Immunohistochemical Based Study on Frequency of HPV in Oral Squamous Cell Carcinoma Biopsies of Iraqi Kurdistan Patients
Introduction: Implication of Human Papilloma Virus (HPV) in the carcinogenesis of Oral Squamous Cell Carcinoma (OSCC) is debatable subject, p16 overexpression indicates active HPV infection in Oropharyngeal Squamous Cell Carcinoma (OPSCC) but in OSCC such relation still needs to be studied. Therefore, we aimed to evaluate the frequency of HPV in OSCC patients in the capital of Kurdistan region of Iraq and its concordance with p16 overexpression.
Materials and methods: We retrieved eighty-six Formalin Fixed Paraffin Embedded (FFPE) samples of OSCC from multi large pathological centres that located in the capital of Kurdistan, we utilized Immunohistochemistry (IHC) to detect the HPV by anti-HPV high risk antibody correlated it with p16 overexpression, besides, twenty FFPE samples of healthy gingiva were used as control in this study.
Statistical analysis: Chi square and fisher’s exact tests were used for correlating the HPV status and p16 overexpression with clinicopathogical patient’s data. The concordance between HPV and p16 overexpression was evaluated by kappa agreement and spearman rank correlation.
Results: The frequency of HPV in OSCC patients were 15.1%, tongue was the most common site affected by HPV infection, other patient data including age, gender, grade and stage did not show significant correlation with neither anti-HPV nor p16 antibodies. The concordance level between p16 overexpression and the HPV status according to kappa agreement was (κ=0.221, p=0.034), Moreover, the correlation according to spearman correlation coefficient was (r=0.229, p=0.034), with 46.15% sensitivity and 80.82% specificity.
Conclusion: We concluded that HPV infection is still low in Erbil and p16 biomarker has only diminutive significance as a predictor of HPV infection in the OSCC patients.