HPV16 drives multistage mutagenesis, preluding to established oropharyngeal carcinoma. HNSCC in a Korean population

To explore the genetic landscape of HPV(+) HNSCC compared to HPV(-) HNSCC in a Korean population, with interest in ethnic disparity, we performed whole exome and genome sequencing on untreated Korean HNSCC patients. This analysis revealed a differently patterned stepwise mutagenesis in the pathologically normal but p16(+) crypt epithelium, located in the vicinity of one HPV(+) HNSCC. Considering that the premalignant events leading to the establishment of HPV(+) HNSCC remain unknown, this finding could help further identify biomarkers to determine HPV-driven premalignant changes prior to the establishment of HNSCC, which could assist in early screening.