Human papillomavirus and Epstein-Barr virus in nasopharyngeal carcinoma in a low-incidence population

Head Neck. 2014 Apr;36(4):511-6. doi: 10.1002/hed.23318. Epub 2013 Jun 18.

Abstract

Background: The significance of human papillomavirus (HPV) in nasopharyngeal carcinomas (NPCs) in a low-incidence population remains unknown.

Methods: Samples from 90 patients with NPC (years, 1957-2012) were analyzed for Epstein-Barr virus (EBV). Clinical data, EBV, HPV, and p16 status were correlated with overall survival (OS; 63 cases; years, 1981-2012).

Results: Of 9 HPV-positive cases, 3 extended from extra-nasopharyngeal sites. Nasopharyngeal origin was confirmed in 6 cases. HPV-positive NPC had OS similar to EBV-positive NPC (85 vs 141 months; p > .05). The OS of patients with EBV/HPV-negative NPC was worse (34 months; p = .004). Nonkeratinizing histology was associated with better outcome than keratinizing (115 vs 25 months; p = .001). Over the last several decades, the proportion of keratinizing NPC decreased from 34.5% to 14.3% (p = .026).

Conclusion: The etiologic role of HPV in NPC is confirmed. The favorable prognostic significance of HPV positivity is similar to that of EBV positivity.

Keywords: Epstein-Barr virus; human papillomavirus; nasopharyngeal carcinoma.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / mortality
  • Carcinoma / virology*
  • Epstein-Barr Virus Infections / epidemiology
  • Female
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / virology*
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / epidemiology
  • Pennsylvania / epidemiology
  • Prevalence
  • Washington / epidemiology
  • Young Adult