Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection

Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising in Western countries and this has been attributed to human papillomavirus (HPV) infection. p16 expression is a marker for HPV infection and p16 positive OPSCC is now recognized as a separate disease entity. Th...

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Main Authors: Yap, Lee Fah, Lai, Sook Ling, Rhodes, Anthony, Sathasivam, Hans Prakash, Abdullah, Maizaton Atmadini, Pua, Kin Choo, Rajadurai, Pathmanathan, Cheah, Phaik Leng, Thavaraj, Selvam, Robinson, Max, Paterson, Ian Charles
Format: Article
Published: BMC 2018
Subjects:
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author Yap, Lee Fah
Lai, Sook Ling
Rhodes, Anthony
Sathasivam, Hans Prakash
Abdullah, Maizaton Atmadini
Pua, Kin Choo
Rajadurai, Pathmanathan
Cheah, Phaik Leng
Thavaraj, Selvam
Robinson, Max
Paterson, Ian Charles
author_facet Yap, Lee Fah
Lai, Sook Ling
Rhodes, Anthony
Sathasivam, Hans Prakash
Abdullah, Maizaton Atmadini
Pua, Kin Choo
Rajadurai, Pathmanathan
Cheah, Phaik Leng
Thavaraj, Selvam
Robinson, Max
Paterson, Ian Charles
author_sort Yap, Lee Fah
collection UM
description Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising in Western countries and this has been attributed to human papillomavirus (HPV) infection. p16 expression is a marker for HPV infection and p16 positive OPSCC is now recognized as a separate disease entity. There are only limited data available regarding HPV-related OPSCC in Asian countries and no data from Malaysia. Methods: We identified 60 Malaysian patients with OPSCC over a 12-year period (2004-2015) from four different hospitals in two major cities, Kuala Lumpur and Penang. The detection of HPV was carried out using p16 immunohistochemistry and high risk HPV DNA in situ hybridisation. Results: Overall, 15 (25%) tumours were p16 positive by immunohistochemistry, 10 of which were also positive for high risk HPV DNA by in situ hybridisation. By comparison, a matched cohort of UK patients had a p16 positive rate of 49%. However, between 2009 and 2015, where cases were available from all four hospitals, 13 of 37 (35%) cases were p16 positive. In our Malaysian cohort, 53% of patients were of Chinese ethnicity and 80% of the p16 positive cases were found in these patients; no Indian patients had p16 positive disease, despite representing 35% of the total cohort. Conclusion: The proportion of OPSCCs associated with HPV in Malaysia appears to be lower than in European and American cohorts and could possibly be more prevalent amongst Malaysians of Chinese ethnicity. Further, our data suggests that the burden of HPV-related OPSCC could be increasing in Malaysia. Larger cross-sectional studies of Malaysian patients are required to determine the public health implications of these preliminary findings.
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spelling um.eprints-203112019-02-14T06:41:12Z http://eprints.um.edu.my/20311/ Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection Yap, Lee Fah Lai, Sook Ling Rhodes, Anthony Sathasivam, Hans Prakash Abdullah, Maizaton Atmadini Pua, Kin Choo Rajadurai, Pathmanathan Cheah, Phaik Leng Thavaraj, Selvam Robinson, Max Paterson, Ian Charles R Medicine RK Dentistry Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising in Western countries and this has been attributed to human papillomavirus (HPV) infection. p16 expression is a marker for HPV infection and p16 positive OPSCC is now recognized as a separate disease entity. There are only limited data available regarding HPV-related OPSCC in Asian countries and no data from Malaysia. Methods: We identified 60 Malaysian patients with OPSCC over a 12-year period (2004-2015) from four different hospitals in two major cities, Kuala Lumpur and Penang. The detection of HPV was carried out using p16 immunohistochemistry and high risk HPV DNA in situ hybridisation. Results: Overall, 15 (25%) tumours were p16 positive by immunohistochemistry, 10 of which were also positive for high risk HPV DNA by in situ hybridisation. By comparison, a matched cohort of UK patients had a p16 positive rate of 49%. However, between 2009 and 2015, where cases were available from all four hospitals, 13 of 37 (35%) cases were p16 positive. In our Malaysian cohort, 53% of patients were of Chinese ethnicity and 80% of the p16 positive cases were found in these patients; no Indian patients had p16 positive disease, despite representing 35% of the total cohort. Conclusion: The proportion of OPSCCs associated with HPV in Malaysia appears to be lower than in European and American cohorts and could possibly be more prevalent amongst Malaysians of Chinese ethnicity. Further, our data suggests that the burden of HPV-related OPSCC could be increasing in Malaysia. Larger cross-sectional studies of Malaysian patients are required to determine the public health implications of these preliminary findings. BMC 2018 Article PeerReviewed Yap, Lee Fah and Lai, Sook Ling and Rhodes, Anthony and Sathasivam, Hans Prakash and Abdullah, Maizaton Atmadini and Pua, Kin Choo and Rajadurai, Pathmanathan and Cheah, Phaik Leng and Thavaraj, Selvam and Robinson, Max and Paterson, Ian Charles (2018) Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection. Infectious Agents and Cancer, 13 (1). p. 21. ISSN 1750-9378, DOI https://doi.org/10.1186/s13027-018-0193-6 <https://doi.org/10.1186/s13027-018-0193-6>. https://doi.org/10.1186/s13027-018-0193-6 doi:10.1186/s13027-018-0193-6
spellingShingle R Medicine
RK Dentistry
Yap, Lee Fah
Lai, Sook Ling
Rhodes, Anthony
Sathasivam, Hans Prakash
Abdullah, Maizaton Atmadini
Pua, Kin Choo
Rajadurai, Pathmanathan
Cheah, Phaik Leng
Thavaraj, Selvam
Robinson, Max
Paterson, Ian Charles
Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title_full Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title_fullStr Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title_full_unstemmed Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title_short Clinico-pathological features of oropharyngeal squamous cell carcinomas in Malaysia with reference to HPV infection
title_sort clinico pathological features of oropharyngeal squamous cell carcinomas in malaysia with reference to hpv infection
topic R Medicine
RK Dentistry
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