 80% of HPV-positive TSCC and BOTSCC patients. Aims: Due to the increase in TSCC and BOTSCC, we wanted to follow oral HPV-prevalence in healthy sexually active youth as well as in patients with TSCC and BOTSCC. This in order to disclose e.g. whether there were specific traits of oral HPV infection in the latter group. In addition, the presence of different HPV16 E6 variants in TSCC were analyzed as well as new biomarkers, which could aid in the identification of patients with HPV positive TSCC and BOTSCC that could be eligible for de-escalated treatment. Result: In Paper I we showed that oral HPV prevalence was 9.3% among youth attending a youth clinic in Stockholm. Oral HPV infection was more common in women with genital infection and there was also HPV-type concordance between the oral and cervical sites. When testing samples from patients with suspected HNSCC in Paper II, nearly all HPVDNA+ oral samples were derived from patients with HPVDNA+ TSCC and BOTSCC. For healthy subjects with oral HPVDNA+ infection, the relative viral load was very low. In Paper III we found that the HPV16E6 L83V variant was common in TSCC, cervical cancer (CC) and cervical samples (CS), while the rare HPV16E6 R10G variant was present in a proportion of TSCC, but absent in CC and only sporadic in CS samples. Neither L83V nor R10G had any significant impact on clinical outcome. In paper IV, high number of CD8+ tumor infiltrating lymphocytes (TILs) was correlated to a better clinical outcome, especially for patients with HPVDNA+ and HPVDNA+ /p16 positive TSCC and BOTSCC. CD4+ TIL counts were not linked to clinical outcome or survival for patients with HPVDNA+ tumors, although there was a tendency of better survival for patients with HPVDNA- and HPVDNA-/p16-negative tumors. Finally in Paper V, patients with HPVDNA+ TSCC and BOTSCC and absent/weak as compared to medium/ strong CD44 intensity staining had a significantly better 3-year DFS and overall survival. Conclusion: Oral HPV infection was relatively frequent in Stockholm youth as compared to other studies during the same time period, but the relative viral load was in general lower than that found for patients with HPV-positive TSCC and BOTSCC. HPV16E6 L83V variant was common in TSCC, CC and CS, while the R10G variant was present in a proportion of TSCC, but absent in CC and only sporadic in CS samples. Both high CD8+ TIL infiltration and absent/weak CD44 intensity staining seemed to be promising predictive markers for patients with HPVDNA+ TSCC and BOTSCC.
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| 4. |
- Näsman, Anders, et al.
(författare)
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Absent/weak CD44 intensity and positive human papillomavirus (HPV) status in oropharyngeal squamous cell carcinoma indicates a very high survival
- 2013
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Ingår i: Cancer Medicine. - : John Wiley & Sons. - 2045-7634. ; 2:4, s. 507-18
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Tidskriftsartikel (refereegranskat)abstract
- Patients with human papillomavirus DNA positive (HPVDNA+) oropharyngeal squamous cell carcinoma (OSCC) have better clinical outcome than those with HPV DNA negative (HPVDNA-) OSCC upon intensive oncological treatment. All HPVDNA+ OSCC patients may not require intensive treatment, however, but before potentially deintensifying treatment, additional predictive markers are needed. Here, we examined HPV, p16(INK4a), and CD44 in OSCC in correlation to clinical outcome. Pretreatment tumors from 290 OSCC patients, the majority not receiving chemotherapy, were analyzed for HPV DNA by Luminex and for p16(INK4a) and CD44 by immunohistochemistry. 225/290 (78%) tumors were HPVDNA+ and 211/290 (73%) overexpressed p16(INK4a), which correlated to presence of HPV (P < 0.0001). Presence of HPV DNA, absent/weak CD44 intensity staining correlated to favorable 3-year disease-free survival (DFS) and overall survival (OS) by univariate and multivariate analysis, and likewise for p16(INK4a) by univariate analysis. Upon stratification for HPV, HPVDNA+ OSCC with absent/weak CD44 intensity presented the significantly best 3-year DFS and OS, with >95% 3-year DFS and OS. Furthermore, in HPVDNA+ OSCC, p16(INK4a)+ overexpression correlated to a favorable 3-year OS. In conclusion, patients with HPVDNA+ and absent/weak CD44 intensity OSCC presented the best survival and this marker combination could possibly be used for selecting patients for tailored deintensified treatment in prospective clinical trials. Absence of/weak CD44 or presence of human papillomavirus (HPV) DNA was shown as a favorable prognostic factors in tonsillar and tongue base cancer. Moreover, patients with the combination of absence of/weak CD44 and presence of HPV DNA presented a very favorable outcome. Therefore, we suggest that this marker combination could potentially be used to single out patients with a high survival that could benefit from a de-escalated oncological treatment.
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| 5. |
- Sivars, Lars, et al.
(författare)
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Human papillomavirus DNA detection in fine-needle aspirates as indicator of human papillomavirus-positive oropharyngeal squamous cell carcinoma : A prospective study
- 2017
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Ingår i: Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 39:3, s. 419-426
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Tidskriftsartikel (refereegranskat)abstract
- Background. Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC) has a better outcome than most head neck squamous cell carcinomas (HNSCCs) and an HPV-positive lymph node metastasis likely has an HPV-positive oropharyngeal SCC origin. Determining HPV-status in cervical lymph nodes by fine-needle aspiration cytology (FNAC) may be useful for diagnosis. Methods. FNACs from 66 patients with neck masses were prospectively examined for HPV DNA and HPV16 mRNA by a polymerase chain reaction (PCR)-based assay, and the data correlated to diagnosis and HPV-status obtained from histopathological specimens. Results. Aspirates from 17 of 66 patients, later diagnosed with HPV-positive oropharyngeal SCC, were HPV16 DNA-positive. HPV16 mRNA was detected in all cases with extractable RNA. All remaining FNACs, including 18 branchial cleft cysts, were HPV DNA-negative. HPV DNA status in the aspirates showed perfect concordance with corresponding biopsies. Conclusion. HPV16 DNA detection in fine-needle aspirations from neck masses is reliable and HPV16 DNA in a metastasis is a strong indicator of an HPV-positive oropharyngeal SCC.
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