ABSTRACT
CONCLUSION: Our results indicate that viral load may serve as an independent prognostic indicator for patients with HPV-16-associated squamous cell carcinoma of the tonsil. OBJECTIVE: HPV-16 has gained increasing attention as a possible causative agent for squamous cell carcinoma of the tonsil. Recent reports have indicated that the viral load within the tumor, along with other factors, may be correlated to the patient survival. In this study, we sought to examine HPV-16 viral load as an independent prognostic indicator. PATIENTS AND METHODS: DNA was extracted from 35 tonsil carcinoma samples and the viral load was determined by real-time PCR. The patients were divided into four groups according to HPV-16 viral load. The correlation between viral load and recurrence, disease-free survival, and overall survival was assessed. RESULTS: We found that HPV-positive patients with the highest viral loads had improved overall and disease-free survival. Recurrences of squamous cell carcinoma were significantly less likely to occur with increasing viral load.
Subject(s)
Carcinoma, Squamous Cell/virology , Human papillomavirus 16 , Papillomavirus Infections/virology , Tonsillar Neoplasms/virology , Viral Load , Adult , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/pathology , Disease-Free Survival , Female , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/virology , Neoplasm Staging , Papillomavirus Infections/mortality , Papillomavirus Infections/pathology , Polymerase Chain Reaction , Prognosis , Survival Rate , Tonsillar Neoplasms/mortality , Tonsillar Neoplasms/pathologyABSTRACT
The presence of tumor-infiltrating lymphocytes has been shown to significantly improve clinical outcomes in many types of cancer. However; their effects on outcomes in patients with oropharyngeal cancer specifically have yet to be elucidated. We conducted a retrospective study in an effort to shed light on this issue. We reviewed the records of 48 consecutively presenting patients with oropharyngeal cancer; and we performed immunohistochemistry to analyze their archived paraffin-embedded tissue samples for the presence of CD3-positive tumor-infiltrating lymphocytes. We also used real-time polymerase chain reaction testing to look for human papillomavirus type 16 (HPV-16) in the tumors. We found that patients with large numbers of tumor-infiltrating lymphocytes (CD3high) had a significantly lower incidence of metastasis at presentation than did those with low numbers of tumor-infiltrating lymphocytes (CD31low) (40.0 vs. 88.5%; p = 0.001), regardless of HPV status. When HPV status was taken into account, the correlation between a high CD3 count and a lower rate of metastasis was maintained in the HPV-positive patients but not in the HPV-negative patients. We also found that the CD3high patients had higher rates of overall survival and disease-free survival at 3 and 5 years than did the CD3low patients; however; these differences only approached but did not reach statistical significance.
