# Defining the Molecular Intricacies of Human Papillomavirus-Associated Tonsillar Carcinoma

## TL;DR

This review explores the molecular mechanisms behind human papillomavirus-induced tonsillar cancer, highlighting proteins and biomarkers involved in tumor development.

## Contribution

The paper provides a comprehensive compilation of molecular biomarkers and proteins linked to HPV-associated tonsillar carcinoma.

## Key findings

- More than 25 proteins and biomarkers were identified as involved in HPV-induced tonsillar cancer.
- The review highlights the urgent need for focused research on virally induced tonsillar cancers to improve treatment strategies.
- Limited literature exists on the specific molecular dynamics of HPV in tonsillar regions.

## Abstract

The past decade has shown a sharp incline in the human papillomavirus (HPV) infection associated oropharyngeal carcinoma cases, especially in men younger than 60 years old. Tonsils are one of the key sites, within the oropharyngeal region, which shows malignant changes due to HPV infection, and there is very limited literature to understand the specific dynamics in the tonsillar areas.

This critical review was undertaken to explore and unravel the bio-molecular interactions and the role of specific proteins associated with HPV infection induced tumorigenesis for the tonsils.

A systematic search of the literature was performed utilising keywords and MeSH terms related to HPV and tonsillar carcinoma in PubMed, Scopus, Embase, and Web of Science without restrictions on dates until July 2023. All studies that reported on molecular biomarkers or genes/genetic proteins in the context of HPV associated tonsillar carcinoma were included in the study.

Preliminary searches revealed a total of 2734 studies of which 23 satisfied the final inclusion criteria and were included. More than 25 proteins and biomarkers were identified, and their role in the malignant process was extracted and compiled. This review also presents a short excerpt on each of the molecules identified to provide a better understanding of the pathogenesis.

Given the rapidly increasing number of cases, there is an urgent need for more focused research on virally induced tonsillar cancers, to develop a better understanding, and for clarity of management and treatment.

Human Papillomavirus is a common, sexually transmitted infection which effects more than 80% of people at least once in their lifetimes. In most cases it is cleared from the body spontaneously with little or no impact, but some types can persist and induce a cancerous change in the affected organs (cervix, penis, anal, oropharynx, tonsil). To elaborate on any specific site impacted by cancer, the understanding of molecular level events is critical, and information linking different events in the tonsils specifically is sparse, This review is an attempt to primarily collate all the HPV and tonsillar cancer data together, and generate an understanding of how cancer occurs, and different strategies to manage it.