OBJECTIVE:
The
implication of HPV in head and neck squamous cell carcinoma (HNSCC) is well
established, especially in oropharyngeal SCC. HIV patients have a higher risk
of persistent HPV infection. We investigated the role of HPV in HNSCC
carcinogenesis in HIV population.
DESIGN:
Retrospective
monocentric study.
METHODS:
We
studied HIV patients who presented with HNSCC between 1994 and 2014. For each
patient, tumor characteristics, HIV disease and survival information were
collected. Tumor HPV testing was performed using p16 immunohistochemistry, in
situ hybridation and PCR. We assessed the percentage of HPV in this population
of HIV patients with HNSCC and compared HIV disease characteristics based on
HPV status.
RESULTS:
Forty
seven patients were included: 11 women/36 men, the median age was 50 years.
Tumor HPV testing was performed in 40 patients. Tumors were located in
oropharynx (32%), oral cavity (32%), larynx (21%) and hypopharynx (11%). At the
time of diagnosis, median CD4 level was 385/mm, 31% of the patients were stage
CDC C. The percentage of HPV linked to HNSCC for all locations in HIV patients
was 30% (n = 12). HPV16 accounted for 50% of all HPV genotypes. HPV positive
status was associated with a CD4 nadir of less than 200 (p = 0.026), but not
with CD4 level at time of diagnosis (p = 0.414). HPV negative tumors tend to be
associated with poorer 5-year overall survival (HR = 2.9, p = 0.0711).
CONCLUSION:
HPV
plays a critical role in HNSCC development in HIV population. HIV
immunodeficiency may increase HPV persistence and progression of HNSCC.
- 1Department of ENT, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7 Department of pathology, European G Pompidou Hospital, APHP, Paris, France, Paris Descartes University, Paris 5 Department of Anatomical pathology, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7 Department of Virology, European G Pompidou Hospital, APHP, Paris, France, Paris Descartes University, Paris 5 Department of Epidemiology and Clinical Research, Bichat Hospital, Paris, France, Paris Diderot University, Paris 7.
- AIDS. 2016 Jan 23.
Below: Distribution of the cases by sex. The Pie chart shows the distribution of males and females in the study. There were 68.2% female and 32.8% male
Below: The distribution of types of Lesions by age. The figure shows the distribution of cancers by age of diagnosis in HIV-1 cases in Kenyatta National Hospital between 2001 and 2011
Below: The distribution of neoplasms Reported between 2000 and 2011. The figure shows the cancers identified in Kenyatta National Hospital in 2001–2011 using patient charts and FFPE
Below: The distribution of neoplasms by site. The figure shows specific types of neoplasms detected at Kenyatta National Hospital with respect to site
A total of 173 lesions were reviewed and analyzed. Of these 118 (68 %) were from females and 55 from males (32 %). The male to female ratio was 1:2. The age range was from two to 56 years with a median of 36 years. Kaposi sarcoma is the leading AIDS defining malignancy in Kenya while invasive squamous cell carcinoma of the conjunctiva is the leading non-AIDS defining malignancy. This is closely followed by invasive squamous cell carcinoma of the cervix and NHL.
Kaposi sarcoma is the leading AIDS associated neoplasm in Kenya. Physicians and caretakers managing and following up on HIV/AIDS patients should look out for Kaposi sarcoma as a form of IRIS following the institution of HAART in all HIV/AIDS patients. The incidence of invasive squamous cell carcinoma of the conjunctiva is increasing in PLWAS in Kenya. There is therefore a need to introduce early screening programs for squamous intraepithelial neoplasm of the conjunctiva in HIV/AIDS patients.
Read more at: http://ht.ly/RL3ln HT https://twitter.com/UpstateNews
Below: Coronal sulcus inflammatory nodules
Malignant priapism is a definition invented in 1938 by Peacock, defined as a persistent erection, not related with sexual activity, caused by cavernous sinus and associated venous systems invasion with malignant cells. Penile secondary lesions are rare entities. Primary locations are usually the pelvic cavity organs, namely the prostate and the bladder as the most common ones. Priapism as a first manifestation of these kinds of lesions is even rarer. The aim was to present a 52-year-old patient harboring a penile metastasis that originated in the primary prostate adenocarcinoma, manifesting itself as a “common” priapism. The patient referred to the emergency room presenting with a priapism and nodules at the coronal sulcus, without previous similar episodes. His evolution until properly diagnosed was catastrophic with multiple lymph nodes, bone and organ involvement, and with his demise soon after from serious bleeding and congestive heart failure, almost 2 months after he first came to the emergency room. We review the literature concerning malignant priapism, diagnosis, and current treatment and survival perspectives.
Via: http://ht.ly/QnrQE HT @NCBI
