Prevalence of human papillomavirus type 16 DNA in squamous cell carcinoma of the palatine tonsil, and not the oral cavity, in young patients: a distinct clinicopathologic and molecular disease entity

Am J Surg Pathol. 2003 Nov;27(11):1463-70. doi: 10.1097/00000478-200311000-00010.


Squamous cell carcinoma of the head and neck commonly affects patients in their sixth decade and older, particularly those with a prolonged history of alcohol and tobacco abuse. Less frequently, carcinomas occur in young individuals even in the absence of known risk factors. The purpose of this study is to investigate a possible relationship between these tumors and human papilloma virus (HPV). Thirty-three cases of squamous cell carcinoma of the head and neck in young patients under the age of 40 years were studied: 15 oral, 11 tonsillar, and 7 laryngeal. HPV DNA was detected by polymerase chain reaction in 10 tonsillar and 2 laryngeal carcinomas and in none of the oral tumors. Of the 12 HPV-positive tumors, 11 were HPV16 and 1 was HPV31. HPV-positive tumors had a distinct nonkeratinizing basal cell morphology, they stained diffusely and strongly with p16 antibodies, had higher Ki-67 and lower p53 staining scores as compared with the conventional keratinizing HPV negative carcinomas. It is concluded that in young patients high-risk HPV, particularly HPV16, is strongly associated with tonsillar squamous cell carcinoma and some cases of laryngeal, but not oral, tumors. The HPV-positive carcinomas have a distinct histopathologic and immunophenotypic features.

MeSH terms

  • Adult
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology*
  • DNA, Neoplasm / analysis
  • DNA, Viral / analysis*
  • Female
  • Humans
  • Ki-67 Antigen / metabolism
  • Male
  • Palatine Tonsil / metabolism
  • Palatine Tonsil / pathology
  • Palatine Tonsil / virology*
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / metabolism
  • Papillomavirus Infections / pathology
  • Polymerase Chain Reaction
  • Tonsillar Neoplasms / metabolism
  • Tonsillar Neoplasms / pathology
  • Tonsillar Neoplasms / virology*


  • Biomarkers, Tumor
  • DNA, Neoplasm
  • DNA, Viral
  • Ki-67 Antigen