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HLA class I and II expression in oropharyngeal squamous cell carcinoma in relation to tumor HPV status and clinical outcome.

Published version
Peer-reviewed

Type

Article

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Authors

Näsman, Anders 
Andersson, Emilia 
Marklund, Linda 
Tertipis, Nikolaos 
Hammarstedt-Nordenvall, Lalle 

Abstract

HPV-DNA positive (HPVDNA+) oropharyngeal squamous cell carcinoma (OSCC) has better clinical outcome than HPV-DNA negative (HPVDNA-) OSCC. Current treatment may be unnecessarily extensive for most HPV+ OSCC, but before de-escalation, additional markers are needed together with HPV status to better predict treatment response. Here the influence of HLA class I/HLA class II expression was explored. Pre-treatment biopsies, from 439/484 OSCC patients diagnosed 2000-2009 and treated curatively, were analyzed for HLA I and II expression, p16(INK4a) and HPV DNA. Absent/weak as compared to high HLA class I intensity correlated to a very favorable disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) in HPVDNA+ OSCC, both in univariate and multivariate analysis, while HLA class II had no impact. Notably, HPVDNA+ OSCC with absent/weak HLA class I responded equally well when treated with induction-chemo-radiotherapy (CRT) or radiotherapy (RT) alone. In patients with HPVDNA- OSCC, high HLA class I/class II expression correlated in general to a better clinical outcome. p16(INK4a) overexpression correlated to a better clinical outcome in HPVDNA+ OSCC. Absence of HLA class I intensity in HPVDNA+ OSCC suggests a very high survival independent of treatment and could possibly be used clinically to select patients for randomized trials de-escalating therapy.

Description

Keywords

Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Cohort Studies, Cyclin-Dependent Kinase Inhibitor p16, DNA, Viral, Female, Gene Expression Regulation, Neoplastic, HLA Antigens, Histocompatibility Antigens Class I, Histocompatibility Antigens Class II, Humans, Male, Middle Aged, Oropharyngeal Neoplasms, Papillomaviridae, Prognosis, Survival Analysis, Treatment Outcome

Journal Title

PLoS One

Conference Name

Journal ISSN

1932-6203
1932-6203

Volume Title

8

Publisher

Public Library of Science (PLoS)