ANALYSIS OF PREVALENCE OF HUMAN PAPILLOMAVIRUS IN LARYNGEAL CARCINOMAS - STUDY OF 40 CASES USING POLYMERASE CHAIN-REACTION AND CONSENSUS PRIMERS

In this study we determined the frequency of association of human papi llomavirus (HPV) and laryngeal carcinomas and investigated the possibi lity that HPV may be associated with larger or more aggressive tumors. Laryngeal squamous cell carcinomas from 40 patients who did not have preexisting papillomas by clinical history were retrieved from formali n-fixed, paraffin-embedded blocks and analyzed for HPV. Twenty-two cas es were tumors of the true vocal folds, and 18 were supraglottic. Clin ical follow-up was available for 25 patients. We used the polymerase c hain reaction (PCR) with the ''hot start'' modification and consensus primers that can detect over 30 distinct BPV types. Three of the 40 pa tients (8%) had detectable HPV DNA. These 3 patients did not have unus ual age demographics and were smokers. All but 1 of the 22 HPV-negativ e patients who were questioned were also smokers. We compared the outc omes for large (4 cm or greater) HPV-positive and -negative tumors. Si x of the 40 tumors were 4 cm or greater and involved contiguous struct ures. Two of these 6 were HPV-positive, and these patients died of dis ease after 3 and 16 months, respectively. Of the 4 HPV-negative patien ts with tumors greater than 4 cm, 3 are disease-free at 41, 42, and 3 months, respectively, and 1 was lost to follow-up. The third HPV-posit ive patient had a tumor less than 1 cm, and is disease-free after 38 m onths. While the number of HPV-positive cases is too small for definit ive conclusions, it is possible that for large tumors the presence of HPV DNA may portend a worse prognosis. However, in the population of p atients with laryngeal carcinoma whom we have studied, we conclude tha t the L1 region of HPV DNA is rarely seen to be present in the tumors by ''hot start'' PCR, and hence HPV is probably not a common cancer pr omoter for laryngeal carcinoma.