Detecção e genotipagem de papilomavírus humano (HPV) em carcinoma de células escamosas de cavidade oral e orofaringe

Abstract

Introduction: Oral cavity and oropharyngeal cancer represent a significant public health issue, with increasing global incidence and a rising number of cases associated with Human Papillomavirus (HPV). Objective: To detect and genotype HPV in samples of squamous cell carcinoma from the oral cavity and oropharynx of patients who underwent tumor surgical excision in Northwest Rio Grande do Sul, Brazil, and to characterize these patients sociodemographically. Materials and Methods: This is a cross-sectional study utilizing secondary and laboratory data from patients treated in Passo Fundo, RS. Sociodemographic, behavioral, and clinical data were collected from the hospital's electronic medical records. HPV detection, as well as the identification of oncogenic HPV subtypes, was performed through conventional PCR and p16 protein overexpression assessed by immunohistochemistry. Statistical analysis was conducted in two stages:first, absolute and relative frequency distributions of descriptive variables and HPV DNA positivity prevalence were calculated using the chi-square test (p<0.05). Subsequently, the relationship between p16 protein overexpression and HPV DNA positivity was investigated. Results: The sample (n=49) was predominantly composed of men (79.6%), White individuals (87.8%), with incomplete elementary education (49%), aged between 56 and 65 years (40.8%), and with a history of alcohol use (55.1%) and smoking (65.3%). Of all participants, 10 (20.4%) tested positive for HPV DNA, of whom 50% had the oropharynx as the affected region, 40% presented with stage I tumors, 40% progressed to death, and half of these deaths occurred more than one year after diagnosis. Viral subtypes were identified in 90% of the positive cases, with subtypes 16, 33, 45, 52, and 58 detected; subtype 52 was the most frequent (40%). Additionally, p16 protein positivity was observed in 8 cases. Conclusion: Squamous cell carcinoma was more prevalent among White men aged 56 to 65 years, with a history of smoking, alcohol use, and lower educational attainment. Approximately 20% of cases were positive for HPV, with genotypes 16, 33, 45, 52, and 58 being the most frequent. These findings highlight the importance of HPV as a risk factor for the development of squamous cell carcinoma and emphasize the need for public policies aimed at the prevention and control of oral cancer. Such policies should include vaccination programs, awareness campaigns about risk factors, and equitable access to oral health services.