Molecular and immunologic analysis of laryngeal squamous cell carcinoma in smokers and non-smokers

Ian James Malm, Lisa M. Rooper, Justin Avery Bishop, Selmin Karatayli Ozgursoy, Alexander T. Hillel, Lee M. Akst, Simon R. Best

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: Laryngeal squamous cell carcinoma (LSCC) is strongly associated with tobacco use, but recent reports suggest an increasing incidence of LSCC in patients without traditional risk factors, suggesting an alternative etiology of tumorigenesis. The purpose of this study is to characterize this non-smoking population and to compare immunohistochemical markers in tumor specimens from non-smokers and smokers with LSCC. Methods: A retrospective chart review of patients with LSCC at Johns Hopkins Hospital (JHH) was performed. A tissue microarray (TMA) was constructed with tumor specimen from non-smokers with stage and age-matched smokers and stained for a variety of immunologic and molecular targets. Results: In the JHH cohort of 521 patients, 12% (n = 63) were non-smokers. Non-smokers were more likely to be <45 years old at time of diagnosis (OR 4.13, p = 0.001) and to have glottic tumors (OR 2.46, p = 0.003). The TMA was comprised of tumors from 34 patients (14 non-smokers, 20 smokers). Only 2 patients (6%) were human-papillomavirus (HPV) positive by high-risk RNA in situ hybridization (ISH). There was no correlation between smoking status and p16 (p = 0.36), HPV-ISH positivity (p = 0.79), phosphatase and tensin homolog (PTEN, p = 0.91), p53 (p = 0.14), or programmed death-ligand 1 (PD-L1, p = 0.27) expression. Conclusions: Non-smokers with LSCC are more likely to be younger at the time of diagnosis and have glottic tumors than smokers with LSCC. In TMA analysis of stage and age-matched specimens from smoker and non-smokers with LSCC, the pattern of expression for common molecular and immunologic markers is similar. Further, HPV does not appear to be a major causative etiology of LSCC in either smokers or non-smokers in our cohort of patients.

Original languageEnglish (US)
Pages (from-to)213-217
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number2
StatePublished - Mar 1 2019


  • HPV
  • Immunohistochemistry
  • Laryngeal cancer
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology


Dive into the research topics of 'Molecular and immunologic analysis of laryngeal squamous cell carcinoma in smokers and non-smokers'. Together they form a unique fingerprint.

Cite this