Human papilloma virus in Oropharyngeal cancers

Ahmad A. Al-Qudah

Supervisor :Dr. Laila F. Nimri

Human papilloma virus in Oropharyngeal cancers

- What is the Virus ? .

- Virus’s and Cancers .- Oropharyngeal Region .

- Human papilloma virus : - Diseases ( Warts , Cancers , STD’s ) . - Diagnosis .- Treatment & Vaccine .

- Call’s for Teenage vaccine ( Male’s and Female’s ) .

- Vaccine Anaphylactic shock .

- Abstract .

- Bibliography .

What is the Virus ?

Virus : is a small infectious agent that can replicate only inside the livingcells of an organism.

What is the Virus ?

- Consist of two or three parts: i) the genetic material made from either DNA or RNA, long molecules that carry

genetic information.ii) a protein coat that protects these genes.iii) and in some cases ; an envelope of lipids that surrounds the protein coat when

they are outside a cell.

What is the Virus ?

- The Major classification of viruses is based on the Viral genomes and mechanism of mRNA production. (Viruses must generate

mRNAs from their genomes to produce proteins and replicate themselves).

- This classification places viruses into seven groups:I: dsDNA viruses II: ssDNA viruses (+)sense DNA III: dsRNA viruses IV: (+)ssRNA viruses (+)sense RNA V: (−)ssRNA viruses (−)senseVI: ssRNA-RT viruses (+)sense RNA with DNA intermediate in life-cycle VII: dsDNA-RT viruses

Virus’s and Cancers

- Oncovirus

is a virus that can cause cancer.

- The vast majority of human and animal viruses do not cause cancer

- Causes transformation in cells through interfering with tumor suppressor proteins

- These transformation lead to Neoplastic and Dysplastic Malignancies .

Virus’s and Cancers

- Epstein-Barr virus (EBV), associated with lymphomas and nasopharyngeal cancer.

- Hepatitis B virus (HBV) and hepatitis C virus (HCV), both associated with cancer of the liver.

- Human papillomaviruses (HPV), associated with cancer of the cervix.

- Human T lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2), associated with adult T-cell leukemia and with hairy-cell leukemia.

- Human herpesvirus 8 (HHV-8), associated with Kaposi sarcoma.

Human papilloma virus

- Small , unenveloped , Double stranded Circular DNA Virus from the papillomavirus family that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes.

- It’s one of the most common STD’s .

- The incubation Period range from 1 month to 2 years .

- There are more than 100 different HPV types , 40 of them can cause Warts or lesions , and some of these 40 can start a carcinoma .

- HPV types 6 and 11 are mostly associated with genital warts . ( low risk of Malignancy ) .

- HPV types 16,18,31,33,35 have a strong association with cervical cancer and other cancers .

Human papilloma virusDiseases ( Warts , Cancers , STD’s )

- Some HPV infections can cause warts :1 - Skin Warts : Common , Plantar , Flat .2 – Genital Warts : condylomata acuminata.

- Respiratory papillomatosis : HPV types 6 and 11 can cause a rare condition known as recurrent respiratory papillomatosis, in which warts form on the larynx or other areas of the respiratory tract.

- Cancers : Cervical Cancer , Anal Cancer ,

Oropharyngeal Cancer .

Human papilloma virus

Human papilloma virus

Human papilloma virus

Human papilloma virus

Oropharyngeal Region

Anatomy

Oropharyngeal Warts

Oropharyngeal Warts

Oropharyngeal Cancer

Oropharyngeal Cancer

Human papilloma virusDiagnosis

1- Cytological & Histological test :The Pap Smear test , looking for HSIL , LSIL , ASC.

Human papilloma virusDiagnosis

3- Serologic Findings : Enzyme-Linked immunosorbant assay ( ELISA ) .

Used to provide IgM and IgG serologic measures of HPV infection .

2- Molecular Method :By PCR , Gives the most Specific Diagnosis of HPV type.

Human papilloma virusTreatment

- There is currently no specific treatment for HPV infection .

- The viral infection, more often than not, clears by itself.

- According to the Centers for Disease Control and Prevention, the body’s immune system clears HPV naturally within two years for 90% of cases .

Human papilloma virusVaccine

- Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer.

- These vaccines are given in three shots. It is important to get all three doses to get the best protection.

- The vaccines are most effective when given at 11 or 12 years of age.

Human papilloma virusVaccine

Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers .

Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers

Human papilloma virus

Calls for teenage boys

to be vaccinated against

sexually transmitted virus

after throat cancer

cases doubled.

- Homosexuality .

Throat cancer became 1# in head and neck cancers .

- HPV16 accounted for a 32-fold increase in risk for oropharyngeal squamous cell cancers.

Human papilloma virusVaccine Anaphylactic shock

- A sudden, serious allergic reaction -- known anaphylaxis or anaphylactic shock -- following vaccination. "extremely rare”.

- Higher Anaphylaxis Rates After HPV Vaccination

Human papilloma virusAbstract

Human papillomavirus (HPV) infection is causally associated with benign and malignant diseases of the upper airway, including respiratory papillomatosis and oropharyngeal cancer. From an epidemiological perspective, a strong and consistent association between markers of HPV16 exposure and oropharyngeal cancer has been demonstrated in numerous case-control studies. HPV-positive oropharyngeal cancers have also been shown to be distinct from HPV-negative head and neck squamous cell cancers with regard to risk-factor profiles, molecular genetic alterations, population-level incidence trends over time, and prognosis.

Tumor HPV status is the strongest determinant of survival for patients with local-regionally advanced oropharyngeal cancer : patients with HPV-positive cancer have at least a 50% improvement in overall survival at 5 years, which is equivalent to an approximate 30% difference in absolute survival. Thus, HPV status determination is now part of the routine diagnostic evaluation for prognostication.

Preliminary evidence indicates that a small proportion of head and neck cancers may be caused by additional HPV types (e.g., 18, 31, 33, 35) and that HPV-caused cancers may arise from non-oropharyngeal sites .

Whether or not HPV vaccination has the potential to prevent oral HPV infections that lead to cancer or papillomatosis in the upper airway is currently unknown, as is the potential for secondary prevention with HPV detection.

Human papilloma virus

Bibliography

- http://en.wikipedia.org/wiki/Human_papillomavirus

- http://www.cdc.gov/std/hpv/stdfact-hpv.htm

- The role of human papillomavirus in nongenital cancers.

- The HPV infection in males: an update.

- The biology and life-cycle of human papillomaviruses.

- Human papillomavirus and diseases of the upper airway: head and neck cancer and respiratory papillomatosis.

- Predicting HPV Status in Head and Neck Cancer: The Predictive Value of Sociodemographic and Disease Characteristics.

- HPV, Oropharyngeal Cancer, and the Role of the Dentist: A Professional Ethical Approach.

- Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States

- Oral HPV Infection and Sexuality: A Cross-Sectional Study in Women