Impact of human papillomavirus (HPV) on pathogenesis, treatment and prognosis of head and neck cancer

Human papilloma virus (HPV) infection has been identified as an aetiological agent for about 25% of head and neck cancers (HNC) and over 50% of tonsillar carcinomas. High risk types of HPV such as 16 and 18 are found in over 95% of such tumours. Malignant transformation is mediated through the E6 and E7 proteins that alter tumour suppressor pathways by inactivating P53 and Rb. Patients suffering from HPV-related HNC (HNC HPV+) have been shown to be younger, and usually not smokers or drinkers. Oral sexual practice is an additional risk factor. Better results of treatment are often observed independently of other prognostic factors such as T or N. Therapeutic vaccines targeting viral proteins may have potential to control HPV-associated malignancies in future. In this paper, diagnostic methods of HPV in HNC patients and the influence of this virus on aetiotogy, course and results of treatment are presented.