Original Research

The radiological features of HPV-positive vs HPV-negative OPSCC at a South African hospital

Anand Naranbhai, Amir Afrogheh, Suzanne O’Hagan, Johan Grobbelaar, Leon Janse van Rensburg
South African Journal of Radiology | Vol 28, No 1 | a2976 | DOI: https://doi.org/10.4102/sajr.v28i1.2976 | © 2024 Anand Naranbhai, Amir Afrogheh, Suzanne O’Hagan, Johan Grobbelaar, Leon Janse van Rensburg | This work is licensed under CC Attribution 4.0
Submitted: 03 July 2024 | Published: 13 November 2024

About the author(s)

Anand Naranbhai, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Amir Afrogheh, Department of Oral and Maxillofacial Pathology, National Health Laboratory Service and University of the Western Cape, Cape Town, South Africa; and, Division of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
Suzanne O’Hagan, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Johan Grobbelaar, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Leon Janse van Rensburg, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Radiology and Diagnostics, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa

Abstract

Background: Studies have found that, at presentation, human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) has a less advanced primary tumour, more advanced lymph node spread and commonly has cystic metastatic lymph nodes in comparison to HPV-negative OPSCC.

Objectives: To compare the radiological features of HPV-positive and HPV-negative OPSCC in South African patients.

Method: A retrospective cross-sectional study was conducted at a large South African hospital. Eligibility required a histologically proven OPSCC between 2007 and 2023; a p16 antigen test and, if positive, a confirmatory HPV DNA PCR test and a baseline pre-treatment contrast enhanced neck CT scan. All eligible HPV-positive OPSCC patients and a random sample of eligible HPV-negative OPSCC patients were enrolled.

Results: Twenty-one HPV-positive and 55 HPV-negative OPSCC patients were recruited. There was no statistically significant difference in the tumour epicentre location, local advancement (≥ T3 in 67% and 71%, respectively, p = 0.54), mean primary tumour size (41 mm vs. 39 mm, p = 0.73), lymph node spread (bilateral or more in 67% vs. 82%, p = 0.22) or morphologically cystic lymph nodes (10% and 4%, p = 0.61).

Conclusion: There was no statistically significant difference in the CT imaging appearances of HPV-positive and HPV-negative OPSCC in the studied sample of South African patients.

Contribution: This study documents the radiological features of OPSCC in a small South African sample population, where HPV-positive and HPV-negative OPSCC could not be distinguished on CT criteria and did not display the classic features described in the literature.


Keywords

Radiology; HPV; oropharyngeal squamous carcinoma; South Africa; CT scan; p16 antigen; HPV DNA PCR

Sustainable Development Goal

Goal 3: Good health and well-being

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