Prognostic Significance of p16 in Squamous Cell Carcinoma of the Larynx and Hypopharynx

• Published in: American journal of otolaryngology 2017-01, Vol.38 (1), p.31-37
• Main Authors: Meshman, Jessica, M.D, Wang, Pin-Chieh, Ph.D, Chin, Robert, M.D., Ph.D, John, Maie St., M.D., Ph.D, Abemayor, Elliot, M.D., Ph.D, Bhuta, Sunita, M.D, Chen, Allen M., M.D
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biomarkers; Biopsy; Cancer therapies; Carcinoma, Squamous Cell - genetics; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - virology; Chemotherapy; Cohort Studies; Databases, Factual; Deoxyribonucleic acid; Disease-Free Survival; DNA; Female; Gene Expression Regulation, Neoplastic; Genes, p16; Head & neck cancer; Human papillomavirus; Humans; Hybridization; Hypopharyngeal Neoplasms - genetics; Hypopharyngeal Neoplasms - mortality; Hypopharyngeal Neoplasms - virology; Kaplan-Meier Estimate; Laryngeal Neoplasms - genetics; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - virology; Larynx; Male; Medical imaging; Medical prognosis; Middle Aged; Neoplasm Invasiveness - pathology; Neoplasm Staging; Otolaryngology; Papillomaviridae - genetics; Papillomavirus Infections - mortality; Papillomavirus Infections - pathology; Papillomavirus Infections - physiopathology; Pathology; Patients; Predictive Value of Tests; Prognosis; Radiation therapy; Retrospective Studies; Sensitivity and Specificity; Studies; Surgery; Survival Analysis; Tobacco
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2016.09.007

Abstract Purpose To evaluate the prognostic significance of p16 expression among patients with squamous cell carcinoma of the larynx (LSCC) and hypopharynx (HSCC). Methods The medical records of all patients with locally advanced, non-metastatic LSCC/HSCC were reviewed. p16INK4A (p16) protein expression was evaluated on pathological specimens by immunohistochemistry (IHC), and the Kaplan–Meier method was used to estimate overall survival (OS) and locoregional control (LRC). In select cases, p16 expression was correlated to high-risk and low-risk HPV genotypes using in situ hybridization (ISH). Results Thirty-one patients (23 LSCC; 8 HSCC) were identified. Seventeen (54.8%) patients were p16 negative; 14 (45.2%) were p16-positive. The primary treatment modality was radiation therapy for 22 (71.0%) patients and surgery for 9 (29.0%). Nineteen (61.3%) patients were evaluated for high-risk HPV and low-risk HPV genotypes by IHC, of whom 2 (10.5%) patients were positive for high-risk HPV and 1 (5.3%) was positive for low-risk HPV. For high-risk HPV, the positive predictive value (PPV), sensitivity, and specificity of p16 was 20.0%, 100%, and 52.9%. There was no significant difference in the 2-year actuarial rates of OS (91% vs. 64%, p = 0.34) or LRC (51% vs. 46%, p = 0.69) between the p16-positive and p-16 negative patients. Conclusion In this small cohort of 31 LSCC and HSCC patients, p16 was not a significant predictive of either LRC or OS. Furthermore, p16 was poorly correlated with HPV genotyping as identified by ISH.