Prognostic role of PD-L1 and P53 proteins in oropharyngeal squamous cell carcinoma depending on the status of the human papilloma virus

Background: At a time lots of cases of HPV associated oropharyngeal squamous cell carcinoma (HPV + OPSCC) are on the rise and excellent outcomes are seen when comparing HPV-OPSCC, identification of HPV status has become a powerful and widely used marker. Despite this, 20–25 % of HPV + OPSCC patients relapse within 3 years. The most significant barrier to identifying patients at high risk of relapse and death is the lack of clinically useful prognostic markers.

Methods: The study included 62 patients treated with OPSCC T1–4N0–3M0 (7th edition, AJCC) in 2015–2020 in clinics located in two large cities of Uzbekistan (Tashkent and Samarkand). The study analyzed the prognostic value of PD-L1 and p53 proteins in OPSCC, taking into account HPV status. In addition, the relationship between PD-L1, p53 and HPV status was analyzed, as well as their impact on patient survival.

Results: Positive HPV status with positive PD-L1 expression improves overall survival of patients compared to their negativity (p = 0.261). The mutant type of p53 protein has a negative correlation with HPV status, which reduces survival time (p < 0.001). Wild type p53 is detected in a small number of patients, but it shows a positive correlation with HPV status as a strong protective factor that reduces the risk of death (p = 0.01).

Conclusion: Positive HPV status is not always a reliable predictor of risk stratification for patients with OPSCC, because additional indicators associated with the development of OPSCC need to be identified to reinforce the value of predictive predictors other than HPV status.

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