Viral DNA integration and methylation of human papillomavirus type 16 in high-grade oral epithelial dysplasia and head and neck squamous cell carcinoma
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Sujita Khanal1, Brian S. Shumway2, Maryam Zahin3, Rebecca A. Redman3,4, John D. Strickley3,4, Patrick J. Trainor3, Shesh N. Rai3, Shin-je Ghim3, Alfred Bennett Jenson3 and Joongho Joh3,4,5
1Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
2Department of Surgical and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA
3James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA
4Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, USA
5Center for Predictive Medicine, University of Louisville, Louisville, KY, USA
Joongho Joh, email: firstname.lastname@example.org
Keywords: human papillomavirus (HPV); HPV integration; HPV methylation; high-grade oral epithelial dysplasia (hgOED); head and neck cancer
Received: April 10, 2018 Accepted: May 25, 2018 Published: July 13, 2018
This study evaluated the integration and methlyation of human papillomavirus type 16 (HPV16) in head and neck squamous cell carcinoma (HNSCC) and its oral precursor, high-grade oral epithelial dysplasia (hgOED). Archival samples of HPV16-positive hgOED (N = 19) and HNSCC (N = 15) were evaluated, along with three HNSCC (UMSCC-1, -47 and -104) and two cervical cancer (SiHa and CaSki) cell lines. HgOED cases were stratified into three groups with increasing degrees of cytologic changes (mitosis, karyorrhexis and apoptosis). The viral load was higher and the E2/E6 ratio lower (indicating a greater tendency toward viral integration) in group 3 than in groups 1 or 2 (p = 0.002, 0.03). Methylation was not observed in hgOED cases and occurred variably in only three HNSCC cases (26.67%, 60.0% and 93.3%). In HNSCC cell lines, lower E7 expression correlated with higher levels of methylation. HgOED with increased cytologic change, now termed HPV-associated oral epithelial dysplasia (HPV-OED), exhibited an increased viral load and a tendency toward DNA integration, suggesting a potentially increased risk for malignant transformation. More detailed characterization and clinical follow-up of HPV-OED patients is needed to determine whether HPV-OED is a true precursor to HPV-associated HNSCC and to clarify the involvement of HPV in HNSCC carcinogenesis.
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