Year: 2020
Type: preprint
Study design: Observational Study
Abstract: HNSCC is the sixth most common cancer worldwide and the seventh most common in Jamaica. Mortality rates for HNSCC in the Caribbean are among the highest in the world. Despite this there is no information on the molecular characterization of these cancers and the relative contribution of tobacco and HPV in this population. This study will examine the molecular features of HNSCC as it relates to p16 expression and HPV in patients from Jamaica. There were no previous published studies of this kind conducted in the English-speaking Caribbean.Methods: This retrospective cohort study was conducted using archival formalin-fixed paraffin-embedded tissue from patients diagnosed with HNSCC at the Department of Pathology, University of the West Indies and the National Public Health Laboratory from 2001–2010. Clinical information was extracted for all patients. P16 immunohistochemistry was performed using P16INK4A clone E6H4 mouse anti-human protein and identification of HR-HPV DNA was done by standard PCR using MY09/MY11 consensus primers of the L1 HR-HPV gene.Results: The study population consisted of 327 HNSCC cases with ages ranging from 18 to 92 years (mean, 65 yrs. ± 15 SD). There were 254 males and 63 females (10 unreported sex) with M: F ratio of 4:1. Most tumors were either moderately differentiated 147/327 (45%) or were poorly differentiated 55/327 (17%). This study cohort consisted of patients diagnosed with cancer of the larynx (57.5%), oral cavity (19.3%), other sites including lip, salivary gland and nasopharynx (14.7%) and oropharynx (8.6%). FFPE tissues from all cases were tested for p16; the majority 255/327 (78%) were negative and 71/327 (21.7%) were positive. All p16 + cases along with a subset of 60 randomly selected p16- cases were tested for HR-HPV by PCR. There were nine p16 + cases which were also positive for HR-HPV DNA. HPV 16 was detected in all cases, one case had HPV16 and 18, and another had HPV 16, 18, 39, 68 and 73. None of the sixty p16- cases were positive for HR-HPV. The nine patients that were HR-HPV + and p16 + had a mean age of 61 years ± 15 SD (range 39–83 years) with a M: F ratio of 8:1. All of these patients had moderately differentiated tumors, from oropharynx and larynx (44.4%) each and oral cavity (11.1%).Conclusion: In Jamaica, cancer of the larynx is the most common head and neck cancer. The prevalence of HPV-related HNSCC appears to be low with most patients with disease in non-oropharyngeal cancer sites. Based on what is known from the literature, our study results suggest that in Jamaica most patients are diagnosed with alcohol and tobacco driven disease. Interventions to reduce smoking and limit alcohol use are highly relevant in Jamaica. The role of HPV in HNSCC warrants further investigation in this population.
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4233361683