Association between human papillomavirus and mutations in advanced lung adenocarcinoma.

Previous studies have demonstrated an association between human papillomavirus (HPV) and mutations in the epidermal growth factor receptor () gene in lung cancer patients; however, few studies have investigated this association in advanced lung adenocarcinoma patients undergoing gefitinib treatment. The present study investigated the association between HPV and mutations in advanced lung adenocarcinoma patients. A total of 95 advanced lung adenocarcinoma patients were enrolled in the study. The HPV infection status and presence of mutations in tumor tissue was evaluated. Patient clinical characteristics were also determined and compared with HPV infection and mutation status to analyze their impact on progression-free survival. HPV DNA was identified in 27/95 (28.4%) lung adenocarcinoma tumors and was most common in patients with lymph node metastasis (P=0.016). A total of 44/95 (46.3%) cases exhibited mutations, which were predominantly observed in female patients and non-smokers. The presence of HPV DNA was significantly associated with mutations (P=0.012) and multivariate analysis also revealed that HPV DNA was significantly associated with mutations (odds ratio=3.971) in advanced lung adenocarcinoma. Patients with both HPV infections and mutations exhibit a marked decrease in the risk of lung cancer progression when compared with those without HPV infection or mutations (adjusted HR=0.640; 95% confidence interval: 0.488-0.840; P=0.001). HPV infection was significantly associated with mutations in advanced lung adenocarcinoma patients. Furthermore, patients with HPV infections exhibited the longest progression-free survival times, which may be due to good response to tyrosine kinase inhibitor- or platinum-based-adjuvant therapy in these patients. Patients with mutations exhibited a better prognosis when compared with those exhibiting wild-type , regardless of HPV status.