Evaluation of High Risk Pathological Features with Regards to HPV Status in Squamous Cell Carcinoma of Head and Neck
Dr. Hetal J Joshi,
Ashish Hospital, Sherpura, Sardar Chowk, Petlad, Anand-388450, Gujarat, India.
Introduction: Positivity for Human Papilloma Virus (HPV) is an important prognostic factor and is associated with a favourable outcome in Head and Neck Squamous Cell Carcinoma (HNSCC). Patients with HPV positive tumours have a better response rate after chemo-radiotherapy. These patients have improved overall survival rates, a low risk of progression and death from any cause as in comparision to those with HPV negative tumours. There are few Indian studies related to HPV status in head and neck cancer patients, and none of them have been reported from Gujarat.
Aim: To study the incidence of HPV and to evaluate its histopathological features in HNSCC patients who have been treated with an intention to cure at Manibhai Shivabhai Patel Cancer Centre, Shree Krishna Hospital, Karamsad, Gujarat, India.
Materials and Methods: This was a retrospective study of 100 cases who underwent treatment for HNSCC at our cancer centre from January 2014 to January 2016. Details of clinical history and histopathological findings were recorded. Representative sections block from the tumour were sent to Gene Lab, Surat for HPV DNA PCR study. Results were analysed statistically by using STATA 14 software for Windows 7 and Microsoft Excel 2007.
Results: Out of 100 cases 11 cases (11%) were positive for HPV. Of these 6 patients (54.54%) were in age group 30-49 years, 10 patients (90.90%) were male, 10 patients (90.90%) had a habit of tobacco chewing. Out of 11 tumours, 7 (63.63%) were ulceroproliferative on gross appearance, 3 (27.27%) involved the tongue and 3 (27.27%) involved the buccal mucosa, 6 (54.54%) were well differentiated tumours, 4 (39.08%) showed lymph node metastasis, 4 (36.36%) were stage IV disease.
Conclusion: HPV is an aetiological agent in development of HNSCC. HPV positive HNSCC occur in middle aged men with a habit of tobacco chewing, early T category and N category as compared to HPV negative HNSCC. HPV positive SCC were predominately keratinising SCC and have marginally better prognosis, survival and response to treatment.