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AU'18 Oral Path II > HPV-Related Cancers - part II > Flashcards

HPV-Related Cancers - part II Flashcards

1
Q

etiology of oral squamous cell carcinoma (OSCC)

A
  1. smoking

2. ETOH

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2
Q

etiology of oropharyngeal squamous cell carcinoma (OPSCC)

A

increased number of sexual partners, majority HPV+

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3
Q

what percent of people with oropharyngeal squamous cell carcinoma (OPSCC) has HPV 16?

A

90%

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4
Q

primary clinical features of oral squamous cell carcinoma (OSCC)

A
  1. leukoplakia
  2. erythroleukoplakia
  3. erythroplakia
  4. ulcer
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5
Q

primary clinical features of oropharyngeal squamous cell carcinoma (OPSCC)

A
  1. enlarged lymph node in neck
  2. dysphagia
  3. very subtle, asymptomatic initially
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6
Q

T/F: incidence of oral squamous cell carcinoma (OSCC) is increasing

A

false, decreasing

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7
Q

T/F: incidence oforopharyngeal squamous cell carcinoma (OPSCC) is increasing

A

true

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8
Q

is there nodal involvement with oral squamous cell carcinoma (OSCC)?

A

yes

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9
Q

is there nodal involvement with oropharyngeal squamous cell carcinoma (OPSCC)?

A

yes and may be the only sign of the disease

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10
Q

gender predilection for oral squamous cell carcinoma (OSCC)

A

3 M: 1 F

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11
Q

gender predilection for oropharyngeal squamous cell carcinoma (OPSCC)

A

5 M : 1 F

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12
Q

what percent of pts with oral squamous cell carcinoma (OSCC) were smokers?

A

80-90%

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13
Q

what percent of pts with oropharyngeal squamous cell carcinoma (OPSCC) were smokers?

A

50-65%

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14
Q

does ETOH have a synergistic effect on pts with oral squamous cell carcinoma (OSCC)?

A

yes

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15
Q

does ETOH have a synergistic effect on pts with oropharyngeal squamous cell carcinoma (OPSCC)?

A

no, not significant factor

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16
Q

what is the px of oral squamous cell carcinoma (OSCC)?

A

40% survival rate

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17
Q

what is the px of oropharyngeal squamous cell carcinoma (OPSCC)?

A

80% survival rate

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18
Q

T/F: oropharyngeal squamous cell carcinoma (OPSCC) can be HPV+ or HPV-

A

true

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19
Q

T/F: all pts who have high-risk HPV in saliva will develop oropharyngeal squamous cell carcinoma (OPSCC)

A

false, not all

20
Q

since 1988, the incidence of HPV+ oropharyngeal cancers are increasing, while HPV-oropharyngeal cancers decreased. why?

A
  1. increase in oral sexual behavior

2. decrease in tobacco use

21
Q

T/F: dx of HPV+ oropharyngeal squamous cell carcinoma (OPSCC) is only characterized by the presence of HPV-16 alone

22
Q

what must be present for dx of HPV+ oropharyngeal squamous cell carcinoma (OPSCC)?

A
  1. E6, E7 within tumor cells must be expressed
  2. serum presence of E6 or E7 antibodies

…this provides unambiguous dx

23
Q

tx of early HPV+ oropharyngeal squamous cell carcinoma (OPSCC)

A
  1. platinum-based chemoradiotherapy

2. surgery

24
Q

tx of late HPV+ oropharyngeal squamous cell carcinoma (OPSCC)

A
  1. surgery
  2. chemotherapy
  3. radiation
25
Q

px of HPV+ oropharyngeal squamous cell carcinoma (OPSCC)

26
Q

what may have a negative effect on the px of HPV+ oropharyngeal squamous cell carcinoma (OPSCC)?

A

comorbidities like smoking and immunodeficiency

27
Q

list from best to worst px for HPV-related orpharyngeal cancer

A
  1. HPV+, non-smoker
  2. HPV+, smoker
  3. HPV-, non-smoker
  4. HPV-, smoker
28
Q

why is HPV testing important in oropharyngeal squamous cell carcinoma?

A

to identify pts that should have tx de-escalated

29
Q

HPV+ improved the survival rate of pts with oropharyngeal squamous cell carcinoma (OPSCC) by how many years?

A

3 years

80% for HPV+ vs 40% for HPV-

30
Q

why does HPV+ increase the survival rate of pts with oropharyngeal squamous cell carcinoma (OPSCC)?

A
  1. fewer genetic alterations

2. better response to therapy (surgery and/or radiotherapy)

31
Q

when have vaccines for HPV been available?

A

since August 2006

32
Q

what does HPV vaccines prevent in BOTH males and females?

A
  1. genital warts

2. epithelial dysplasia and anal cancer

33
Q

what does HPV vaccines prevent in females?

A
  1. epithelial dysplasia
  2. cervical cancer
  3. vulvar cancer
  4. vaginal cancer
34
Q

why does the HPV vaccine not provide protection against diseases?

A

due to ALL HPV types

35
Q

when does the HPV vaccines NOT provide protection against HPV types?

A

when a person has already been exposed through sexual activity

36
Q

what percent of the Healthy People 2020 goal for complete HPV vaccine coverage for girls and boys 13 to 15 years old is finished?

37
Q

what percent of adolescents up-to-date has the HPV series?

38
Q

what percent of 13-17 year olds have received the 1st dose of the HPV series?

39
Q

which demographic is facing disparities in HPV vaccinations?

A

with urban (higher rate) and non-urban youth

40
Q

T/F: the HPV vaccine is a tx for genital warts or HPV-related cancer

A

false, is NOT

41
Q

Cervarix (GlaxoSmithKline) targets what HPV types?

42
Q

Guardasil (quadrivalent) targets what HPV types?

A

6, 11, 16, 18

43
Q

Guardasil 9 (nonavalent) targets what HPV types?

A

6, 11, 16, 18, 31, 33, 45, 52, 58

44
Q

in October 2018, the FDA approved expanded use of Gardasil 9 to include individuals of what ages?

A

27-45 y.o.

45
Q

vaccines are safe. what are the side effects of a vaccine?

A

typical side effects…

  1. erythema
  2. headache
  3. myalgia
46
Q

T/F: there is strong evidence of a causal relationship between vaccines and serious health concerns

AU'18 Oral Path II (31 decks)

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