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. 2022 Nov 21;14(22):5717.
doi: 10.3390/cancers14225717.

Epidemiological Study of p16 Incidence in Head and Neck Squamous Cell Carcinoma 2005-2015 in a Representative Northern European Population

Mari Mylly  1 , Linda Nissi  2 , Teemu Huusko  1 , Johannes Routila  1 , Samuli Vaittinen  3 , Heikki Irjala  1 , Ilmo Leivo  4 , Sami Ventelä  1   5
Affiliations

Epidemiological Study of p16 Incidence in Head and Neck Squamous Cell Carcinoma 2005-2015 in a Representative Northern European Population

Mari Mylly et al. Cancers (Basel). .

Abstract

The incidence of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC) has increased globally. Our research goal was to study HNSCC incidence in a representative Northern European population and evaluate the utility of the HPV surrogate marker p16 in clinical decision-making. All new HNSCC patients diagnosed and treated in Southwest Finland from 2005-2015 (n = 1033) were identified and analyzed. During the follow-up period, the incidence of oropharyngeal (OPSCC) and oral cavity squamous cell carcinoma (OSCC) increased, while the incidence of laryngeal squamous cell carcinoma (LSCC) decreased. This clinical cohort was used to generate a population-validated tissue microarray (PV-TMA) archive for p16 analyses. The incidence of p16 positivity in HNSCC and OPSCC increased in southwest Finland between 2005 and 2015. p16 positivity was mainly found in the oropharynx and was a significant factor for improved survival. p16-positive OPSCC patients had a better prognosis, regardless of treatment modality. All HNSCC patients benefited from a combination of chemotherapy and radiotherapy, regardless of p16 expression. Our study reaffirms that p16 expression offers a prognostic biomarker in OPSCC and could potentially be used in cancer treatment stratification. Focusing on p16 testing for only OPSCC might be the most cost-effective approach in clinical practice.

Keywords: HNSCC; HPV; OPSCC; epidemiology; incidence; p16; survival.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
The study protocol for the identification and analysis of all patients with new HNSCC in the Southwestern Finland region from 2005–2015 (n = 1033). The same clinical cohort was used in the formation of an unbiased and population-validated HNSCC tissue microarray (TMA) archive for p16 immunostaining.
Figure 2
Figure 2
HNSCC incidence in the southwestern Finland population from 2005–2015.
Figure 3
Figure 3
OPSCC incidence in the southwestern Finland population from 2005–2015.
Figure 4
Figure 4
OPSCC overall survival (OS, A), disease-specific survival (DSS, B) and disease-free survival (DFS, C) after radio- (RT) or chemoradiotherapy (CRT).
Figure 5
Figure 5
Overall survival (A), disease-specific survival (B) and disease-free survival (C) comparison between PV-TMA and background HNSCC populations.
Figure 6
Figure 6
Representative immunohistochemical figures of negative (left panel) and positive (right panel) p16 staining. Black bars represent 100 µm.
Figure 7
Figure 7
p16-positive OPSCC incidence in PV-TMA from 2005–2015.
Figure 8
Figure 8
Overall survival (A), disease-specific survival (B) and disease-free survival (C) comparison between p16− and p16+ in OPSCC.
See this image and copyright information in PMC

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