Human Papillomavirus Is Rare and Does Not Correlate with p16INK4A Expression in Non-Small-Cell Lung Cancer in a Jordanian Subpopulation

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2024-04, Vol.60 (4), p.660
• Main Authors: Abu Al Karsaneh, Ola, Al Anber, Arwa, AlMustafa, Sahar, AlMa’aitah, Hussien, AlQadri, Batool, Igbaria, Abir, Tayem, Rama, Khasawneh, Mustafa, Batayha, Shaima, Saleh, Tareq, ALQudah, Mohammad, Sughayer, Maher
• Format: Article
• Language: English
• Subjects: Cyclin-dependent kinases; Ethanol; HPV; Human papillomavirus; immunohistochemistry; Infections; Jordan; Kinases; Lung cancer; NSCLC; Outdoor air quality; p16INK4a; Pathogenesis; Pathology; PCR; Proteins; Squamous cell carcinoma; Viral infections
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60040660

Background and Objectives: Human papillomavirus (HPV) was previously investigated in lung cancer with wide inter-geographic discrepancies. p16INK4a has been used as a surrogate for detecting high-risk HPV (HR-HPV) in some cancer types. This study assessed the evidence of HPV in non-small-cell lung cancer (NSCLC) among Jordanian patients, investigated the expression of p16INK4a, and evaluated its prognostic value and association with HPV status. Materials and Methods: The archived samples of 100 patients were used. HPV DNA detection was performed by real-time polymerase chain reaction (RT-PCR). p16INK4a expression was assessed by immunohistochemistry (IHC). The Eighth American Joint Committee on Cancer protocol (AJCC) of head and neck cancer criteria were applied to evaluate p16INK4a positivity considering a moderate/strong nuclear/cytoplasmic expression intensity with a distribution in ≥75% of cells as positive. Results: HPV DNA was detected in 5% of NSCLC cases. Three positive cases showed HR-HPV subtypes (16, 18, 52), and two cases showed the probable HR-HPV 26 subtype. p16INK4a expression was positive in 20 (20%) NSCLC cases. None of the HPV-positive tumors were positive for p16INK4a expression. A statistically significant association was identified between p16INK4a expression and the pathological stage (p = 0.029) but not with other variables. No survival impact of p16INK4a expression was detected in NSCLC cases as a group; however, it showed a statistically significant association with overall survival (OS) in squamous cell carcinoma (SqCC) cases (p = 0.033). Conclusions: This is the first study to assess HPV and p16INK4a expression in a Jordanian population. HPV positivity is rare in NSCLC among a Jordanian subpopulation. P16 INK4a reliability as a surrogate marker for HPV infection in lung cancer must be revisited.