HPV DETECTION USING HOT-START POLYMERASE CHAIN-REACTION IN PATIENTS WITH ORAL-CANCER - A CLINICOPATHOLOGICAL STUDY OF 64 PATIENTS

We examined the incidence of human papillomavirus (HPV) in intraoral c ancers from 64 patients as determined by the highly sensitive techniqu e of ''hot start'' polymerase chain reaction (PCR) in formalin-fixed p araffin-embedded tissues. Polymerase-chain-reaction-amplified HPV DNA was detected in the carcinomas of 16 patients (25%). The percentage of men in the HPV-positive (HPV+) group was greater than that in the HPV -negative (HPV-) group (86% versus 68%), but the difference was not st atistically significant. There was no intraoral site preference for th e HPV+ tumors. The mean age of viral-positive and -negative groups was similar (55 versus 53.8 yr). Three of 16 HPV+ patients (19%) had neve r smoked cigarettes; however, 16% of the HPV- group had also never smo ked. Of interest, 38% of patients interviewed had occupation-related e xposures that may have contributed to their carcinogenesis, and a disp roportionate percentage of these patients (57%) were from the HPV+ gro up. There were no statistically significant differences between HPV+ a nd HPV- cases regarding T stage, clinical stage, and tumor differentia tion. The disease-free interval did not differ significantly for HPVand HPV- patients in total nor when patients were stratified for tumor stage and clinical stage. The only group that showed some difference in outcome was that of the stage III/IV patients with oral cancer. We observed a shorter survival time for the HPV+ patients as compared wit h the HPV- patients (P = 0.09). We conclude that, in general, HPV is a ssociated with a minority of intraoral cancers and its presence is not predictive of patient outcome.