HPV status as predictive biomarker in head and neck cancer – which method fits the best for outcome prediction?

Introduction Head and neck squamous cell carcinomas (HNSCCs) belong to the six most commen cancers worlwide and are associated with a poor prognosis. Over the past years, infection of the oral mucosa with high risk human papillomavirus (HPV) was discovered as an additional risk factor apart from well-known carcinogenic effects of chronic tobacco and alcohol consumption. In clinical studies, HPV-induced HNSCCs showed a better response to radiation and radiochemotherapy compared with tobacco and alcohol induced cancers. However, there is no standardized method for determining HPV status in HNSCCs, so far.

Methods Tissue samples from 153 HNSCC patients with a median follow-up of 46,28 months (15 – 186 months) were analyzed with HPV-DNA-in situ hybridization (HPV-DNA-ISH), HPV-DNA-PCR and immunohistochemistry (IHC) targeting p16, p16 and Ki67, pRB or Cyclin D1 and analyzed for their relevance as prognostic biomarkers.

Results Positive HPV-DNA-ISH (p = 0.0039), positive HPV-DNA-PCR (p = 0.0113), positive p16-Ki67-IHC (p = 0.0047) and positive p16-IHC (p = 0.003) showed a significant correlation with the patients’ overall survival. Cyclin D1 and pRb expression had no prognostic relevance in our analysis. The prognostic validity was not further enhanced by combining the analyzed biomarkers.

Conclusion P16 IHC showed the best correlation with the patients‘ overall survival with nearly equal prognostic validity for p16-Ki67-IHC and HPV-DNA-ISH. For the future, a worldwide standard for HPV diagnostics in head and neck oncology should be pursued.

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Artikel online veröffentlicht:
10. Juni 2020