Expression rates of p16, p53 in head and neck cutaneous squamous cell carcinoma based on human-papillomavirus positivity

Abstract

Background: The high prevalence of human papillomavirus (HPV) infection in oropharyngeal squamous cell carcinoma (SCC) is well established, and p16 expression is a strong predictor. HPV-related tumors exhibit unique mechanisms that target p16 and p53 proteins. However, research on HPV prevalence and the combined predictive value of p16 and p53 expression in head and neck cutaneous SCC (HNCSCC), particularly in Asian populations, remains limited. This retrospective study surveyed 62 patients with HNSCC (2011-2020), excluding those with facial warts or other skin cancer.

Aim: To explore the prevalence of HPV and the predictive value of p16 and p53 expression in HNCSCC in Asian populations.

Methods: All patients underwent wide excision and biopsy. Immunohistochemical staining for HPV, p16, and p53 yielded positive and negative results. The relevance of each marker was investigated by categorizing the tumor locations into high-risk and middle-risk zones based on recurrence frequency.

Results: Of the 62 patients, 20 (32.26%) were male, with an average age of 82.27 years (range 26-103 years). High-risk included 19 cases (30.65%), with the eyelid and lip being the most common sites (five cases, 8.06%). Middle-risk included 43 cases (69.35%), with the cheek being the most common (29 cases, 46.77%). The p16 expression was detected in 24 patients (38.71%), p53 expression in 42 patients (72.58%), and HPV in five patients (8.06%). No significant association was found between p16 expression and the presence of HPV (P > 0.99), with a positive predictive value of 8.33%.

Conclusion: This study revealed that p16, a surrogate HPV marker in oropharyngeal SCC, is not reliable in HNCSCC, providing valuable insights for further research in Asian populations.