HPV Infection and Anemia Status Stratify the Survival of Early T2 Laryngeal Squamous Cell Carcinoma.

OBJECTIVE

This study was designed to investigate the potentially prognostic indicators of early laryngeal squamous cell carcinomas (LSCCs), including human papillomavirus (HPV) status.

METHODS

A total of 336 patients with T2N0-1M0 LSCC were included in this study. Clinical data were collected from archival documents, and HPV infection and p16(INK4A) expression were detected.

RESULTS

A total of 32/318 cases of high-risk HPV infection and 10/336 cases of p16(INK4A) overexpression were found. Three hundred eighteen tumors were classified into a three-class model according to HPV infection and p16(INK4A) expression: class I, HPV+/p16+; class II, HPV+/p16-; and class III, HPV-/p16-. Class III had a trend of decreased overall survival (OS) (P = 0.076) and a markedly low relapse-free survival (RFS) (P = 0.022) compared with class I and class II. HPV-positive cases (class I plus class II) had a significantly longer OS (P = 0.038) and RFS (P = 0.006). In multivariate analysis, HPV-positive (P = 0.020), nonanemia (P = 0.011), and N0 stage (P = 0.005) were significant predictors for high RFS. But only HPV-positive (P = 0.047) and nonanemia (P < 0.001) were significant predictors for superior OS.

CONCLUSION

A trend of discrete survival among HPV+/p16+, HPV+/p16-, and HPV-/p16 classes was found in early LSCCs. We suggest that HPV infection and hemoglobin level are the potential factors that can stratify outcome of early LSCCs.