The International Tinnitus Journal

Distribution of HPV Genotypes 16 and 18 among Resected Tonsillar Tissues from Pediatric Patients Operated for Non- Oncologic Nasopharyngeal and Palatine Tonsillar Hypertrophies

Author(s): Tahseen Mezher Hashim, Shamil Abbood Hilal, Zainab Khalid Shehab Almukhtar, Saad Hasan Mohammed Ali, Shakir H. Mohammed Al-Alwany, Athraa Y. Al-hijazi, Ahmed Muhei Rasheed*, khalil Ismail Abid Mohammed

Background: Recent advancements in molecular techniques have identified over 450 genotypes of Human Papillomavirus (HPV), classified into low- and high-oncogenic risk categories. The rise in high-oncogenic risk HPV genotypes has been linked to various cancers, including those affecting the oral, oropharyngeal, and nasopharyngeal regions in both pediatric and adult populations. Methods: In this study, a cohort of 102 tonsillar tissue samples was included. This comprised 40 specimens from pediatric patients aged 4 to 9 years with nasopharyngeal adenoid hypertrophies, and 42 specimens from pediatric patients aged 5 to 12 years with palatine tonsillar hypertrophies. Among the 82 tonsillar tissue samples analyzed, 38 were from pediatric patients who underwent single-tonsillar type operations, while 22 were from pediatric patients who underwent dual-tonsillar type operations, resulting in a total of 44 tissues. Additionally, 20 control tissue samples were obtained from apparently healthy pediatric patients aged 5 to 12 years, following trimming operations of their inferior nasal turbinate tissues, which exhibited no notable pathological changes. For the detection of HPV 16/18 DNA, a recent iteration of Chromogenic in Situ Hybridization (CISH) technique employing specific DNA probes was utilized. Results: In the analysis, among the 40 nasopharyngeal tonsillar hypertrophied tissues, 35.0% exhibited positive CISH reactions for HPV 16/18 DNA detection. Similarly, within the palatine tonsillar hypertrophied tissue group, 30.1% displayed positive CISH signals for HPV 16/18 DNA. For the 22 specimens obtained from dual-tonsillar type operations in the same pediatric patients (totaling 44 tissues), 45.5% showed positive-CISH signals for HPV 16/18 DNA at both sites. Notably, none of the control nasal tissues demonstrated positive-CISH reactions. Statistical analysis revealed a significant difference (P Value <0.05) when comparing the results of tonsillar hypertrophied tissues to those of the control group. Conclusions: The notable presence of human papillomaviruses 16 and 18, particularly in their integrated forms of HPV-DNA, within pediatric groups exhibiting nasopharyngeal and palatine tonsillar non-oncologic hypertrophies, raises critical concerns regarding the potential spread of these high-oncogenic risk genotypes. These findings suggest that these sites may serve as reservoirs for the transmission of such viruses to adjacent mucosal tissues in the head and neck region. Furthermore, this presence of HPV could be a contributing factor in the pathogenesis, tumorigenesis, and carcinogenesis processes, constituting a significant step in this chain of events. Understanding these dynamics is crucial for developing effective strategies to prevent and manage the associated health risks in affected populations.

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