P0023 human papillomavirus and p53 mutation in oral cavity cancers of Pakistani patients: correlation with histological variables and disease outcome

S.M.A. Ali, Mohammad Sohail Awan, Shahid Pervez

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Cancer of the oral cavity is extremely prevalent in Pakistan. The incidence rate of oral cavity cancer in Karachi is estimated to be among the highest in the world, and is attributed to the local custom of chewing betel quid or betel nut. The aim of this study was to determine the human papillomavirus (HPV) infection rate and p53 protein expression in oral squamous-cell carcinoma (OSCC), and to assess their correlation with overall survival (OS) and disease-free survival in OSCC patients.


The presence of HPV, in general and types 16 and 18, was investigated by PCR. p53 protein overexpression was investigated by means of immunohistochemistry. Results of HPV association and p53 overexpression were evaluated in relation to different clinicopathological parameters and survival.


Out of 140 patient samples, HPV was detected in 95 (68%) cases, of which 85 (90%) were associated with HPV 16, two (2%) were associated with HPV 18, two (2%) were co-infected (with HPV 16 and 18), and six (6%) were positive for HPV by the general primer and could not be type-specified. HPV-positive patients had comparatively prolonged OS when compared with HPV-negative patients, but this difference was not statistically significant (p = 0.97). Furthermore, overexpression of p53 protein was observed in 75 patients (54%) using a threshold of 10% stained tumour nuclei. Patients with p53-negative tumours had improved OS when compared with patients with p53-positive tumours. This difference was statistically significant (p = 0.036) in univariate Cox regression analysis; however, it was not significant in multivariate analysis.


Our study found a high prevalence of HPV (type 16) in OSCC of Pakistani patients, with male sex showing significant correlation with HPV. However, we did not find a statistically significant favourable association between p53 overexpression, HPV, survival, and histological variables.

Original languageUndefined/Unknown
JournalDepartment of Surgery
Publication statusPublished - 1 Jul 2014

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