Detecção e genotipagem do HPV em esfregaços e biópsias buco-faríngeos

Scope : Approximately 90% of head-neck carcinomas are squamous cell carcinomas (HNSCC), that includes the oral cavity, nasopharynx, larynx, hypopharynx and oropharynx. It is a disease with a complex etiology with the alcohol and tobacco consumption being the main risk factors. In last decade, there has been an increase in incidence of oropharyngeal carcinoma (OPSCC), that includes tumors of the amygdala and the base of the tongue, mostly associated with the presence of Human Papilloma Virus (HPV). According to some preliminary studies, the population with OPSCC and presence of HPV is typically younger and presents favorable prognosis, posing the hypothesis of therapeutic de-intensification to be applied in this cohort. Objective : Estimate prevalence and identify the HPV genotypes. Correlation of the different risk factors in OPSCC diagnosis in a population from a tertiary center in Lisbon. Study Design : It is a prospective, longitudinal and observational study in tertiary cancer centre in Lisbon, Portugal. Material and methods : Population from the Otorhinolaryngology department from a tertiary center in Lisbon, with lesions in the oropharynx, selected between 2009 and 2014. In total, 78 patients were included for analysis (mean age 58 years), 60 men (mean age 57 years) and 18 women (mean age 62 years). HPV detection was performed using molecular biology techniques briefly, an In-house real-time PCR, with fluorescence dye SYBR Green and SPF10 primers, was optimized to detect 40 different HPV genotypes; The genotyping was performed with array or/and Lira technology that identify about 27 different HPV genotypes. Results : The majority of the population evaluated is male (3: 1) with a mean age of 58A, 74% with a diagnosis of OPSCC and 80% had habits of consumption. In the 58 patients with OPSCC, the estimated HPV prevalence was 59%, where HPV16 is the most present genotype (62%) in the positive cases. Conclusions : The data obtained is consistent with other publications regarding prevalence of HPV and most frequent genotype. In this cohort was possible to confirm the existence of two distinct entities in OPSCC (HPV positive and HPV Negative).