Feasibility of p16 surrogate biomarker as adjunct diagnosis of oral and oropharyngeal malignancy in a resource-constrained country

Abstract

Background

Cases of Human papillomavirus (HPV)-associated oral and oropharyngeal cancer are increasing. Proper diagnostic tools are required to detect HPV among patients, especially in areas where high technology is lacking.

Aims

To provide mapping of HPV prevalence in Southeast Asia and to determine the effectivity of p16 as a surrogate biomarker for HPV infection in oral and oropharyngeal cancer.

Methods

Medical records of 56 patients diagnosed with oral and oropharyngeal squamous cell carcinomas (SCC) were reviewed. HPV PCR DNA and p16 immunohistochemistry (IHC) examination were performed to detect HPV positivity.

Results

HPV PCR prevalence in oropharyngeal SCC is 42.9% and 28.6% in oral SCC. P16 IHC has 67% sensitivity and 75% specificity in detecting HPV in oropharyngeal cancer, and 33% and 72% in oral cancer.

Conclusion

We conclude that p16 IHC with a 5% cut-off can be used as a surrogate biomarker for oropharyngeal SCC, but not oral SCC, in areas where resources are restricted. However, further diagnostic tools may be needed.

Chinese abstract

背景：HPV相关的口腔和口咽癌的病例正在增加。需要使用适当的诊断工具来检测患者的HPV, 尤其是在缺乏高科技的地区。

目的：提供东南亚地区HPV流行情况的图谱, 并确定p16作为口腔和口咽癌HPV感染的替代生物标记物的有效性。

方法：回顾性分析了56例诊断为口腔和口咽鳞状细胞癌（SCC）的患者的病历。进行了HPV PCR DNA和p16免疫组化（IHC）检查以检测是否HPV阳性。

结果：口咽SCC中HPV PCR的患病率为42.9%, 口腔SCC中HPV PCR的患病率为28.6％。 P16 IHC对检测口咽癌HPV, 有67％的敏感性和75％的特异性；口腔癌的相应比率为33％和72％。

结论：我们得出的结论是, 在资源有限的地区, 5%截止的p16 IHC可以用作口咽SCC而非口腔SCC的替代生物标志物。但是, 可能还需要其它诊断工具。

Keywords:

• Oral cancer
• oropharyngeal cancer
• HPV
• p16

Disclosure statement

No potential conflict of interest was reported by the authors.