HPV & Oral Cancer in Taiwan by Dr. Ken Liao Liu 劉耿僚

1. Human Papillomavirus and Oral Cancer in Taiwan Speaker: Ken-Liao Liu Instructors: Prof. Huei Lee, Ya-Wen Cheng Dec. 19, 2008.

18. Prevalence of HPV in Oral Cancer

20. HPV16: 68.2% 86.7% 69.2%

24. HPV appears to play an etiologic role in many cancers of the oropharynx and possibly a small subgroup of cancers of the oral cavity. The most common HPV type in genital cancers (HPV16) was also the most common in these tumors. The mechanism of transmission of HPV to the oral cavity warrants further investigation.

29. Am J Clin Pathol 2003; 120: 909-916

31. The positive rates : 75% (69/92) by nested PCR-based genechips , 53% (49/92) by overexpression of p16INK4A (ISH), 44% (40/92) by high-risk HPV (ISH) Both overexpression of P16INK4A and high-risk HPV (ISH) positivity were associated with favorable prognoses and also independent prognostic factors .

32. aDepartment of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan Oral Oncology,2008, 44(2), 174-179

36. 29 OSCC cases 29 controls In situ PCR ISH

38. Our Data:

40. Comparison of HPV16/18 prevalence in tumor sites of cases & controls. 4 (9.1%) 35 (46.1%) Oral Cavity 12 (26.1%) 14 (22.6%) Pharynx Control 16/90 Case 49/138 HPV16 or 18+

43. HPV vs Areca-chewing in cases & controls

44. HPV vs Areca-chewing in cancer cases Higher HPV16 + in Non-areca-chewing pharyngeal cancer

45. HPV v.s. P53 in oral cancers: Molecular Classification

46. p53 mutations in 25 /138

50. Joint assessment of p53 /HPV status : 4 biomarker subgroups

72. Clinical Implications of HPV vs HNSCC (OSCC) poorly differentiated Basaloid, advanced stage Histopathology ♂ ♂ =♀ Gender Less sensitive, poor prognosis Sensitive, better prognosis ( Less “field cancerization”) Treatment (R/T , C/T) older - 5 years younger Age ┼ ─ /┼ Tobacco/alcohol ─ ↑ p16 expression ─ ↓ Protein p53 & pRb Mutated Wild type TP53 & Rb1 genes Non-HPV related HPV related

73. Molecular Classification