Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population

Abstract Background The aim of this study was to investigate the effect of inconsistent expression of p16 and HPV on the prognosis of patients with Oropharyngeal squamous cell carcinoma (OPSCC) in Chinese/Asian populations. Methods The study included 130 patients. Inclusion criteria were primary OPS...

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Main Authors: Jieying Li, Kai Zhou, Xiaohong Zhan, Haijun Lu, Dapeng Hao, Kai Song, Shuangyi Wang, Yuanyong Feng, Haoyue Xu, Zongxuan He, Xiaochen Yang, Wei Shang, Lin Wang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Infectious Agents and Cancer
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Online Access:https://doi.org/10.1186/s13027-025-00657-z
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author Jieying Li
Kai Zhou
Xiaohong Zhan
Haijun Lu
Dapeng Hao
Kai Song
Shuangyi Wang
Yuanyong Feng
Haoyue Xu
Zongxuan He
Xiaochen Yang
Wei Shang
Lin Wang
author_facet Jieying Li
Kai Zhou
Xiaohong Zhan
Haijun Lu
Dapeng Hao
Kai Song
Shuangyi Wang
Yuanyong Feng
Haoyue Xu
Zongxuan He
Xiaochen Yang
Wei Shang
Lin Wang
author_sort Jieying Li
collection DOAJ
description Abstract Background The aim of this study was to investigate the effect of inconsistent expression of p16 and HPV on the prognosis of patients with Oropharyngeal squamous cell carcinoma (OPSCC) in Chinese/Asian populations. Methods The study included 130 patients. Inclusion criteria were primary OPSCC. The primary outcome was the proportion of cohort patients showing different combinations of p16 and HPV outcomes, as well as overall survival (OS) and progression-free survival (PFS). Patients with relapsed or metastatic disease or palliative care were excluded from the survival analysis. A multivariate analysis model was used to calculate the adjusted hazard ratio for overall survival for different p16 and HPV tests, adjusted for pre-specified confounders. Results Among the 130 patients, 25 (19.2%) demonstrated inconsistency between HPV and p16 expressions. The inconsistency in HPV/p16 status was significantly associated with patient age, smoking history, and alcohol consumption, leading to significant differences in tumor site, TNM staging, and differentiation, thereby influencing treatment decisions. There were significant differences in OS (P = 0.04) and PFS (P = 0.011) among the three groups, with the inconsistent group falling between the HPV+/p16 + group and the HPV-/p16- group but closer to the latter. Out of 54 p16-positive patients, only 33 (61.1%) were HPV-positive, indicating a lower predictive value of p16 for HPV positivity in OPSCC than observed in Western populations. Moreover, the study suggested a potential positive correlation between p16 expression intensity and improved patient prognosis. Conclusion In the China/Asia region, where HPV infection rates are relatively low, the predictive power of p16 for HPV-related OPSCC is low. We recommend additional HPV testing in patients with p16 + OPSCC to improve diagnostic accuracy, thereby enabling the selection of the best de-escalation treatment strategy, increasing treatment response rates, and ultimately improving the overall prognosis in these patients.
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spelling doaj-art-3aa3230b0f3942fa9b93bca84584fb692025-08-20T03:20:59ZengBMCInfectious Agents and Cancer1750-93782025-06-0120111210.1186/s13027-025-00657-zPrognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma populationJieying Li0Kai Zhou1Xiaohong Zhan2Haijun Lu3Dapeng Hao4Kai Song5Shuangyi Wang6Yuanyong Feng7Haoyue Xu8Zongxuan He9Xiaochen Yang10Wei Shang11Lin Wang12Department of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversitySchool of Stomatology, Qingdao UniversitySchool of Stomatology, Qingdao UniversitySchool of Stomatology, Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityDepartment of Oral & Maxillofacial Surgery, the Affiliated Hospital of Qingdao UniversityAbstract Background The aim of this study was to investigate the effect of inconsistent expression of p16 and HPV on the prognosis of patients with Oropharyngeal squamous cell carcinoma (OPSCC) in Chinese/Asian populations. Methods The study included 130 patients. Inclusion criteria were primary OPSCC. The primary outcome was the proportion of cohort patients showing different combinations of p16 and HPV outcomes, as well as overall survival (OS) and progression-free survival (PFS). Patients with relapsed or metastatic disease or palliative care were excluded from the survival analysis. A multivariate analysis model was used to calculate the adjusted hazard ratio for overall survival for different p16 and HPV tests, adjusted for pre-specified confounders. Results Among the 130 patients, 25 (19.2%) demonstrated inconsistency between HPV and p16 expressions. The inconsistency in HPV/p16 status was significantly associated with patient age, smoking history, and alcohol consumption, leading to significant differences in tumor site, TNM staging, and differentiation, thereby influencing treatment decisions. There were significant differences in OS (P = 0.04) and PFS (P = 0.011) among the three groups, with the inconsistent group falling between the HPV+/p16 + group and the HPV-/p16- group but closer to the latter. Out of 54 p16-positive patients, only 33 (61.1%) were HPV-positive, indicating a lower predictive value of p16 for HPV positivity in OPSCC than observed in Western populations. Moreover, the study suggested a potential positive correlation between p16 expression intensity and improved patient prognosis. Conclusion In the China/Asia region, where HPV infection rates are relatively low, the predictive power of p16 for HPV-related OPSCC is low. We recommend additional HPV testing in patients with p16 + OPSCC to improve diagnostic accuracy, thereby enabling the selection of the best de-escalation treatment strategy, increasing treatment response rates, and ultimately improving the overall prognosis in these patients.https://doi.org/10.1186/s13027-025-00657-zOropharyngeal squamous cell carcinomaHuman papillomavirusHPVp16PrognosisInconsistent
spellingShingle Jieying Li
Kai Zhou
Xiaohong Zhan
Haijun Lu
Dapeng Hao
Kai Song
Shuangyi Wang
Yuanyong Feng
Haoyue Xu
Zongxuan He
Xiaochen Yang
Wei Shang
Lin Wang
Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
Infectious Agents and Cancer
Oropharyngeal squamous cell carcinoma
Human papillomavirus
HPV
p16
Prognosis
Inconsistent
title Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
title_full Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
title_fullStr Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
title_full_unstemmed Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
title_short Prognostic analysis of inconsistent combinations of HPV and p16 in a Chinese/Asian oropharyngeal squamous cell carcinoma population
title_sort prognostic analysis of inconsistent combinations of hpv and p16 in a chinese asian oropharyngeal squamous cell carcinoma population
topic Oropharyngeal squamous cell carcinoma
Human papillomavirus
HPV
p16
Prognosis
Inconsistent
url https://doi.org/10.1186/s13027-025-00657-z
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