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Objectives: Nasopharyngeal carcinoma (NPC) is a rare cancer in the United States. An association between NPC and Epstein-Barr virus (EBV) is well-established for World Health Organization (WHO) types II and III (WHO-II/III) NPC but less well-established for WHO type I (WHO-I) NPC. Given the rise in oropharyngeal tumors positive for high-risk human papillomavirus (HPV) and the unique biology of WHO-I NPC, we examined the relationship between HPV and WHO-I NPC. Study Design: Retrospective case-comparison study. Methods: A search of a large multidisciplinary cancer center tumor registry identified 183 patients seen from January 1999 to December 2008 with incident NPC and no prior cancer. Available paraffin-embedded tumor specimens (N = 30) were analyzed for oncogenic HPV status by in situ hybridization (ISH) and polymerase chain reaction (PCR) for HPV-16 and HPV-18; EBV status by ISH; and p16 expression by immunohistochemistry. Demographic parameters, including race and smoking, were obtained from the medical records. Results: Among the 18 WHO-I NPC patients, 66% (N = 12) were smokers and 17% (N = 3) Asian; among the 165 WHO-II/III NPC patients, 44% (N = 73) were smokers and 24% (N = 39) Asian. Eight WHO-I NPC patients had available paraffin blocks; five of six were HPV-16-positive by PCR and four of eight were HPV-positive by ISH; only two of eight (25%) were EBV-positive. Twenty-two WHO-II/III NPC patients had available paraffin blocks; only 1 was HPV-positive by ISH, and 13 of 22 (60%) were EBV-positive. Conclusions: These results suggest that WHO-I NPC is associated with oncogenic HPV, although larger studies are needed to verify these findings. Laryngoscope, 2010

Nasopharyngeal carcinoma (NPC) is a rare cancer in the U.S. that has a well-established association with Epstein-Barr virus(EBV) for WHO types II/III but less so for WHO type I. Given the rise in oropharyngeal tumors positive for high risk human papillomavirus (HPV) and the unique biology of WHO type INPC, we chose to examine the relationship between HPV and WHO type I NPC.Retrospective case comparison study.A search of a large multidisciplinary cancer center tumor registry identified 183 patients seen from January 1999 to December 2008 with incident NPC and no history of prior cancer. Available paraffin embedded tumor specimens (N=30) were analyzed for HPV status by in situ hybridization (ISH) and polymerase chain reaction (PCR) for HPV 16 and 18, EBV status by ISH, and p16 expression by immunohistochemistry. Demographic parameters, including race, smoking, and alcohol exposure were obtained from the medical records.Patients with incident WHO-I NPC (N=18) tended to be smokers (66%) and only 17% were Asian, while for patients with incident WHO-II/III NPC (N=165), 44% were smokers and 24% were Asian. For WHO-I NPC patients with available paraffin blocks (N=8), 5 of 6 were HPV 16+ by PCR and 4 of 8 had HPV identified by ISH, while only 2 of 8 were EBV+. Of patients with WHO II/III NPC and available archival tissue (N=22), 60% were EBV+ and only one was HPV positive by ISH.These results suggest that WHO type I NPC may be associated with oncogenic HPV, though larger studies are needed to verify these findings.