Presenting symptoms and clinical findings in HPV-positive and HPV-negative oropharyngeal cancer patients

Abstract

Objectives: Oropharyngeal squamous cell carcinoma (OPSCC) is divided in two different disease entities depending on HPV involvement. We investigated differences in presenting symptoms and clinical findings in patients with HPV-positive and -negative OPSCC tumors.

Methods: Altogether 118 consecutive patients diagnosed with primary OPSCC between 2012 and 2014 at the Helsinki University Hospital were included. HPV-status of the tumors was assessed by PCR detection of HPV DNA and immunostaining with p16-INK4a antibody.

Results: Fifty-one (47.7%) of the patients had HPV-positive and 56 (52.3%) HPV-negative tumors. Forty-nine (49/51, 96.1%) of the HPV+ tumors were also p16+ showing high concordance. The most common presenting symptom among HPV+/p16+ patients was a neck mass (53.1%), whereas any sort of pain in the head and neck area was more frequently related to the HPV−/p16− (60.0%) group. HPV+/p16+ tumors had a tendency to locate in the tonsillar complex and more likely had already spread into regional lymph nodes compared with HPV−/p16− tumors. Smoking and heavy alcohol consumption were significantly more common among HPV−/p16− patients but also rather common among HPV+/p16+ patients.

Conclusions: This analysis of symptoms and signs confirm that OPSCC can be dichotomized in two distinct disease entities as defined by HPV status.

Chinese abstract

目的：根据HPV涉及, 口咽鳞状细胞癌（OPSCC）可分为两中不同的疾病。我们调查了HPV阳性和HPV阴性的OPSCC肿瘤患者的之间在症状和临床表现上的差异。

方法：包括了2012年至2014年在赫尔辛基大学医院诊断患有原发性OPSCC的118例连续患​​者。通过HPV DNA的PCR检测和p16-INK4a抗体的免疫染色, 来评估肿瘤的HPV-状态。

结果：51例（47.7%）患者呈HPV阳性, 56例（52.3%）呈HPV阴性。49例（49/51,96.1%）HPV 阳性肿瘤也是p16 阳性, 显示高度一致性。 HPV 阳性/p16 阳性患者最常见的症状是颈部肿块（53.1%）, 而头颈部任何类型的疼痛更常与HPV阴性/p16阴性（60.0%）组相关。与HPV阴性/p16阴性肿瘤相比, HPV 阳性/p16 阳性肿瘤倾向于位于扁桃体复合体中, 更可能已经扩散到区域淋巴结中。吸烟和饮酒在HPV +/p16 +患者中更常见, 而在HPV-/p16-患者中也相当常见。

结论：这种症状和体征的分析证实, OPSCC可以根据HPV状态分成两种不同的疾病。

Keywords:

• Human papillomavirus
• oropharynx
• p16
• symptom
• cancer
• etiology

View correction statement:

Correction to: Carpén et al., Presenting symptoms and clinical findings in HPV-positive and HPV-negative oropharyngeal cancer patients

Disclosure statement

The authors declare no conflict of interest.

Additional information

Funding

This study was supported by grants from the Helsinki University Hospital Research Fund.