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BACKGROUND: The presence of human papillomavirus (HPV), the HPV type and viral load in early stage cervical carcinoma were investigated in order to elucidate whether any of these factors were important for clinical outcome. PATIENTS AND METHODS: Twelve patients who were disease-free 5 years after diagnosis were matched and compared with 12 patients who died within 2 years. The presence of HPV, HPV type and viral load in their tumours was examined by PCR. RESULTS: The distribution and load of HPV was similar in the 2 patient groups. HPV-16 was, however, significantly more common in tumours of the surviving patients than in those of patients who died (88.9% and 18.2%, respectively, p = 0.0152). CONCLUSION: HPV-16 was significantly more common in early stage carcinomas of patients surviving more than 5 years in comparison to early stage carcinomas of patients with a poor prognosis.

The aim of this thesis was to confirm the presence of human papillomavirus (HPV) in tonsillar cancer and the previous finding that presence of HPV in tonsillar cancer is prognostic favorable for patient survival. Furthermore, the physical state and viral load of HPV in tonsillar cancer, and the influence of HPV on chromosomal patterns and on the clinical outcome for tonsillar cancer patients were examined. In addition, the presence of HPV in tongue cancer and influence of HPV on clinical outcome for tongue cancer patients were studied. Finally, the presence of HPV, viral load and proliferation rate were determined in recurrent respiratory papillomatosis in response to Interferon-alpha treatment. It was shown that HPV was present in 62.2% of examined tonsillar cancer and HPV was shown to be a favorable prognostic factor. Furthermore, the viral genome was shown to be mainly episomal, hence integration of the viral genome was not a requisite for malignant transformation. Quantification of I-IPV16 was performed by real-time quantitative PCR. The viral load was shown to vary greatly and patients with a higher viral load in their tumors had a significantly better disease specific survival than patients with a lower viral load. The pattern of chromosomal aberrations in tonsillar cancer was examined by comparative genomic hybridization. Generally, more aberrations were seen in HPV negative tumors compared to HPV positive tumors. In addition, there were specific differences between HPV positive and HPV negative tonsillar cancers. Gain of chromosome 3q was statistically more common in the HPV positive versus negative tonsillar tumors, while gain of chromosome 7 was more common in HPV negative tumors. Survival could not be correlated to gain or loss of any specific chromosome since there were too few cases in each group, however, HPV was a prognostic favorable factor. HPV was found in 40% of examined base of tongue cancer patients and patients with HPV positive tumors had a si

The frequency of human papilloma virus (HPV) and its influence on clinical outcome was analyzed retrospectively in pre-treatment paraffin embedded biopsies from 110 patients with tongue cancer. The presence of HPV DNA was examined in 85 mobile tongue tumors and 25 base of tongue tumors by a polymerase chain reaction (PCR) with 2 general primer pairs, GP5+/6+ and CPI/IIG. When HPV-DNA was found, HPV-type specific primers and direct sequencing were used for HPV sub-type verification. Twelve of 110 (10.9%) samples were HPV-positive; 9 for HPV-16, 1 for HPV-33, 1 for HPV-35 and 1 could not be analyzed because of shortage of DNA. HPV was significantly more common in base of tongue tumors (10/25, 40.0%) compared to tumors of the mobile tongue (2/85, 2.3%). The influence of HPV on clinical outcome in mobile tongue cancer could not be studied, due to that HPV was present in too few cases. Of the 19 patients with base of tongue cancer that were included in the survival analysis, however, 7 patients with HPV-positive base of tongue cancer had a significantly favorable 5-year survival rate compared to the 12 HPV-negative patients. In conclusion, HPV is significantly more common in base of tongue cancer than in mobile tongue cancer, and has a positive impact on disease-specific survival in patients with base of tongue cancer.

The purpose of this article is to review the current knowledge on the status and significance of human papillomavirus (HPV) in tonsillar cancer. Current data in scientific reports and data from the Karolinska Hospital and Karolinska Institute, Sweden, demonstrate that approximately half of all tonsillar cancer is HPV-positive. Moreover, patients with HPV-positive cancer have a lower risk of relapse and longer survival compared to patients with HPV-negative tonsillar cancer. The favourable outcome for patients harbouring HPV-positive tonsillar cancer cannot be attributed to increased radiosensitivity, since there is no significant difference in sensitivity to radiotherapy between HPV-positive and -negative tonsillar cancer. However, HPV-positive cancer exhibits less genetic instability i.e. shows a lower degree of aneuploidy and a tendency to have fewer chromosomal aberrations, when compared to HPV-negative tonsillar cancer.