HPV & Oral Cancer in Taiwan by Dr. Ken Liao Liu 劉耿僚

Human Papillomavirus and Oral Cancer in Taiwan Speaker: Ken-Liao Liu Instructors: Prof. Huei Lee, Ya-Wen Cheng Dec. 19, 2008.

Oral cancer in Taiwan (Epidemiologic data) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

In the past 20 years… (Worldwide data) ,[object Object],[object Object],[object Object],[object Object]

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[object Object],[object Object],[object Object],[object Object],Johns Hopkins Kimmel Comprehensive Cancer Center JNCI 2008 100(6):407-420

[object Object],[object Object],Johns Hopkins Bloomberg School NEJM 2007;356;1944-56

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Clinical impact ,[object Object],[object Object]

Clinical impact: HPV effect on tumor staging & treatment ? ,[object Object]

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Prevention & Screening? ,[object Object],[object Object]

Prevalence of HPV in Oral Cancer

HPV appears to play an etiologic role in many cancers of the oropharynx and possibly a small subgroup of cancers of the oral cavity. The most common HPV type in genital cancers (HPV16) was also the most common in these tumors. The mechanism of transmission of HPV to the oral cavity warrants further investigation.

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In Taiwan… ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Am J Clin Pathol 2003; 120: 909-916

The positive rates : 75% (69/92) by nested PCR-based genechips , 53% (49/92) by overexpression of p16INK4A (ISH), 44% (40/92) by high-risk HPV (ISH) Both overexpression of P16INK4A and high-risk HPV (ISH) positivity were associated with favorable prognoses and also independent prognostic factors .

aDepartment of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan Oral Oncology,2008, 44(2), 174-179

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In Taiwan…. ,[object Object]

29 OSCC cases 29 controls In situ PCR ISH

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Comparison of HPV16/18 prevalence in tumor sites of cases & controls. 4 (9.1%) 35 (46.1%) Oral Cavity 12 (26.1%) 14 (22.6%) Pharynx Control 16/90 Case 49/138 HPV16 or 18+

HPV vs Areca-chewing in cases & controls

HPV vs Areca-chewing in cancer cases Higher HPV16 + in Non-areca-chewing pharyngeal cancer

HPV v.s. P53 in oral cancers: Molecular Classification

Joint assessment of p53 /HPV status : 4 biomarker subgroups

Summary: HPV ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Summary: HPV/Areca ,[object Object],[object Object]

Summary: p53 ,[object Object],[object Object],[object Object],[object Object]

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Ongoing/Future Work ,[object Object],[object Object],[object Object]

Brief Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]

In cancer cases ,[object Object],[object Object],[object Object],[object Object]

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Clinical Implications of HPV vs HNSCC (OSCC) poorly differentiated Basaloid, advanced stage Histopathology ♂ ♂ =♀ Gender Less sensitive, poor prognosis Sensitive, better prognosis ( Less “field cancerization”) Treatment (R/T , C/T) older - 5 years younger Age ┼ ─ /┼ Tobacco/alcohol ─ ↑ p16 expression ─ ↓ Protein p53 & pRb Mutated Wild type TP53 & Rb1 genes Non-HPV related HPV related

HPV & Oral Cancer in Taiwan by Dr. Ken Liao Liu 劉耿僚

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HPV & Oral Cancer in Taiwan by Dr. Ken Liao Liu 劉耿僚