High-risk type human papillomavirus infection and p16 expression in laryngeal cancer

BackgroundOropharyngeal cancers associated with high-risk type human papillomavirus (HR-HPV) infection have better prognosis than virus negative cancers. Similarly, the HPV status in laryngeal cancer (LC) may be associated with better outcome.MethodsSamples from 88 patients with LC were investigated using the polymerase chain reaction (PCR) and p16 immunohistochemistry for HR-HPV analysis. The cut-off point for p16 overexpression was diffuse (75%) tumor expression with at least moderate (+2/3) staining intensity.ResultsThe 5-year cumulative survival (CS) rate was 80.7% in all patients with LC. According to a combination of HR-HPV DNA status and p16 overexpression, subjects with LC were divided into four groups: HR-HPV DNA-positive/p16 overexpression-positive (n=5, 5.7%; CS=100%), HR-HPV DNA-positive/p16 overexpression-negative (n=11, 12.5%; CS =81.8%), HR-HPV DNA-negative/p16 overexpression-positive (n=0), and HR-HPV DNA-negative/p16 overexpression-negative (n=72, 81.8%; CS=79.5%). HR-HPV DNA-positive/p16-positive cases tended to have integrated HPV infection and high viral load, compared with HR-HPV DNA-positive/p16 overexpression-negative cases.ConclusionsLC patients with HPV infection and high levels of p16 expression might have an improved survival outcome; however, it is necessary to recruit additional LC cases with HPV infection to determine the definitive characteristics of HPV-mediated LC and estimate survival outcome. These results may contribute to the development of a useful method for selecting patients with a potentially fair response to treatment and ensure laryngeal preservation.