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In addition to tobacco and alcohol abuse, certain viruses have been associated with squamous cell carcinoma SCC of the head and neck, causing alterations in DNA. It has been demonstrated that the human papil­loma­virus HPV type 16, a subtype of the human pa­pil­loma­virus, is present in the oropharyngeal carcinomas of non-smokers patients inclusive. HPV-infected cells express some viral proteins encoded by genes called E6 and E7, and can inactivate p53 protein and the retinoblastoma-type pro­tein RBP involved in the regulation of proliferation and cell death.

Materials and method.

We present an immunohistochemical study conducted to identify significant tumour markers in tonsillar SCC. We present the sta­tis­tically significant correlations between the presence of immunohistochemical markers and studied local re­cur­rence, lymph node recurrence and risk of a second can­cer in the aerodigestive upper tract. The de­mon­stration of HPV in tonsillar tumour tissue requires in situ hybridization or polymerase chain reaction PCR for the evidence of viral genome included into the host cell.

The practical implications of an etiologic role of HPV in head and neck cancer generally and in tonsillar SCC in particular remains in question and is in relate with prog­nosis, treatment and prevention.

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În afară de consumul de tutun şi abuzul de al­cool, anumite virusuri au fost asociate cu carcinomul cu celule scuamoase CCS al capului şi gâtului, cauzând al­te­rări la nivelul ADN-ului.

Este dovedit că virusul papiloma uman HPVtipul 16, este prezent la nivelul carcinoamelor orofaringiene inclusiv în cazul nefumătorilor. Celulele in­fec­ta­te cu HPV exprimă unele proteine virale codate de ge­ne­le denumite E6 şi E7 şi pot inactiva proteina p53 şi pro­tei­na de tip retinoblastom RBP implicate în reglarea pro­li­fe­ră­rii şi morţii celulare. Materiale şi metodă.

Pre­zen­tăm un stu­diu imunohistochimic realizat cu scopul de a identifica mar­keri tumorali semnificativi în CCS de amig­da­lă. Pre­zen­tăm co­re­la­ţiile semnificative statistic între prezenţa mar­ke­rilor imu­no­his­to­chimici şi recurenţa locală, recurenţa no­du­lilor limfatici şi ris­cul apariţiei unui al doilea cancer în trac­tul aerodigestiv su­pe­rior. Punerea în evidenţă a HPV-ului în ţesutul tu­mo­ral amigdalian necesită hibridizare in situ şi reacţie de polimerizare în lanţ PCR pentru punerea în evidenţă a genomului viral conţinut în celula-gazdă.

Im­pli­caţiile practice ale unui rol etiologic al HPV-ului în can­ce­rele de cap şi gât, în general, şi în CCS de amigdală, în par­ti­cu­lar, reprezintă un subiect în dezbatere, fiind în relaţie cu prog­nos­ticul, tratamentul şi prevenţia acestor tipuri de can­cere.

Cuvinte cheie carcinomul cu celule scuamoase de amigdală CCS HPV markeri tumorali Introduction The tonsillar squamous cell carcinoma SCC is becoming a public health problem hpv and cancer link of its rising incidence in the last 20 years, in contrast to the decreasing incidence of carcinomas in other subsites of head and neck associated to the reduced prevalence of smoking.

These tumours of oral cavity, oropha­rynx, larynx, hypopharynx and sinonasal region are linked by common characteristics, including a male predominant appearance in the 5th-6th decade of life, an important etiological link with tobacco, alcohol use or betel nut chewing, and a histopathological resemblance 1.

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Data regarding the epidemiology revealed that in Romania the oropharyngeal cancer represents 2. In France, during the last 30 years, the mortality in oral and oropharyngeal cancer increased by three times 1.

As in cervical hpv and cancer link, the oropharyngeal infection with HPV is a sexually transmitted disease which involves some particularities of sexual behaviour: a large number of vaginal sex hpv and cancer link, oral and anal sex.

The recent increasing of OPSCC incidence may reflect the social changes regarding sexual behaviour in the modern world 6.

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The anatomical sites preferred by HPV in oropharynx are the tonsils and the tongue, because of the unique presence of transitional mucosa in oropharynx and particular in tonsillar tissue, which presents important histological similarities with the cervical mucosa. Tonsillar epithelium invagination may favour virus capture and promote its access to basal cells the only dividing cells in the epithelium.

Oamenii de știință cred că vaccinarea la nivel mondial contra acestei forme de cancer ar putea însemna eradicarea definitivă a bolii. Fetele și adolescenetele sunt vaccinate contra virusului HPV în Anglia, iar Scoția a introdus programul național de imunizare contra HPV înpe fetele de ani. Cercetătorii au mai descoperit și că vârsta este un factor important în succesul acestui vaccin: imunizarea fetelor în vârstă de 12 ani este de aproape două ori mai eficientă decât imunizarea adolescentelor de 17 ani.

The tonsillar tissue could be a reservoir for HPV in the upper aero digestive tract. We had two premises for our study on tonsillar cancers.

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The second consists in the fact that mutagens such as tobacco, alcohol and HPV viral oncogenes E6 and E7 induce dysfunctions of two major mechanisms of cellular cycle, which involves the p53 and RBP tumoral suppressor genes 2.

Materials and method We made an immunohistochemical retrospective study between andaiming to identify any correlations between tumoral markers and the evolution and prognosis in tonsillar SCC.

Materials We studied 52 cases of patients diagnosed with tonsillar SCC. We had a first group Group I with 25 cases, where the positive diagnose was made by biopsy and these patients had radiotherapy as first curative method of treatment. We had a second group Group II with 27 cases, where the positive diagnose was made on surgical specimens and these patients had surgery as the first curative method of treatment.

The two groups were similar regarding age and gender distribution. The dilutions and markers specifications are revealed in Table 1. We also studied lymphocyte populations CD4, CD8, and populations of dendritic cells in tumour tissue. Table 1.

The dilutions and markers specifications For the immunohistochemical identification of tumoral antigens we used the three-stadial indirect condiloame perianale Avidine-Biotine-Peroxidase ABPafter Hsu and colab. Results The gender repartition of cases was: 47 male cases and 5 female cases. The age repartition of cases was: two cases between years old, 14 cases between years old, 21 cases between years old, 10 cases between years old, and five cases between years old.

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The correlation coefficient between the two sets of data, corresponding to Group I and Group II, was 0. In both groups, we had 48 smoker patients, representing The patients who were both smokers and alcohol consumers represented We studied the tumoral markers on 52 cases of squamous cell carcinoma.

Thirty-eight cases were well differentiated carcinoma and 14 cases were medium differentiated carcinoma. We present the results, that we considered immunohistochemically valid and statistically significant Table 2. Table 2. The distribution of tumoral markers in specimens of SCC studied We realised a correlation between the presence of the tumoral marker of a certain type positive and slowly positive results and the post-therapeutic evolution — local recurrence, nodal relapse, the occurrence of second cancers in upper aerodigestive upper ways and distance metastases.