Head and neck cancer: mortality trends and comparative analysis of in situ hybridization techniques, RT-qPCR, and p16 for HPV infection diagnosis
Name: JÉSSICA GRAÇA SANT'ANNA
Publication date: 17/12/2024
Examining board:
Name |
Role |
|---|---|
| FLAVIA DE PAULA | Examinador Interno |
| MARIA PAULA CURADO | Examinador Externo |
| MELISSA DE FREITAS CORDEIRO SILVA | Examinador Externo |
| OLÍVIA PERIM GALVÃO DE PODESTÁ | Examinador Externo |
| SANDRA LUCIA VENTORIN VON ZEIDLER | Presidente |
Summary: In Brazil, regional disparities in mortality rates from head and neck squamous cell carcinoma (HNSCC) are high. Infection with high-risk oncogenic human papillomavirus (HR-HPV) is an important risk factor, associated with an increase in cases of oropharyngeal squamous cell carcinoma (OPSCC) in Brazil and globally. This study analyzed mortality trends from HNSCC between 1998 and 2017 in Espírito Santo, Brazil (ES-BR), and methods for detecting HR-HPV in OPSCC using messenger RNA (mRNA) E6 by RT-qPCR, mRNA E6/E7 by in situ hybridization (RNA-ISH), and immunohistochemistry for p16 expression (IHC-p16) in Espírito Santo, Brazil (ES-BR) and Bogotá, Colombia (BO-CO). The mortality trend methodology was conducted in reference hospitals in ES-BR, using mortality data from DATASUS, the Mortality Information System (SIM), and data from the Brazilian
Institute of Geography and Statistics (IBGE). Clinicopathological characteristics and HPV status of the studied sites were analyzed, and HPV detection methods were compared using RNA-ISH and IHC-p16 with RT-qPCR as the standard for sensitivity and specificity analysis. Between 1998 and 2017, mortality from HNSCC increased in ES, especially among men, rising from 48.96 to 58.24 deaths per 100,000 inhabitants. Regarding anatomical subsites, men showed an increase in deaths from oral cavity, oropharyngeal, and laryngeal cancers, while women’s increase was limited to oral cavity cancer. Regarding HR-HPV, samples from ES showed lower frequencies of infection compared to those from BO. Lymph node metastasis was associated with a worse prognosis, while HPV-positive patients had better survival. Smoking negatively impacted survival. Detection methods for HR-HPV, such as IHCp16, RNA-ISH, and RT-qPCR, showed statistical significance. The results show an increase in HNSCC mortality in ES, especially among men and in OPSCC. The IHCp16 technique had high sensitivity, while RNA-ISH showed high specificity. Regional
strategies and advanced diagnostics are crucial for managing HNSCC.
