Predictive Markers and Cancer Prevention
Human papillomavirus positivity predicts favourable outcome for squamous carcinoma of the tonsil
Article first published online: 3 JUN 2003
Copyright © 2003 Wiley-Liss, Inc.
International Journal of Cancer
Volume 106, Issue 4, pages 553–558, 10 September 2003
How to Cite
Li, W., Thompson, C. H., O'Brien, C. J., McNeil, E. B., Scolyer, R. A., Cossart, Y. E., Veness, M. J., Walker, D. M., Morgan, G. J. and Rose, B. R. (2003), Human papillomavirus positivity predicts favourable outcome for squamous carcinoma of the tonsil. Int. J. Cancer, 106: 553–558. doi: 10.1002/ijc.11261
- Issue published online: 1 JUL 2003
- Article first published online: 3 JUN 2003
- Manuscript Accepted: 18 FEB 2003
- Manuscript Revised: 9 JAN 2003
- Manuscript Received: 18 SEP 2002
- tonsil cancer;
- cyclin D1;
Mutations in the p53 and retinoblastoma (pRb) pathways associated with the use of tobacco and alcohol are common in squamous cell carcinoma (SCC) of the head and neck. Cell cycle proteins are also affected by human papillomavirus (HPV), which may also have an aetiological role in cancers at particular sites, most notably the tonsil. Attempts to identify prognostic molecular markers in head and neck cancers have met with conflicting results, but few studies have been undertaken with tumours of known HPV status at a single anatomic site. In our study 86 tonsil cancers were analysed for HPV status by sequence analysis of polymerase chain reaction products and for the expression of cell cycle proteins (p53, p21CIP1/WAF1, pRb, p16INK4A, cyclin D1 and p27KIP1) by immunohistochemistry. The HPV status could be established in 67 of the tumours. Thirty-one (46%) of these were HPV-positive, predominantly (28/31) for HPV16. Findings were related to tumour recurrence and patient survival. None of the cell cycle proteins independently predicted recurrence or survival. Patients with HPV-positive tumours, however, were significantly less likely (p < 0.05) to have recurrence or to die of disease than those with HPV-negative tumours, after adjusting for the effects of the cell cycle proteins, clinical stage, pathological node status, tumour grade, age, gender and treatment. These findings support the concept that HPV-positive tonsil cancers may be a distinct biological group with less aggressive characteristics. Screening of tonsil cancers for HPV DNA may help optimise treatment and provide more accurate prognostic information. © 2003 Wiley-Liss, Inc.