Bibliographic citations
Castañeda, C., (2023). Evaluación del rol de p16 y el infiltrado linfocitario en la sobrevida de pacientes con cáncer células epidermoide de cabeza y cuello [Universidad Peruana Cayetano Heredia]. https://hdl.handle.net/20.500.12866/14540
Castañeda, C., Evaluación del rol de p16 y el infiltrado linfocitario en la sobrevida de pacientes con cáncer células epidermoide de cabeza y cuello []. PE: Universidad Peruana Cayetano Heredia; 2023. https://hdl.handle.net/20.500.12866/14540
@phdthesis{renati/910954,
title = "Evaluación del rol de p16 y el infiltrado linfocitario en la sobrevida de pacientes con cáncer células epidermoide de cabeza y cuello",
author = "Castañeda Altamirano, Carlos Arturo",
publisher = "Universidad Peruana Cayetano Heredia",
year = "2023"
}
Introduction: Overexpression of p16 (p16+) is a surrogate marker of human-papillomavirus infection and prognosis in oropharyngeal cancer, and its role in head and neck squamous cell cancer (HNSCC) is under study. Tumor-infiltrating-lymphocytes (TIL) predict prognosis in different neoplasms. Objective: To evaluate the association between p16+, TIL, density of immune cells (CD3+ and CD8+ lymphocytes and macrophages CD163+) and overall survival in patients with HNSCC. Material and methods: The medical records of patients with HNSCC treated at the National Institute of Neoplastic Diseases between the years 2005-2013 were reviewed. Those cases with an anatomopathological sample stored were selected and TILs were calculated. The status of p16 and the previously mentioned populations of immune cells was evaluated through immunohistochemical methods. Statistical analysis included association tests and Kaplan Meier survival curves. The SPSS program was used and p<0.05 was accepted as significant. Results: 432 cases were included, the median age was 61 years and 51.4% were women. The most frequent locations were the oral cavity (63%) and oropharynx (25.7%). Most cases (61.8%) were grade-2, ki67 median was 30%, and 23.8% debuted in stage-III and 38.1% IV. p16+ was found in 65 patients (18%) and the median TIL was 70%. The p16+ status was associated with oropharynx location (40.9%) (p<0.001), males (p=0.024), grade-3 (p<0.001), Ki67-high (p<0.001) and stage-IV (p=0.009). The p16+ status was associated with high TIL in the oropharynx (p=0.02) but not in oral cavity (p=0.43). p16+/high TIL was found in 17 (8.67%) HNSCC cases and these cases had a trend for higher survival rates at 5 years (70.6% vs 44.7%, p=0.095). Cases with p16+/high TIL in the oropharyngeal primaries subgroup had better OS (p=0.013). When TIL was replaced by CD3 or CD8, it was found that p16+/high CD3 (p=0.002) and p16+/ high CD8 (p=0.002) had a lower survival in the general HNSCC population. Conclusion: The p16+ status and high levels of TIL have a tendency to present a higher survival in HNSCC.
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