Association of viral load and physical status of HPV-16 with survival of patients with head and neck cancer

Abstract

Introduction: Head and neck cancers (NHCs) are of multifaceted origins, and tobacco and alcohol are the primary risk factors. Currently, other factors associated with the genesis of these tumours are being considered, among these viral infections, especially human papillomavirus (HPV) infection.

Objective: The objective was to evaluate HPV infection, HPV-16 E6 load and its physical status in patients with squamous cell carcinoma in the head and neck and evaluate its effects in the survival of these patients.

Methodology: A total of 80 fresh biopsies of HNC were evaluated. The genetic material was extracted using the commercial kit QIAGEN. The detection and classification of HPV were carried out using INNO-LiPA, whereas the quantification and analysis of integration of the viral genome into the host cell were carried out using real-time PCR.

Results: The average age of the patients included was 60.34 ± 14.48 years, with a predominance of the male gender. The most frequent HPV infection was genotype 16 (52.8%), with an average of 10 copies of the HPV-16 E6/β-globin gene. Furthermore, an integration of the viral genome in the host cell was observed in 86% of cases with a statistically significant relationship between the location of the tumour and the viral load (p < 0.05).

Conclusions: HPV-16 is the most common infection, and its physical status in the host cell is the determining factor in establishing response to treatment. However, more studies are needed to demonstrate the role of HPV infection in carcinogenesis.

Keywords: HPV; head and neck; integration; survival; viral load.

Figure 1.. Survival curves of patients with squamous cell carcinoma in the head and neck. A) Patients with HNSCC in relation to tobacco consumption (n = 80; p = 0.187). B) Patients with HNSCC in relation to tumour stage (n = 80; p = 0.087). C) Patients with HNSCC in relation to gender (n = 80. p = 0.171).

Figure 2.. Analysis of survival of patients with squamous cell carcinoma in the head and neck in relation to: A) HPV genome presence (without distinguishing genotype) (n = 53; p > 0.05). B) Integration of the viral genome into the host cell genome (n = 28. p > 0.05).