HPV infection in relation to OSCC histological grading and TNM stage. Evaluation by traditional statistics and fuzzy logic model

• Published in: Oral oncology 2006-07, Vol.42 (6), p.638-645
• Main Authors: Campisi, G., Giovannelli, L., Calvino, F., Matranga, D., Colella, G., Di Liberto, C., Capra, G., Leao, J.C., Lo Muzio, L., Capogreco, M., D’Angelo, M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Cross-Sectional Studies; Female; Fuzzy Logic; Grading; HPV-DNA; Human papillomavirus; Humans; Male; Middle Aged; Models, Biological; Mouth Neoplasms - epidemiology; Mouth Neoplasms - pathology; Mouth Neoplasms - virology; Multivariate Analysis; OSCC; Papillomavirus Infections - epidemiology; Papillomavirus Infections - pathology; Stage; TNM
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2005.11.007

We aimed to evaluate if in oral squamous cell carcinoma (OSCC) there is a relationship between histological grading (HG), TNM clinical stage and HPV infection; and to study the performance of fuzzy logic compared to traditional statistics, in the analysis of HPV status and correlates of OSCC. In cross-sectional analysis, the study group comprised 63 patients (mean age 68.89 years (SD ± 11.78), range (32–93); males 28 (44.4%), females 35 (55.6%)) with OSCC histologically diagnosed. HPV-DNA was studied in exfoliated oral epithelial cells by nested PCR (MY09/MY11 and GP5+/GP6+ primers). Data were analysed in parallel by traditional statistics with multivariate analysis and a fuzzy logic (FL) technique (membership functions as input, the ANFIS methodology, and the Sugeno’s model of first order). HPV infection was detected in 24/63 (38.1%) of OSCC, as being HPV+ve 14/36 (38.9%) in G1, 7/18 (38.9%) in G2, and 3/9 (33.3%) in G3; HPV+ve 8/33 (24.2%) in Stage I, 9/12 (75.0%) in Stage II, 6/11(54.5%) in Stage III, and 1/7 (14.3%) in Stage IV. In both methods of analysis, no significantly increased risk of HPV infection was found for any HG score; whereas, TNM stage II was significantly associated to HPV infection ( p = 0.004; OR = 9.375 (95% CI = 2.030:43.30); OR′ = 11.148 (95% CI = 1.951:43.30)), and, in particular, to primary tumour size T2 ( p = 0.0036; OR = 7.812 (95% CI = 1.914:31.890); OR′ = 9.414 (95% CI = 1.846:48.013)); FL (% of prevision: 79.8; Root Mean-Square Error (RMSE): 0.29). No association was found between HPV infection and any demographical variable. Our findings show an association between HPV infection with TNM (stage II – T2), but not with histological grading of OSCC. Also, FL seems to be an additional effective tool in analysing the relationship of HPV infection with correlates of OSCC.