Human papillomavirus and oropharynx cancer: Biology, detection and clinical implications

Authors

  • Clint T. Allen MD,

    Corresponding author
    1. Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
    • Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, Campus Box 8115, 660 South Euclid Avenue, St. Louis, MO 63110
    Search for more papers by this author
  • James S. Lewis Jr. MD,

    1. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
    Search for more papers by this author
  • Samir K. El-Mofty DMD, PhD,

    1. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
    Search for more papers by this author
  • Bruce H. Haughey MBChB,

    1. Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
    Search for more papers by this author
  • Brian Nussenbaum MD

    1. Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.
    Search for more papers by this author

  • This research did not received any financial support.

    The authors have no conflicts of interest to disclose.

Abstract

Objectives:

To review evidence for the role of human papillomavirus (HPV) in the etiology of oropharyngeal cancers, methods of viral detection, and the resulting clinical implications.

Study Design:

Contemporary review.

Methods:

Published journal articles identified through PubMed and conference proceedings were reviewed.

Results:

HPV-associated squamous cell carcinomas represent a distinct disease entity from carcinogen-associated squamous cell carcinomas. HPV oncoproteins lead to mucosal cell transformation through well-defined mechanisms. Different methods of detecting HPV exist with variable levels of sensitivity and specificity for biologically active virus. Although virus is detected in a number of head and neck subsites, studies demonstrate improved outcomes in HPV-associated carcinoma of the oropharynx only. The cell cycle regulatory protein p16 is upregulated by biologically active HPV and serves as a biomarker of improved response to therapy.

Conclusions:

HPV-associated squamous cell carcinoma of the oropharynx is a biologically distinct entity from carcinogen-associated carcinoma. Understanding the molecular mechanisms behind the improved outcomes in patients with HPV-associated oropharyngeal carcinoma may lead to novel therapeutics for patients with carcinogen-associated carcinomas. Laryngoscope, 2010

Ancillary