HPV genotyping in head and neck cancer: Insights from a Colombian cohort

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OBJECTIVE: To describe the frequency and distribution of Human Papillomavirus (HPV) infection in patients with Head and Neck Squamous Cell Carcinoma (HNSCC) treated at a tertiary hospital in Colombia. METHODS: A descriptive cross-sectional study was conducted in 81 patients diagnosed with HNSCC between 2015 and 2021 at Fundación Santa Fe de Bogota, Colombia, as part of the Colombian cohort of the InterCHANGE and HEADSpace study. Formalin-Fixed Paraffin-Embedded (FFPE) tumor samples were analyzed for HPV DNA detection and genotyping. Fifty-nine samples were processed using the HPV-Direct Flow CHIP assay (Master Diagnóstica, Seville, Spain), and 22 with the INNO-LiPA HPV Genotyping Extra assay (Fujirebio, Gothenburg, Sweden). Both techniques identify high- and low-risk HPV genotypes through PCR amplification and reverse hybridization. Immunohistochemistry for p16 was performed in all cases using the anti-p16INK4a (E6H4 clone) antibody, considering strong nuclear and cytoplasmic staining in ≥ 70% of tumor cells as positive. Descriptive statistics included absolute and relative frequencies. RESULTS: The mean age was 66-years (±11), and 64.2% were male. The oropharynx was the most frequent tumor location (50.6%, n = 41), followed by the oral cavity (35.8%, n = 29) and larynx (13.6%, n = 11). Overall, 51.9% (n = 42) of tumors were HPV DNA-positive. HPV infection was more frequent in oropharyngeal carcinomas (92.7%, n = 38) than in the oral cavity (6.9%, n = 2) or larynx (18.2%, n = 2). HPV-16 was the predominant genotype (79.4%), followed by HPV-35, HPV-18, and HPV-33. p16 overexpression was observed in 49.4% (n = 40) of cases, mainly in oropharyngeal carcinomas (87.8%, n = 36). Among HPV DNA-positive tumors, 92.5% (n = 37) were also p16-positive. CONCLUSIONS: This study demonstrates a high prevalence of HPV, predominantly HPV-16, in oropharyngeal carcinomas compared with other head and neck sites in our cohort. These results provide baseline data for Colombia and highlight the need for multicenter studies including more heterogeneous populations to guide future prevention and control strategies. LEVEL OF EVIDENCE: 4 (According to the Oxford Centre for Evidence-Based Medicine, 2011).

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