Infecção pelo Papiloma vírus humano em indivíduos portadores de neoplasia de cavidade oral e orofaringe atendidos por hospital terciário em Salvador – Bahia

Abstract

Introduction: Cancer is one of the main causes of morbidity and mortality in the world, with carcinoma of the oropharynx and oral cavity representing about 2% to 4% of all cases, accounting for the fifth most common type of cancer in men in Brazil. Classically associated with lifestyle habits such as smoking and alcohol consumption, at an older age, the appearance of these cancers in younger individuals without such habits has been associated with Human Papillomavirus (HPV) infection. This virus with a wide global distribution and high prevalence may play an important role in the carcinogenesis of cancers of the oral cavity and oropharynx in our population, but there is no data in the literature that estimate the real importance of formal information on patients. Objective: To investigate HPV infection in patients diagnosed with cancer of the oral cavity and oropharynx treated at a tertiary hospital specialized in cancer treatment in the city of Salvador, Bahia, in the period 2017-2021. Method: A retrospective, descriptive observational study, with inclusion criteria of people residing in the state of Bahia who were referred for diagnosis, staging and/or treatment of oropharyngeal or oral cavity carcinoma at Hospital Aristides Maltez (HAM) - Tertiary Hospital specialized in treatment of cancer, over 18 years old, located in Salvador-BA, from 2017 to 2021. A search for p16 protein by immunohistochemistry, an indirect marker of HPV infection, was performed in lesions suspected and diagnosed with oral cavity and oropharyngeal cancer. Results: Among the 39 individuals who participated in the study, 25.6% (10) were considered HPV positive due to p16 positivity. HPV negative patients had a mean age of 63.0 years, while HPV positive patients had a mean age of 55.4 (p=0.03, Mann Whitney). A significant association was found between cancer staging and age in HPV negative patients, showing that elderly patients are associated with more advanced stage tumors (r= 0.397; p= 0.04, Spearman). Regarding the association of alcoholism and smoking, it was found that 90.5% (19 individuals) of those who drink and smoke at the same time have more advanced tumor staging (p=0.03; Fisher's exact test). Discussion: Our study showed that the study population mostly have HPV negative oral cavity and oropharynx tumors (74.35%), with HPV positive tumors accounting for 25.65%, being these more common in younger individuals. Smoking and drinking habits, concomitantly, are associated with more advanced grades of tumors. Conclusion: Most cases of oral cavity and oropharyngeal cancer in our population are not associated with HPV. Its prevalence is similar to that of developed countries about 20 years ago, enabling the development of public policies to prevent HPV infection.