Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia
HPV infection is a clear etiopathogenetic factor in oropharyngeal carcinogenesis and is associated with a markedly better prognosis than in smoking- and alcohol-associated cases, as specified by AJCC classification. The aim of the present work is to evaluate the prevalence of HPV-induced OPSCC in an...
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MDPI AG
2022-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/17/4205 |
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| author | Francesco Bussu Narcisa Muresu Claudia Crescio Roberto Gallus Davide Rizzo Andrea Cossu Illari Sechi Mariantonietta Fedeli Antonio Cossu Giovanni Delogu Andrea Piana |
| author_facet | Francesco Bussu Narcisa Muresu Claudia Crescio Roberto Gallus Davide Rizzo Andrea Cossu Illari Sechi Mariantonietta Fedeli Antonio Cossu Giovanni Delogu Andrea Piana |
| author_sort | Francesco Bussu |
| collection | DOAJ |
| description | HPV infection is a clear etiopathogenetic factor in oropharyngeal carcinogenesis and is associated with a markedly better prognosis than in smoking- and alcohol-associated cases, as specified by AJCC classification. The aim of the present work is to evaluate the prevalence of HPV-induced OPSCC in an insular area in the Mediterranean and to assess the reliability of p16 IHC (immunohistochemistry) alone, as accepted by AJCC, in the diagnosis of HPV-driven carcinogenesis in such a setting. All patients with OPSCC consecutively managed by the referral center in North Sardinia of head and neck tumor board of AOU Sassari, were recruited. Diagnosis of HPV-related OPCSS was carried out combining p16 IHC and DNA testing on FFPE samples and compared with the results of p16 IHC alone. Roughly 14% (9/62) of cases were positive for HPV-DNA and p16 IHC. Three more cases showed overexpression of p16, which has a 100% sensitivity, but only 75% specificity as standalone method for diagnosing HPV-driven carcinogenesis. The Cohen’s kappa coefficient of p16 IHC alone is 0.83 (excellent). However, if HPV-driven carcinogenesis diagnosed by p16 IHC alone was considered the criterion for treatment deintensification, 25% of p16 positive cases would have been wrongly submitted to deintensified treatment for tumors as aggressive as a p16 negative OPSCC. The currently accepted standard by AJCC (p16 IHC alone) harbors a high rate of false positive results, which appears risky for recommending treatment deintensification, and for this aim, in areas with a low prevalence of HPV-related OPSCC, it should be confirmed with HPV nucleic acid detection. |
| first_indexed | 2024-03-10T01:59:02Z |
| format | Article |
| id | doaj.art-9a647970fe6f4a2587165ad7140d8354 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T01:59:02Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9a647970fe6f4a2587165ad7140d83542023-11-23T12:51:35ZengMDPI AGCancers2072-66942022-08-011417420510.3390/cancers14174205Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern SardiniaFrancesco Bussu0Narcisa Muresu1Claudia Crescio2Roberto Gallus3Davide Rizzo4Andrea Cossu5Illari Sechi6Mariantonietta Fedeli7Antonio Cossu8Giovanni Delogu9Andrea Piana10Department of Medicine, Surgery and Pharmacy, University of Sassari-ENT Division, AOU Sassari, 07100 Sassari, ItalyDepartment of Humanities and Social Sciences, University of Sassari, 07100 Sassari, ItalyOtolaryngology Division, Azienda Ospedaliera Universitaria, 07100 Sassari, ItalyOtolaryngology, Mater Olbia Hospital, 07026 Olbia, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari-ENT Division, AOU Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyFacoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, ItalyDepartment of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyHPV infection is a clear etiopathogenetic factor in oropharyngeal carcinogenesis and is associated with a markedly better prognosis than in smoking- and alcohol-associated cases, as specified by AJCC classification. The aim of the present work is to evaluate the prevalence of HPV-induced OPSCC in an insular area in the Mediterranean and to assess the reliability of p16 IHC (immunohistochemistry) alone, as accepted by AJCC, in the diagnosis of HPV-driven carcinogenesis in such a setting. All patients with OPSCC consecutively managed by the referral center in North Sardinia of head and neck tumor board of AOU Sassari, were recruited. Diagnosis of HPV-related OPCSS was carried out combining p16 IHC and DNA testing on FFPE samples and compared with the results of p16 IHC alone. Roughly 14% (9/62) of cases were positive for HPV-DNA and p16 IHC. Three more cases showed overexpression of p16, which has a 100% sensitivity, but only 75% specificity as standalone method for diagnosing HPV-driven carcinogenesis. The Cohen’s kappa coefficient of p16 IHC alone is 0.83 (excellent). However, if HPV-driven carcinogenesis diagnosed by p16 IHC alone was considered the criterion for treatment deintensification, 25% of p16 positive cases would have been wrongly submitted to deintensified treatment for tumors as aggressive as a p16 negative OPSCC. The currently accepted standard by AJCC (p16 IHC alone) harbors a high rate of false positive results, which appears risky for recommending treatment deintensification, and for this aim, in areas with a low prevalence of HPV-related OPSCC, it should be confirmed with HPV nucleic acid detection.https://www.mdpi.com/2072-6694/14/17/4205North SardiniaOPSCCHPV-driven carcinogenesistreatment deintensificationHPV prevalencediagnostic methods |
| spellingShingle | Francesco Bussu Narcisa Muresu Claudia Crescio Roberto Gallus Davide Rizzo Andrea Cossu Illari Sechi Mariantonietta Fedeli Antonio Cossu Giovanni Delogu Andrea Piana Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia Cancers North Sardinia OPSCC HPV-driven carcinogenesis treatment deintensification HPV prevalence diagnostic methods |
| title | Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia |
| title_full | Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia |
| title_fullStr | Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia |
| title_full_unstemmed | Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia |
| title_short | Low Prevalence of HPV Related Oropharyngeal Carcinogenesis in Northern Sardinia |
| title_sort | low prevalence of hpv related oropharyngeal carcinogenesis in northern sardinia |
| topic | North Sardinia OPSCC HPV-driven carcinogenesis treatment deintensification HPV prevalence diagnostic methods |
| url | https://www.mdpi.com/2072-6694/14/17/4205 |
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