p16 positive oropharyngeal squamous cell carcinoma:an entity with a favorable prognosis regardless of tumor HPV status.
p16 positive oropharyngeal squamous cell carcinoma:an entity with a favorable prognosis regardless of tumor HPV status.
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P16阳性口咽鳞状细胞癌：无论肿瘤HPV状态如何，具有良好预后的实体。
DOI：
10.1097/pas.0b013e3181e84652
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发表时间：
2010-08
期刊：
影响因子：
--
通讯作者：
El-Mofty SK
中科院分区：
文献类型：
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作者：
Lewis JS Jr;Thorstad WL;Chernock RD;Haughey BH;Yip JH;Zhang Q;El-Mofty SK
在人乳头瘤病毒（HPV）时代，评估口咽鳞状细胞癌（SCC）风险分层的最佳方法尚不清楚。许多人建议同时使用p16免疫组化和HPV原位杂交（ISH）。少数肿瘤是p16阳性和HPV ISH阴性，其意义尚不清楚。239例口咽部鳞状细胞癌进行了p16免疫组化检测和高危型HPV ISH检测。对p16阳性、HPV ISH阴性的病例进行HPV的PCR检测。结果与病理和临床表现相关。在239例中，187例（78%）p16阳性。其中，139例（74%）经ISH检测为HPV阳性。在其余48例病例中，45例有PCR材料。19例HPV阳性，剩下26例p16阳性和HPV检测不到的SCC。在p16阳性队列中，HPV ISH阳性和阴性病例之间的生存率没有差异。比较HPV ISH阳性和HPV ISH和PCR阴性SCC，生存率也没有差异。单因素和多因素分析显示p16阳性、HPV阴性的SCC患者的生存率仍明显高于p16阴性的SCC患者。p16阳性、HPV阴性的口咽鳞癌的结局与p16阳性、HPV阳性的肿瘤无显著差异，且显著优于p16阴性的肿瘤。这些结果表明，p16免疫组化单独是最好的测试，用于口咽鳞癌的危险分层。
In the human papillomavirus (HPV) era, the best way to assess oropharyngeal squamous carcinomas (SCC) for risk stratification is not clear. Many recommend use of both p16 immunohistochemistry and HPV in situ hybridization (ISH). A significant minority of tumors are p16 positive and HPV ISH negative, the significance of which is unclear. Two hundred thirty-nine oropharyngeal SCC were tested by immunohistochemistry for p16 and by ISH for highrisk HPV. For p16 positive, HPV ISH negative cases, PCR was conducted for HPV. The findings were correlated with pathologic and clinical findings. Of the 239 cases, 187 (78%) were positive for p16. Of these, 139 (74%) were positive for HPV by ISH. Of the remaining 48 cases, 45 had material for PCR. Nineteen were positive for HPV, leaving a group of 26 p16 positive and HPV undetectable SCCs. In the p16 positive cohort, there was no difference in survival between HPV ISH positive and negative cases. Comparing the HPV ISH positive and HPV ISH and PCR negative SCC, there was again no difference in survival. p16 positive, HPV negative SCC still had significantly better survival than p16 negative SCC in univariate and multivariate analysis. Outcomes for p16 positive, HPV negative oropharyngeal SCC are not significantly different from p16 positive, HPV positive tumors and are significantly better than for p16 negative tumors. These results suggest that p16 immunohistochemistry alone is the best test to use for risk stratification in oropharyngeal SCC.