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Potential Implications for Treatment Choices

Pawadee Lohavanichbutr, MD; John Houck, BS; Wenhong Fan, PhD; Bevan Yueh, MD; Eduardo Mendez, MD; Neal Futran, MD; David R. Doody, MS; Melissa P. Upton, MD; D. Gregory Farwell, MD; Stephen M. Schwartz, PhD; Lue Ping Zhao, PhD; Chu Chen, PhD

Arch Otolaryngol Head Neck Surg. 2009;135(2):180-188.

Objective  To study the difference in gene expression between human papillomavirus (HPV)–positive and HPV-negative oral cavity and oropharyngeal squamous cell carcinoma (OSCC).

Design  We used Affymetrix U133 plus 2.0 arrays to examine gene expression profiles of OSCC and normal oral tissue. The HPV DNA was detected using polymerase chain reaction followed by the Roche LINEAR ARRAY HPV Genotyping Test, and the differentially expressed genes were analyzed to examine their potential biological roles using the Ingenuity Pathway Analysis Software, version 5.0.

Setting  Three medical centers affiliated with the University of Washington.

Patients  A total of 119 patients with primary OSCC and 35 patients without cancer, all of whom were treated at the setting institutions, provided tissues samples for the study.

Results  Human papillomavirus DNA was found in 41 of 119 tumors (34.5%) and 2 of 35 normal tissue samples (5.7%); 39 of the 43 HPV specimens were HPV-16. A higher prevalence of HPV DNA was found in oropharyngeal cancer (23 of 31) than in oral cavity cancer (18 of 88). We found no significant difference in gene expression between HPV-positive and HPV-negative oral cavity cancer but found 446 probe sets (347 known genes) differentially expressed in HPV-positive oropharyngeal cancer than in HPV-negative oropharyngeal cancer. The most prominent functions of these genes are DNA replication, DNA repair, and cell cycling. Some genes differentially expressed between HPV-positive and HPV-negative oropharyngeal cancer (eg, TYMS, STMN1, CCND1, and RBBP4) are involved in chemotherapy or radiation sensitivity.

Conclusion  These results suggest that differences in the biology of HPV-positive and HPV-negative oropharyngeal cancer may have implications for the management of patients with these different tumors.

Author Affiliations: Programs in Epidemiology (Drs Lohavanichbutr, Mendez, Schwartz, Zhao, and Chen and Messrs Houck and Doody) and Biostatistics and Biomathematics (Drs Fan and Zhao), Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Minneapolis (Dr Yueh); Surgery and Perioperative Care Service, Veterans Affairs Puget Sound Health Care System, Seattle (Dr Mendez); Departments of Otolaryngology–Head and Neck Surgery (Drs Mendez, Futran, and Chen), Pathology (Dr Upton), and Epidemiology (Drs Schwartz and Chen), University of Washington, Seattle; and Department of Otolaryngology–Head and Neck Surgery, University of California, Davis (Dr Farwell).

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