Biologic and behavioral associations of estrogen receptor alpha positivity in head and neck squamous cell carcinoma.

Abstract

OBJECTIVES:

Tumor HPV status is an established independent prognostic marker for oropharynx cancer (OPC). Recent studies have reported that tumor estrogen receptor alpha (ERα) positivity is also associated with prognosis independent of HPV. Little is known about the biologic and behavioral predictors of ERα positivity in head and neck squamous cell cancer (HNSCC). We therefore explored this in a multicenter prospective cohort study.

MATERIALS AND METHODS:

Participants with HNSCC completed a survey and provided a blood sample. Tumor samples were tested for ERα using immunohistochemistry. ERα positivity was defined as ≥1%, standardized by the American Society of Clinical Oncology/College of American Pathologists in breast cancer. Characteristics were compared with χ2 and Fisher's exact test. Odds ratios (OR) were calculated using logistic regression.

RESULTS:

Of 318 patients with HNSCC, one third had ERα positive tumors (36.2%, n = 115). Odds of ERα expression were significantly increased in those with HPV-positive tumors (OR = 27.5, 95% confidence interval[CI] 12.1-62), smaller tumors (≤T2, OR = 3.6, 95% CI 1.9-7.1), male sex (OR = 2.0, 95% CI 1.1-3.6), overweight/obesity (BMI ≥ 25, OR = 1.9, 95% CI 1.1-3.3), and those married/living with a partner (OR = 1.7, 95% CI 1.0-3.0). In a multivariate model, HPV-positivity (aOR = 27.5, 95% CI 11.4-66) and small tumor size (≤T2, aOR = 2.2, 95% CI 1.0-4.8) remained independently associated with ERα status. When restricted to OPC (n = 180), tumor HPV status (aOR = 17.1, 95% CI 2.1-137) and small tumor size (≤T2, aOR = 4.0 95% CI 1.4-11.3) remained independently associated with ERα expression.

CONCLUSION:

Tumor HPV status and small tumor size are independently associated with ERα expression in HNSCC.

• Authors: Virginia Drake, Elaine Bigelow, Carole Fakhry, Melina Windon, Lisa M Rooper, Patrick Ha, Brett Miles, Christine Gourin, Rajarsi Mandal, Wojciech Mydlarz, Nyall London, Peter S Vosler, Siddhartha Yavvari, Tanya Troy, Tim Waterboer, David W Eisele, Gypsyamber D'Souza
• Journal: Oral oncology (Oral Oncol) Vol. 121 Pg. 105461 (10 2021) ISSN: 1879-0593 [Electronic] England
• PMID: 34304004 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Chemical References

• Estrogen Receptor alpha

Topics

• Estrogen Receptor alpha (genetics)
• Female
• Head and Neck Neoplasms (genetics, virology)
• Humans
• Male
• Oropharyngeal Neoplasms (genetics, virology)
• Papillomavirus Infections (complications)
• Prognosis
• Prospective Studies
• Squamous Cell Carcinoma of Head and Neck (genetics, virology)