Hyunchul Kim1, Mi Jung Kwon2,3*, Bumjung Park4, Hyo Geun Choi4, Kyung Chan Choi5, Eun Sook Nam6, Seong Jin Cho6, Yun Joong Kim3, Nan Young Kim3, Kyueng-Whan Min7, Ha Young Park8 and Eun Soo Kim9
1Department of Pathology, Dongtan Sacred Heart Hospital, Republic of Korea
2Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
3Hallym Institute of Translational Genomics and Bioinformatics, Hallym University Medical Center, Republic of Korea
4Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
5Department of Pathology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
6Department of Pathology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
7Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Republic of Korea
8Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Republic of Korea
9Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Republic of Korea
Background: Telomerase Reverse Transcriptase (TERT) gene promoter mutation, leading to immortalization of cancer cells, is a potential candidate for pathogenesis and therapeutic target of Tonsillar Squamous Cell Carcinomas (TSCCs) in association with Human Papillomavirus (HPV). However, the prevalence of TERT promoter mutations and their clinical or prognostic relevance in patients with tonsil cancer in association with HPV under the new staging system is not clear. Methods: We analyzed the TERT promoter mutations through real-time peptide nucleic acidmediated PCR methods and detected the HPV status in 80 TSCC patients. Results: The TERT promoter mutation was found in 7.5%, and HPV in 80.0% of the patients. We did not observe any association between TERT promoter mutation and the clinicopathological variables. However, TERT promoter mutation was identified as the independent prognostic factor for Disease-Free Survival (DFS) in TSCC patients. Interestingly, TERT promoter mutation had strong prognostic impacts on worse Overall Survival (OS) and DFS only in HPV-negative tumors. The HPV-negative and TERT promoter-mutated subgroup had the worst prognosis than other subgroups. In addition, the 8th American Joint Committee on Cancer (AJCC) staging system performed better in the discrimination and stratification of T, and N categories, and overall staging than the 7th edition. Conclusion: Our results suggest that a combined analysis of HPV and TERT promoter mutation could define a representative subset of patients and prognostic groups.
Tonsil; Squamous cell carcinoma; Human papillomavirus; TERT promoter mutation
Kim H, Jung Kwon M, Park B, Geun Choi H, Chan Choi K, Sook Nam E, et al. Prognostic Relevance of TERT Promoter Mutations in Tonsillar Squamous Cell Carcinoma in Association with Human Papillomavirus. Clin Surg. 2019; 4: 2613..