HPV associated HNSCC
HPV infection is a known risk factor for a subset of head and neck squamous cell carcinomas (HNSCC). HNSCC refers to cancers that arise in the squamous cells lining the mucosal surfaces of the head and neck region, including the oral cavity, oropharynx, larynx, and hypopharynx.93-103 HPV-associated HNSCC primarily involves the oropharynx, which includes the tonsils, base of the tongue, and the soft palate. The most prevalent HPV types associated with HNSCC are HPV16 and, to a lesser extent, HPV18. These high-risk HPV types are known to have oncogenic potential and can contribute to the development of cancer.100-103 The incidence of HPV-related HNSCC has been increasing over the past few decades, particularly in younger individuals and those without traditional risk factors such as tobacco and alcohol use. It is estimated that approximately 70-80% of oropharyngeal cancers are associated with HPV infection.100-104
HPV-associated HNSCC is primarily linked to sexual transmission, particularly through oral-genital contact. It has been suggested that performing oral sex on an HPV-infected individual may increase the risk of acquiring HPV infection in the oral cavity and subsequently developing HPV-related HNSCC.93-103
The oncogenic potential of HPV in HNSCC is mainly attributed to the expression of the viral oncoproteins E6 and E7. These oncoproteins interfere with cellular regulatory mechanisms, promoting uncontrolled cell growth, inhibiting cell cycle control, and evading immune responses. The disruption of tumor suppressor proteins, such as p53 and pRb, by HPV oncoproteins contributes to the malignant transformation of cells.102-104
HPV-related HNSCC often presents with distinct clinical and pathological characteristics compared to non-HPV-related HNSCC. Patients with HPV-associated tumors tend to be younger, have a better response to treatment, and have a more favorable prognosis compared to those with non-HPV-related HNSCC.100-103
HPV status in HNSCC is typically determined by detecting HPV DNA or by assessing the expression of specific viral proteins, such as p16. The presence of HPV in the tumor is associated with improved overall survival and disease-free survival rates in patients with HNSCC, particularly in oropharyngeal cancers. HPV status is considered an important prognostic factor and may influence treatment decisions.100,103
The treatment of HPV-related HNSCC follows similar principles as non-HPV-related HNSCC. Treatment options may include surgery, radiation therapy, chemotherapy, or a combination of these modalities, depending on the stage and extent of the disease. HPV-positive tumors may have a better response to treatment and may require less aggressive therapy compared to HPV-negative tumors.100,103,105