HPV DNA/RNA detection in various oral and oropharyngeal biomaterials identifies active HPV infections also in non-neoplastic tonsils

• Published in: Translational oncology Vol. 14; no. 2; p. 101002
• Main Authors: Quabius, Elgar Susanne, Tribius, Silke, Heinrichs, Alessa, Haaser, Dirk, Kühnel, André, Laudien, Martin, Hoppe, Florian, Mlynski, Robert, Ambrosch, Petra, Hoffmann, Markus
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2021; Neoplasia Press; Elsevier
• Subjects: Gargle; HPV; Original Research; p16INK4A; Surrogate marker; Swabs sputum; Tissue; Tonsils; TSCC; Tissue; TSCC; Surrogate marker; Tonsils; Gargle; Swabs sputum; p16INK4A; HPV; p16(INK4A)
• ISSN: 1936-5233; 1936-5233
• DOI: 10.1016/j.tranon.2020.101002

•Fist study analysing tissue, brushes and sputum for all patients also for viral mRNA.•HPV detection performed in brushes/sputum inconsistently reflect tissue HPV status.•In terms of virus activity, p16 seems insufficient to predict tissue HPV status.•E6-mRNA analysis detects active HPV infection in non-neoplastic tonsillar tissues.•Data gives rise to the question whether tonsillectomy might prevent TSCC. Previous studies describe a correlation between HPV-positivity and non-smoking in TSCC; p16INK4A-expression as surrogate-marker for HPV-DNA/RNA-positivity is discussed controversially. In the present study, these parameters are assessed prospectively. HPV-status of sputum and tonsillar-swabs was analyzed to determine their validity as surrogate-marker for tissue-HPV-status. TSCC- (n = 52) and non-neoplastic tonsillar tissue (n = 163) were analyzed. HPV-DNA- and HPV-RNA-status of total sputum, cellular fraction and supernatants, tonsillar-swabs and -tissue was determined by (RT)-PCR. Immunohistochemistry determined p16INK4A-expression. 23/163 (14.2%) non-neoplastic tonsils were HPV-DNA-positive; five patients (3 HPV16, 2 HPV11) had active HPV-infections (HPV-RNA-positive), in all biomaterials. 140/163 (85.9%) patients were either HPV-DNA-positive or HPV-DNA-negative in all samples. 21/52 (40.4%) TSCC-tonsils were HPV-DNA-positive; 17 patients were HPV-RNA-positive (14 HPV16; 4 HPV18). 40/52 (76.9%) TSCC-patients were congruent in all biomaterials. p16INK4A-expression alone would have misclassified the HPV-status of 14/52 (26.2%) TSCC-patients. This prospective study confirms the discrepancy between HPV-status and p16INK4A-expression and the significant correlation between non-smoking and HPV-DNA-positivity. HPV-sputum- and/or swab-results do not consistently match tissue-results, possibly having (detrimental) consequences if those were used to assess tissue-HPV-status. In the 5 patients with active HPV infection in the non-neoplasitic tonsils, tonsillectomy likely prevented subsequent development of TSCC.