ACTA OTORHINOLARYNGOLOGICA ITALICA 2009;29:119-126
Review
Human Papilloma Virus (HPV) in head and neck region: review of literature
L’infezione da papilloma virus umano (HPV) nel distretto cervico-facciale: revisione della letteratura
L. MANNARINI, V. KRATOCHVIL1, L. CALABRESE2, L. GOMES SILVA, P. MORBINI, J. BETKA1, M. BENAZZO Department of Otolaryngology HN Surgery, University of Pavia,IRCCS Policlinico S. Matteo Foundation, Pavia, Italy; 1 Department of Otolaryngology Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; 2 Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy SUMMARY
The evidence that human papillomavirus infection is related to head and neck squamous cell carcinoma is supported by molecular andepidemiological data. The definition of a distinct subset of head and neck squamous cell carcinoma, independent of the traditional risk factors and with different clinical presentation and outcome, has led to increasing interest in human papillomavirus infection. This review summarizes current knowledge regarding human papillomavirus biology, oncogenic mechanisms, risk factors for transmission,clinical significance and prophylactic strategies. KEY WORDS: Human papillomavirus • Head and neck • Squamous cell carcinoma • Oropharynx • Oral cavity
RIASSUNTO
Dati molecolari ed epidemiologici sostengono una correlazione tra infezione da papilloma virus umano (HPV) e carcinomi squamocellulari del distretto cervico facciale (HNSCC). La definizione di un sottogruppo di HNSCC, indipendente daitradizionali fattori di rischio e con caratteristiche cliniche e prognostiche differenti, ha portato ad avere un interesse sempre maggiore nell’infezione da HPV. Questa review riassume le conoscenze attuali sulle caratteristiche biologiche, i meccanismi oncogenetici, i fattori di rischio per la trasmissione ed il significato clinico e terapeutico dell’infezione da HPV. PAROLE CHIAVE: Papillomavirus umano • Testa e collo • Carcinoma squamocellulare • Orofaringe • Cavità orale
Acta Otorhinolaryngol Ital 2009;29:119-126
Introduction
Squamous cell carcinomas (SCCs) represent the most frequent malignancy in the head and neck region. They originate from the pluristratified squamous epithelium which lines the upper aerodigestive tract and are characterised by a multi-phasic andmulti-factorial aetiopathogenesis 1-10. Common risk factors in head and neck squamous cell carcinoma (HNSCC) are smoking and alcohol abuse, however, in an increasing proportion of cases, no significant smoking or drinking history has been reported. Approximately 35 years ago, a role of human papillomavirus (HPV) in cervical cancer was postulated. Today, it is well established how this very heterogeneousvirus family represents an important human carcinogen, causing not only the vast majority of cervical and ano-genital tumours, but also a variable number of cancers in other districts of the human body including the head and neck.
In females, HPV infections, on a global scale, account for more than 50% of infection-linked cancers, in males it is responsible for barely 5% 11. HPV positive HNSCC havebeen reported to share some epidemiological and biological characteristics 3. This review will attempt to focus on relevant characteristics of HPV, analyse its role in oral and oro-pharyngeal cancer and discuss some emerging developments.
Human Papilloma Virus (HPV) infection
Papilloma viruses are members of the Papillomavirus family and together with Polyomaviruses form the speciesPapovaviridae. The HPV virion consists of a circular double DNA strand of about 7.9 kb, protected by a small capsid. The capsid is about 55 nm in diameter and consists of only two structural proteins. HPV genomes reveal a well-preserved general organisation. All putative open reading frames (ORFs) are restricted to one DNA strand.
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The second, presumably non-coding strand,…
