RESULTS OF PROLIFERATION MARKERS KI 67 AND P16 HAVE HPV-POSITIVE AND HPV-NEGATIVE PATIENTS WITH CANCER OF THE ORAL CAVITY AND OROPHARYNX IN KAZAKHSTAN
Objective: to study the prevalence and the role of different types of human papillomavirus (HPV), as well as its impact on treatment outcomes and survival in patients with cancer of the oral cavity and oropharynx in Kazakhstan. Cancer of the oral cavity and oropharynx remains an urgent global problem, and the most common form of head and neck tumors. Increasing the number of patients with cancer of the oral cavity and oropharynx in the last decade by almost half, it gave the background to the conduct of many of the world research in this field, and has revealed a direct correlation with the spread of human papillomavirus (HPV) among the population. Squamous cell carcinoma associated with HPV, most often affects the oropharyngeal region and is characterized by a better prognosis. HPV diagnostics may be based on a study of its specific DNA contained in the DNA of the tumor cells by PCR. Another way to detect HPV may be an immunohistochemical study to detect expression of a gene product p16, which is an indirect marker of HPV infection. Defining a single cell proliferation markers (p16 and Ki-67) represents a violation of control cell division and identifies the cells infected with HPV. The study included 49 patients with morphologically verified cancer of the oral cavity or oropharynx I to stage IV disease. Treatment was carried out regardless of the presence or absence of HPV in the normal way, depending on the stage and location of the tumor process. All patients underwent PCR, IHC and ICC to determine the presence of HPV DNA chains as well as proliferation markers p16 and Ki 67. As a result of PCR study in 9 patients revealed a positive HPV, of which the genome of HPV type 16 in 6 patients, and in 3 cases a positive genome of HPV 56 type. In the study of p16 protein expression levels in tumor cells revealed a positive correlation between the presence of p16 expression and HPV carriage, as well as a high level of proliferative activity of Ki 67, which may be a good prognostic sign for this group of patients.