Assessing for Primary Oropharyngeal or Nasopharyngeal Squamous Cell Carcinoma From Fine Needle Aspiration of Cervical Lymph Node Metastases
Assessing for Primary Oropharyngeal or Nasopharyngeal Squamous Cell Carcinoma From Fine Needle Aspiration of Cervical Lymph Node Metastases
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DOI：
10.1002/dc.21293
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发表时间：
2010-11-01
影响因子：
1.3
通讯作者：
Siddiqui, Momin T.
中科院分区：
文献类型：
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作者：
Jannapureddy, Suneal;Cohen, Cynthia;Siddiqui, Momin T.
在转移性鳞状细胞癌 (SCC) 颈部淋巴结的细针抽吸中，起源部位在临床上可能不明显。口咽部和鼻咽部原发性鳞状细胞癌之间的区别具有重要的治疗意义。在本研究中，我们评估了转移性鳞状细胞癌的 HPV 类型 16、18、31、33、51（通过原位杂交 [ISH]）、p16 和 ProExC（替代 HPV 标记物），以及鼻咽鳞状细胞癌中报告的 Epstein Barr 病毒。 2004 年至 2008 年间诊断出的 40 名患者具有足够的细胞块材料。对高危 HPV 和 EBV (EBER) 进行 ISH，并对 p16 和 ProExC 进行免疫组织化学检查。 31 例中指定原发部位，其中 26 个头部和 Fleck，包括 11 个口咽部和 2 个鼻咽部，以及 5 个其他部位。 9 例 (22.5%) 检出高危 HPV，16 例 (40%) 检出 p16，35 例 (87.5%) 检出 ProExC，2 例 (5%) 检出 EBER。所有高危 HPV ISH 病例也显示 p16 过度表达。两种替代标记物对 HPV 感染的敏感性均为 100%：p16 和 ProExC 的特异性分别为 78.7% 和 16.1%。 7 例（63.6%）口咽部 SCC HPV ISH 阳性，EBV 阴性； 1 例鼻咽鳞状细胞癌 (50%) EBER 阳性且 HPV 阴性。 HPV 和 EBER 检测可分别作为口咽部和鼻咽部原发性 SCC 的指标，但我们的数据显示，只有一小部分 (63.6%) 口咽部 SCC 与高危 HPV 相关。此外，尽管替代标记物（尤其是 ProExC）对 HPV 感染具有高敏感性，但缺乏特异性。诊断。细胞病理醇。 2010；38：795-800。 (C) 2009 Wiley-Liss, Inc.
In fine needle aspirates of cervical lymph nodes with metastatic squamous cell carcinoma (SCC), the site of origin may not be clinically evident. The distinction between oropharyngeal and nasopharyngeal primary SCC has important management consequences. In the current study, we evaluated metastatic SCC for HPV types 16, 18, 31, 33, 51 (by in situ hybridization[ISH]), p16 and ProExC (surrogate HPV markers), and Epstein Barr Virus reported in nasopharyngeal SCC. Forty patients diagnosed between 2004 and 2008, with adequate cell block material were identified. ISH for high risk HPV and EBV (EBER), and immunohistochemistry for p16 and ProExC were performed. Primary site was designated in 31 cases with 26 head and Fleck including 11 oropharyngeal and 2 nasopharyngeal, and 5 other sites. High risk HPV was detected in 9 cases (22.5%), p16 in 16 (40%), ProExC in 35 (87.5%), and EBER in 2 (5%). All cases with high risk HPV ISH also showed overexpression of p16. The sensitivity for HPV infection by both surrogate markers was 100%: specificity for p16 and ProExC was 78.7 and 16.1%, respectively. Seven (63.6%) oropharyngeal SCC were positive for HPV ISH and negative for EBV; one nasopharyngeal SCC (50%) was EBER positive and HPV negative. HPV and EBER detection can serve as indicators for oropharyngeal and nasopharyngeal primary SCC, respectively, however our data show that only a subset (63.6%) of oropharyngeal SCC are high risk HPV-related. Additionally, despite their high sensitivity for HPV infection, surrogate markers, especially ProExC, lack specificity. Diagn. Cytopathol. 2010;38:795-800. (C) 2009 Wiley-Liss, Inc.