Koilocytosis Is Associated with Human PapilomaVirus Infection in Laryngeal Squamous Cell Carcinoma
FJ Bilbao, MC Etxezarraga, M Garmendia, J Bilbao, A Ugalde, A Gaafar, C Ereno. Hospital de Basurto, Osakidetza, Bilbao, Euskadi, Spain; Euskal Herriko Unibersitatea (EHU-UPV), Bilbao, Euskadi, Spain
Background: Human papiloma virus (HPV) is a pathogenic agent in some carcinomas, like those of the uterine cervix . Some head and neck squamous cell carcinomas (SCC) have also revealed infections by HPV . In these carcinomas, p16INK4A (p16) expression has been correlated with HPV infection. We have identified koilocytosis in some infiltrating laryngeal SCC (LSCC), similar to the observed cytopatic effect of HPV on cervix. We have evaluated whether this effect is related to HPV infection and p16 expression.
Design: Forty-five biopsies corresponding to 30 infiltrating LSCC were analyzed during 2007 in our laboratory. All cases were evaluated for koilocytosis and for p16 expression, with immunostaining scored as positive (diffuse cytoplasmatic and nuclear or focally intense) or negative if none or few isolated cells showed positivity. All cases were also evaluated for HPV viral DNA by PCR.
Results: Twenty-nine of 30 cases were men. Mean age was 63.2 12.2 years, with a five years difference between HPV-negative (65.1 13,4) and HPV-positive (60.3 10,2) LSCC. Koilocytosis was present in 14 (47%), while HPV was detected in 12 (40%) of the cases. All HPV subtypes were high risk, and type16 was the most frequent (60%). p16 expression was positive in 15 (50%) of the cases, out of which 7 were diffuse and 8 focal. Seventy-one per cent (10 of 14) of the LSCC with koilocytosis were HPV-positive. In contrast, 88% (14 of 16) of the LSCC not showing koilocytosis were HPV-negative. Seventy-five per cent (9 of 12) of the HPV-positive carcinomas showed p16 expression, and of those 100% (9 of 9) showed koilocytosis. Conversely, 67% (12 of 18) of the HPV-negative cancers lacked p16 immunoreactivity, and of those 75% (9 of 12) did not show koilocytosis. Here we report a sensitivity, specificity and concordance coefficient for koilocytosis and p16 expression of 83%, 78%, 0.595 and 75%, 67%, 0.400, respectively.
Conclusions: These data show not only that there is a relationship between koilocytosis and HPV status in LSCC, but also that koilocytosis correlates better than p16 expression with the presence of the HPV-DNA in LSCC, being more specific and sensitive. Koilocytosis may therefore serve as a surrogate marker that could replaced more expensive analysis, and help to define a biologically different tumor entity in LSCC.
Category: Head & Neck
Monday, March 9, 2009 1:00 PM
Poster Session II # 168, Monday Afternoon