- This is one of
the first studies to show that HPV antibodies are a good prognostic marker
for increased patient survival with head and neck cancer.
- The presence of
the HPV antibody in the blood can be used as a signal of prognosis and it
is not dependent on the quantity of antibody present.
- Identification of
both E6 and E7 antibodies is a better prognostic marker
An evidence of human
papilloma virus (HPV) in patients with head and neck cancer is an indication of
better prognosis, according to a new study published in the Journal JAMA Oncology
. The researchers have
found that, instead of a biopsy, a blood serum test that identifies one of the
two antibodies against HPV virus is a good and reliable signal for prognosis.
This test could be an effective marker of prognosis for all types of head and neck
professor of epidemiology and of pathology and laboratory medicine, Dr. Karl
Kelsey, who is the senior author of the study said "What this adds is that it helps us know how best to measure clinically
the HPV contribution to this disease
‘Smoking increases risk for head and neck cancer with poor prognosis.’
and Neck Cancer
Head and neck cancers
cancers that begin in the squamous cells that line the mucosal membrane. The
different types of head and neck cancers include cancer of the oral cavity,
salivary glands, larynx, pharynx and the paranasal sinuses and the nasal cavity.
Head and neck
cancer is caused mostly due to tobacco smoking and alcohol
consumption, while a small percentage of head and neck cancers may also be caused
due to Human Papilloma Virus (HPV) infection.
Identifying the Prognosis
Blood samples of 1000 people with head
and neck cancer who were diagnosed between the years 1999 and 2011 were
- Patients who
tested positive for oncogene HPV proteins E6 or E7 had a better prognosis
- They were less
likely to die when assessed after a 5 year period.
- 25% less likely
to die when they showed an immune response compared to people with no
Cancer Prognosis Testing
It is very important to
carry out a prognosis test for cancer to determine the survival risk and to
identify the best method of treatment. Every individual responds differently to
cancer and a prognosis test will provide a better understanding of the
It can be used to decide
upon the course of treatment, as in some forms of cancer, rigorous chemotherapy
may not be required. Some of the prognosis tests are also used to determine
recurrence risk of the specific cancer.
HPV virus was earlier associated only
with cancers in the oropharynx, however, now it is associated with all cancers
in the head and neck region. In the current study, it was found that the HPV
immune response identified among cancers that were located in the oropharynx
and the larynx showed a better but similar survival risk. The risk of survival
was lower among cancers in the oral cavity.
The prognosis test based
on the HPV antibodies were dependent on the following conditions
for Better Survival Rates:
- The detection of
the antibodies in the patients with head and neck cancer was an indicator
of better prognosis, it was not dependent on the quantity of antibodies
- Testing for both
E6 and E7 antibodies was a better detector of prognosis than detecting
only one type of antibody.
- There was a
lowered risk of dying for people who showed the presence of antibody, even
among those who consumed alcohol and tobacco.
- The least
survival rate was witness among smokers without any antibody for HPV.
There are two major factors which could
influence prognosis of head and neck cancer patients due to infection by the
- Tumor Suppressor Genes:
The HPV virus delineates the tumor suppressor genes among head and neck
cancer patients, these genes are known to drive tumor growth.
- Immune Response:
The presence of additional antibodies due to the HPV virus may have an
effect on the growth and maturation of the cancer cells, leading to better
prognosis. Cancers are known to
evade the immune response of the host, failing to mount a suitable
response, which encourages their proliferation. However, in patients with
HPV infection, the immune response against the virus might lead to the
destruction of cancer cells. The importance of eliciting an immune
response to cancer is utilized in immunotherapy, where the immune cells of the
host are used to control the growth of cancer.
This study is of great
significance in the treatment and management of head and neck cancers
Many studies now focus on the genetic risk factors that are associated with the
various cancers, to help determine the nature of cancer and the recurrence
risk. However, the current study that focuses on the presence of antibodies
provides a better understanding about the survival rate.
Prognostic Markers in Cancer
There are some well-established factors
that are considered to be good prognostic markers for cancer.
- The age of the
patient is an important factor in cancer prognosis. When the age is over
60 years, the prognosis is lower.
- The hemoglobin
level in the body should be above 12mg/l
- The stage of
cancer should be I or II
- Fewer than 4
lymph nodes should be affected
The ease of detection of
the E6 and the E7 proteins that determine the antibodies of HPV, according to
the current study, might soon make this test widely available. The benefits of
understanding the prognosis make effective testing mandatory.
- Prognostic factors versus predictive factors: Examples from a clinical trial of erlotinib - (http://www.moloncol.org/article/S1574-7891(07)00102-0/abstract)
- Molecular Pathology Testing To Estimate Prognosis for Common Cancers - (https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/downloads/id69b.pdf)
- Survival rates and factors that affect prognosis (outlook) for non-Hodgkin lymphoma - (http://www.cancer.org/cancer/non-hodgkinlymphoma/detailedguide/non-hodgkin-lymphoma-factors-prognosis)
- Head and Neck Cancers - (https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet)