Head and neck squamous cell carcinomas in HIV-positive patients: A preliminary investigation of viral associations

Michael S. McLemore, Missak Haigentz, Richard V. Smith, Gerard J. Nuovo, Llucia Alos, Antonio Cardesa, Margaret Brandwein-Gensler

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60%) men and 16 (40%) women. The larynx was most commonly involved (65%, n = 26); followed by the oropharynx (22.5%, n = 9). Four carcinomas arose from the oral cavity (10%) and one from the nasal cavity (2.5%). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5%) than the control group (27/102, 26%, p 0.001, chi-square). HPV was detected in 6 of 25 (24%) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83%) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3%) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24% of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.

Original languageEnglish (US)
Pages (from-to)97-105
Number of pages9
JournalHead and Neck Pathology
Volume4
Issue number2
DOIs
StatePublished - Jun 2010

Fingerprint

HIV
Human Herpesvirus 8
Neoplasms
Human Herpesvirus 4
Human Herpesvirus 2
Human Herpesvirus 1
Control Groups
Oropharynx
Carcinoma, squamous cell of head and neck
Virus Diseases
Giant Cells
Human Immunodeficiency Virus nef Gene Products
nef Gene Products
Viruses
Carcinoma
Polymerase Chain Reaction
Oncogenic Viruses
Human papillomavirus 16
Nasal Cavity
Opportunistic Infections

Keywords

  • AIDS
  • HIV
  • HNSCC
  • HPV
  • Squamous carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Oncology
  • Otorhinolaryngology

Cite this

Head and neck squamous cell carcinomas in HIV-positive patients : A preliminary investigation of viral associations. / McLemore, Michael S.; Haigentz, Missak; Smith, Richard V.; Nuovo, Gerard J.; Alos, Llucia; Cardesa, Antonio; Brandwein-Gensler, Margaret.

In: Head and Neck Pathology, Vol. 4, No. 2, 06.2010, p. 97-105.

Research output: Contribution to journalArticle

McLemore, Michael S. ; Haigentz, Missak ; Smith, Richard V. ; Nuovo, Gerard J. ; Alos, Llucia ; Cardesa, Antonio ; Brandwein-Gensler, Margaret. / Head and neck squamous cell carcinomas in HIV-positive patients : A preliminary investigation of viral associations. In: Head and Neck Pathology. 2010 ; Vol. 4, No. 2. pp. 97-105.
@article{04d636fe9dd146938d0b856263d25728,
title = "Head and neck squamous cell carcinomas in HIV-positive patients: A preliminary investigation of viral associations",
abstract = "Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60{\%}) men and 16 (40{\%}) women. The larynx was most commonly involved (65{\%}, n = 26); followed by the oropharynx (22.5{\%}, n = 9). Four carcinomas arose from the oral cavity (10{\%}) and one from the nasal cavity (2.5{\%}). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5{\%}) than the control group (27/102, 26{\%}, p 0.001, chi-square). HPV was detected in 6 of 25 (24{\%}) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83{\%}) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3{\%}) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24{\%} of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.",
keywords = "AIDS, HIV, HNSCC, HPV, Squamous carcinoma",
author = "McLemore, {Michael S.} and Missak Haigentz and Smith, {Richard V.} and Nuovo, {Gerard J.} and Llucia Alos and Antonio Cardesa and Margaret Brandwein-Gensler",
year = "2010",
month = "6",
doi = "10.1007/s12105-010-0171-9",
language = "English (US)",
volume = "4",
pages = "97--105",
journal = "Head and Neck Pathology",
issn = "1936-055X",
publisher = "Humana Press",
number = "2",

}

TY - JOUR

T1 - Head and neck squamous cell carcinomas in HIV-positive patients

T2 - A preliminary investigation of viral associations

AU - McLemore, Michael S.

AU - Haigentz, Missak

AU - Smith, Richard V.

AU - Nuovo, Gerard J.

