Diagnostic and prognostic significance of Epstein-Barr virus and Human Papillomavirus Associated with throat Cancer: A literature review

Abstract

Relevance:  Pharyngeal cancer (PC) is a malignant neoplasm in the oropharynx and nasopharynx associated with Epstein-Barr viruses (EBV) and human papillomavirus (HPV). Both viruses have oncogenic potential, affecting the pathogenesis of  PC.

EBV, which infects more than 90% of the population, can cause various benign and malignant diseases. HPV, especially types 16 and 18, is the main oncogenic factor of oropharyngeal cancer (OPC). The E6 and E7 proteins produced by HPV disrupt the action of tumor suppressors p53 and Rb, which leads to uncontrolled cell proliferation.

EBV activates latent proteins and regulates the immune response, whereas HPV affects cell cycle control by inactivating p53 and Rb. HPV-induced PC has a better prognosis compared to EBV-associated cancer due to higher sensitivity to treatment.

The study aimed to systematize literature data on assessing the diagnostic and prognostic significance of EBV and HPV associated with PC and improve programs for early diagnostics and primary prevention of head and neck tumors.

Methods: Since 2015, a literature review has been conducted on the study’s keywords in the PubMed and MedLine databases.

Results:  Studies show that EBV and HPV are important in the diagnosis and prognosis of  PC. The EBV presence in tumor cells can mark a more aggressive course of the disease. However, in some cases, it is associated with better treatment results. Patients with HPV-positive tumors have better prognoses and a more favorable response to treatment compared to HPV-negative cases. Both viruses play an important role in the pathogenesis of PC, and their diagnosis and characterization can significantly affect treatment tactics and prognosis of the outcome of the disease.

Conclusion: EBV and HPV play key roles in the pathogenesis of RG, but their mechanisms of action and clinical outcomes differ. EBV is more often associated with nasopharyngeal cancer, and HPV is associated with OPC. The latter is more common in Western countries and has a more favorable prognosis. Future research should focus on developing more effective prevention, diagnosis, and treatment methods for these viruses.