Comparison of Human Papillomavirus In Situ Hybridization and p16 Immunohistochemistry in the Detection of Human Papillomavirus-Associated Head and Neck Cancer Based on a Prospective Clinical Experience
Comparison of Human Papillomavirus In Situ Hybridization and p16 Immunohistochemistry in the Detection of Human Papillomavirus-Associated Head and Neck Cancer Based on a Prospective Clinical Experience
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DOI：
10.1002/cncr.25033
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发表时间：
2010-05-01
期刊：
影响因子：
6.2
通讯作者：
Westra, William H.
中科院分区：
文献类型：
--
作者：
Singhi, Aatur D.;Westra, William H.
背景：人乳头瘤病毒（HPV）是头颈部鳞状细胞癌（HNSCCs）的一种病原体。这些hpv相关的癌症具有不同于hpv阴性HNSCCs的临床病理特征。因此，HPV检测可能很快成为HNSCCs标准病理评估的一部分。方法：前瞻性地收集了所有在约翰霍普金斯医院接受HPV检测的头颈癌患者的数据，这些患者在57个月的时间里接受了HPV检测，作为临床护理的一部分。HPV检测包括HPV16原位杂交（ISH）和p16免疫组化（IHC）。广谱HPV ISH保留在p16阳性的HPV-16阴性病例中。结果：对256例头颈部癌进行了HPV分析，以预测临床结果（56%），定位原发肿瘤来源（21%），确定肿瘤分类（9%），确定患者是否适合疫苗试验（8%），或满足患者的好奇心（5%）。182例（71%）肿瘤为HPV阳性。HPV阳性与口咽部位（82%对9%）和男性（77%对48%）相关。所有176例HPV-16阳性病例中p16呈阳性，80例HPV-16阴性病例中19例（24%）呈阳性。在6例（32%）不一致的病例中，p16的表达是由于存在另一种HPV类型。结论：结合p16 IHC和HPV ISH的可行策略能够在高比例的口咽癌中检测出HPV。HPV状态经常被肿瘤学家要求评估临床结果，并被病理学家用于建立肿瘤分类和确定肿瘤起源部位。癌症2010;116:2166 - 73。(C) 2070美国癌症协会
BACKGROUND: Human papillomavirus (HPV) is a causative agent in a subset of head and neck squamous cell carcinomas (HNSCCs). These HPV-related cancers have a clinicopathologic profile that diverges from HPV-negative HNSCCs. Accordingly, HPV testing may soon become integrated into standard pathologic assessment of HNSCCs. METHODS: Data were prospectively collected for all patients with head and neck carcinomas who had undergone HPV testing at the Johns Hopkins Hospital as part of clinical care during a 57-month period. HPV testing consisted of concurrent HPV16 in situ hybridization (ISH) and p16 immunohistochemistry (IHC). Wide spectrum HPV ISH was reserved for p16-positive cases that were HPV-16 negative. RESULTS: HPV analysis was performed on 256 head and neck carcinomas in an effort to predict clinical outcomes (56%), localize primary tumor origin (21%), establish tumor classification (9%), determine patient eligibility for vaccine trials (8%), or satisfy patient curiosity (5%). A total of 182 (71%) tumors were HPV positive. HPV positivity correlated with oropharyngeal site (82% vs 9%) and male sex (77% vs 48%). p16 positivity was present in all 176 HPV16-positive cases, and in 19 of 80 (24%) cases that were HPV-16 negative. In 6 (32%) discordant cases, p16 expression was because of the presence of another HPV type. CONCLUSIONS A feasible strategy that incorporates p16 IHC and HPV ISH is able to detect HPV in a high percentage of oropharyngeal carcinomas. HPV status is frequently requested by the oncologist to estimate clinical outcome, and used by pathologists to establish tumor classification and determine site of tumor origin. Cancer 2010;116:2166-73. (C) 2070 American Cancer Society