A Study of Squamous Cell Carcinoma in Upper Aerodigestive Tract and Its Association with Hpv

Abstract

Introduction: Squamous cell carcinoma (SCC) of the upper aerodigestive tract (UADT) is one of the most prevalent malignancy worldwide with tobacco use and human papillomavirus (HPV) infection recognized as major risk factors. This study aimed to evaluate the prevalence of HPV in SCC cases and assess its association with clinicopathological parameters in a tertiary care hospital.

Methodology:  A cross-sectional study was conducted on 150 biopsy-confirmed SCC cases, with p16 immunohistochemistry (IHC) used as a surrogate marker for HPV detection. Data were analysed using SPSS version 20.

Results: The majority of participants (76%) were above 40 years of age and 76% were male. Tobacco consumption was prevalentwith 78% having a history of tobacco use. Site-wise analysis revealed that the oral cavity accounted for most cases (n=90) with 22% testing positive for p16 indicating HPV association. The upper oesophagus had the p16 positivity 16% despite fewer cases, while sites such as the larynx, oropharynx, and hypopharynx showed lower positivity rates. Histopathologically, 43.3% of cases were moderately differentiated SCC, followed by 30% well-differentiated, 23.3% poorly differentiated, and 3.3% de-differentiated SCC. Overall, p16 positivity was observed in 16% of cases, highlighting a lower prevalence of HPV in this cohort.

Conclusion: SCC of the UADT in this study was predominantly associated with older males and tobacco use with HPV playing a limited role compared to western populations. Site-specific HPV variations emphasize the need for targeted screening and management strategies. Further research into molecular profiling and larger cohorts is necessary to validate these findings and refine therapeutic interventions.