Human Papillomavirus Infection and p53 Expression in Oral Squamous Cell Carcinoma

Abstract

Objectives:

Determine the human papillomavirus (HPV) infection and p53 protein expression in oral squamous cell carcinoma (OSCC) and their correlation with patient overall survival (OS) and disease-free survival (DFS).

Methods:

HPV general and type specific 16 and 18 were investigated by means of PCR. P53 protein overexpression was investigated by means of immunohistochemistry. Results of HPV association and p53 overexpression were evaluated in relation to different clinicopathological parameters and survival.

Results:

Out of 140 patient samples HPV was detected in 95 (68%) cases, out of which 85 (90%) were associated with HPV16, 2 (2%) were associated with HPV 18, 2 (2%) were co-infected (with HPV 16 and 18), and 6 (6%) were positive for HPV by the general primer and could not be type specified. HPV positive patients had comparatively prolonged OS when compared with HPV-negative patients, but this difference was not statistically significant (P = .97). Furthermore, overexpression of p53 protein was observed in 75 patients (54%) using a threshold of 10% stained tumor nuclei. Patients with p53 negative tumors had improved OS when compared with patients with p53 positive tumors. This difference was statistically significant (P = .036) in univariate Cox regression analysis; however, it lost its worth in the multivariate analysis.

Conclusions:

Our study found a high prevalence of HPV (type 16) in OSCC of Pakistani patients with male sex showing significant correlation with HPV. However, we did not find a statistically significant favorable association between p53 overexpression, HPV, survival, and histologic variables.