Expression of Ki-67 and P16 are related with HPV in squamous cell carcinoma of the external auditory canal

Background Squamous cell carcinoma of the external auditory canal (EACSCC) is an uncommon tumor and responsible for no more than 0.2% of all the head and neck malignancies. Although there is remarkable research evidence exhibiting that high-risk human papillomavirus (HPV) accounts for considerable head and neck malignancies, its role in the pathogenesis of EACSCC is yet to be determined. Methods We evaluated 16 patients with EACSCC treated at our department. We employed PCR to assay for high-risk subtypes of HPV. Two pathologists reviewed the histopathological staining via hematoxylin and eosin along with immunohistochemical staining of p16 INK4a and Ki‑67. Results Detection of HPV DNA was done via PCR in 3 (18.75%) patients, and 8 (50%) positive (+) cases were determined via p16 INK4a immunostaining. Besides, 3 (37.5%) individuals were HPV positive as per p16 INK4a PCR results. In addition, all of the p16 INK4a -positive specimens were diagnosed as moderately differentiated carcinomas. Conclusions Expression of Ki-67 was related to HPV status. This is the first report implicating high-risk HPV in squamous cell carcinoma of the external auditory canal. However, p16 INK4a immunostaining is a suspectable approach for diagnosing HPV for EACSCC. In addition, HPV might enhance an elevated proliferation rate in EACSCC, illustrated via expression of Ki-67. Graphical Abstract