AU - Alos, Llucia

AU - Cardesa, Antonio

AU - Brandwein-Gensler, Margaret

PY - 2010/6

Y1 - 2010/6

N2 - Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60%) men and 16 (40%) women. The larynx was most commonly involved (65%, n = 26); followed by the oropharynx (22.5%, n = 9). Four carcinomas arose from the oral cavity (10%) and one from the nasal cavity (2.5%). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5%) than the control group (27/102, 26%, p 0.001, chi-square). HPV was detected in 6 of 25 (24%) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83%) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3%) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24% of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.

AB - Oncogenic human papillomaviruses (HPVs) are associated with oropharyngeal squamous cell carcinoma (SCC). Infection with human immunodeficiency virus (HIV) increases susceptibility to opportunistic infections and viral-promoted cancers. The prevalences of HPV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and human herpesvirus-8 (HHV-8) have not been established for head and neck squamous cell carcinoma in HIV-positive patients (HIV+ HNSCC). We have observed that HIV+ HNSCC tend to contain numerous multinucleated tumor giant cells, this finding has not been described previously. The goal of this study is to test for these oncogenic viruses in a small cohort of retrospectively identified patients with HIV infection, and to compare histologically these cancers to a control group of HNSCC patients. Tumors were reviewed histologically and compared to a control group of 102 patients with HNSCC (serologically untyped or HIV negative). Polymerase chain reaction (PCR) was performed on formalin-fixed, paraffin-embedded HIV+ HNSCC samples from combined 25 patients in two institutions. In situ hybridization was performed to identify EBV (EBER) and immunohistochemistry was performed to detect HSV-1, HSV-2, HHV-8, and HIV-related proteins (Nef, p24). The study sample consisted of 34 HIV+ patients with HNSCC from Montefiore Medical Center, and six HIV+ HNSCC patients from Hospital Clinic, University of Barcelona; 24 (60%) men and 16 (40%) women. The larynx was most commonly involved (65%, n = 26); followed by the oropharynx (22.5%, n = 9). Four carcinomas arose from the oral cavity (10%) and one from the nasal cavity (2.5%). Histologically, multinucleated tumor giant cells were more common in the HIV+ group (39/40, 97.5%) than the control group (27/102, 26%, p 0.001, chi-square). HPV was detected in 6 of 25 (24%) HNSCC tumors by PCR, five were typed as HPV 16 and one as HPV 26/69; five of these tumors (83%) were located in the oropharynx. EBV, HSV-1, HSV-2, and HHV-8 were detected only infrequently in tumor cells. Nef protein was detected in tumor cells in 7 of 21 (33.3%) cases; p24 was not detectable in 6 tumors studied. There were no significant associations between HPV positive tumors and co-infections with other viruses. This study is consistent with other reports that suggest an increased incidence of laryngeal carcinoma for HIV+ patients. HPV was detected in 24% of HIV+ HNSCC, however, the number of tumors with amplifiable DNA (n = 25) is too small to allow for conclusions. EBV, HSV-1, HSV-2, and HHV-8 are uncommon in HIV+ HNSCC; it is unlikely that these viruses have a promoting effect. MNTCG are significantly common in HIV+ HNSCC, but there is overlap in MNTCG counts with the control group and therefore this finding cannot be used as a biomarker of HIV infection.

KW - AIDS

KW - HIV

KW - HNSCC

KW - HPV

KW - Squamous carcinoma

UR - http://www.scopus.com/inward/record.url?scp=77953082599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953082599&partnerID=8YFLogxK

U2 - 10.1007/s12105-010-0171-9

DO - 10.1007/s12105-010-0171-9

M3 - Article

C2 - 20333562

AN - SCOPUS:77953082599

VL - 4

SP - 97

EP - 105

JO - Head and Neck Pathology

JF - Head and Neck Pathology

SN - 1936-055X

IS - 2

ER -