Association between p53 and human papillomavirus in head and neck cancer survival

Elaine M Smith; Donghong Wang; Linda M Rubenstein; William A Morris; Lubomir P Turek; Thomas H Haugen

doi:10.1158/1055-9965.EPI-07-2597

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Association between p53 and human papillomavirus in head and neck cancer survival

Journal article

Open access

Peer reviewed

Association between p53 and human papillomavirus in head and neck cancer survival

Elaine M Smith, Donghong Wang, Linda M Rubenstein, William A Morris, Lubomir P Turek and Thomas H Haugen

Cancer epidemiology, biomarkers & prevention, Vol.17(2), pp.421-427

02/2008

DOI: 10.1158/1055-9965.EPI-07-2597

PMID: 18268127

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Abstract

High-risk human papillomavirus (HPV-HR) is a significant risk factor for head and neck cancer (HNC), abrogating normal p53 function. In addition, HPV and p53 have been associated with prognosis of these tumors but the findings have been inconsistent. We examined p53 expression and HPV-HR individually and jointly for differences in predicting HNC survival. HNC patients (n = 294) were evaluated for p53 by immunohistochemical staining. HPV was detected by PCR/dot blot hybridization and sequencing. HNC tumors showed 48% with p53 overexpression and 27% with HPV-HR. Multivariate analyses showed that p53 positivity was significantly associated with higher risk of disease-specific [hazard ratio (HR); 2.0; 95% confidence interval (95% CI), 1.1-3.7] and recurrence-free mortality (HR, 2.8; 95% CI, 1.4-5.3). HPV- cases had significantly worse disease-specific survival (HR, 2.8; 95% CI, 1.3-6.3) compared with HPV-HR cases. When analyzed jointly, with p53(-)/HPV-HR tumors as the reference group, p53(+)/HPV(-) patients had the worst disease-specific (HR, 5.3; 58% versus 15%, P = 0.006) and recurrence-free survival rates (HR, 9.5; 17% versus 89%, P = 0.001), in contrast to the p53(-)/HPV(-) and p53(+)/HPV-HR groups, which had less elevated and different risks for disease-specific survival (HR, 2.5 and 1.7, respectively) and recurrence-free survival (HR, 4.2 and 7.2, respectively). Joint assessment of p53/HPV status provides different HRs for each clinical outcome in the four biomarker groups that are distinct from the individual biomarkers. These findings suggest that joint assessment of p53/HPV provides a better indicator of prognosis and potentially different types of treatments.

Papillomavirus Infections - complications

Head and Neck Neoplasms - virology

Prognosis

Humans

Middle Aged

Risk Factors

Proportional Hazards Models

Logistic Models

Male

Tumor Suppressor Protein p53 - genetics

Human papillomavirus 16 - isolation & purification

Survival Analysis

Female

Head and Neck Neoplasms - genetics

Neoplasm Recurrence, Local - genetics

Biomarkers, Tumor - genetics

Head and Neck Neoplasms - mortality

Human papillomavirus 16 - genetics

Details

Title: Subtitle: Association between p53 and human papillomavirus in head and neck cancer survival
Creators: Elaine M Smith - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. elaine-smith@uiowa.edu
Donghong Wang
Linda M Rubenstein
William A Morris
Lubomir P Turek
Thomas H Haugen
Resource Type: Journal article
Publication Details: Cancer epidemiology, biomarkers & prevention, Vol.17(2), pp.421-427
Publisher: United States
DOI: 10.1158/1055-9965.EPI-07-2597
PMID: 18268127
ISSN: 1055-9965
eISSN: 1538-7755
Grant note: R01 15944 / PHS HHS R01 DE13110 / NIDCR NIH HHS R01 DE11979 / NIDCR NIH HHS
Language: English
Date published: 02/2008
Academic Unit: Epidemiology; Pathology; Otolaryngology; Internal Medicine
Record Identifier: 9984047784502771

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