Name: JESSICA GRAÇA SANT'ANNA
Publication date: 17/12/2024
Summary: In Brazil, regional disparities in mortality rates from head and neck squamous cell carcinoma (HNSCC) represent a significant concern. Infection with high-risk oncogenic human
papillomavirus (HR-HPV) has emerged as a critical risk factor, particularly in the rising
incidence of oropharyngeal squamous cell carcinoma (OPSCC). Accurate diagnosis plays a
fundamental role in guiding effective and appropriate treatment.This study aimed to analyze
HNSCC mortality trends in Brazil between 1998 and 2017 and to evaluate the applicability of
HR-HPV detection methods in OPSCC. The techniques used included E6 mRNA detection
through real-time polymerase chain reaction (RT-qPCR) and E6/E7 mRNA detection by in situ
hybridization (RNA-ISH) in tumor samples. The research involved a comparative analysis
between samples from Brazil and Colombia.A multicenter and prospective study was
conducted across three centers: two in Espírito Santo, Brazil (Hospital Santa Rita de Cássia
and Cassiano Antônio de Moraes University Hospital), and one in Bogotá, Colombia
(Fundación Santa Fe). Mortality data were sourced from DATASUS, with population statistics
obtained from IBGE. Annual percent change (APC) was used to assess mortality trends, and
spatial analyses compared mortality rates across municipalities in Espírito Santo. HR-HPV
detection methods included RNA-ISH, immunohistochemistry (IHC) for p16, and RT-qPCR
targeting HPV16 and HPV18 mRNA. Clinical and pathological data were gathered from
medical records and patient interviews.Between 1998 and 2017, HNSCC mortality rates in
Espírito Santo increased, particularly among men, with age-standardized rates rising from
48.96 to 58.24 per 100,000 inhabitants. The Central health regions recorded the highest
mortality rates. Among anatomical subsites, cancers of the oral cavity, oropharynx, and larynx
accounted for increased male mortality, while in women, the rise was limited to oral cavity
cancers.HR-HPV frequencies in Espírito Santo samples were lower compared to those in
Bogotá. Patients positive for HR-HPV exhibited better survival outcomes, while lymph node
metastasis and tobacco exposure were associated with poorer prognoses. Comparison of HR-
HPV detection methods demonstrated that IHC-p16, RNA-ISH, and RT-qPCR are valid and
effective for OPSCC diagnosis and monitoring.The study's findings highlight a rising trend in
HNSCC mortality in Espírito Santo, particularly among men, with notable increases in OPSCC
cases. HR-HPV presence was linked to improved survival rates, underscoring its clinical
significance. The analysis also revealed geographic and cultural variations between
populations in Espírito Santo and Bogotá, suggesting a need for region-specific prevention and
treatment strategies. The validated HR-HPV detection methods can enhance diagnostic
precision and prognostic assessment in clinical practice.
