The clinical impact of p16 status in fine-needle aspirates of cervical lymph node metastasis of head and neck squamous cell carcinomas
The clinical impact of p16 status in fine-needle aspirates of cervical lymph node metastasis of head and neck squamous cell carcinomas
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DOI：
10.1007/s00405-012-2039-y
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发表时间：
2013-02-01
影响因子：
2.6
通讯作者：
Fischer, Claude A.
中科院分区：
文献类型：
--
作者：
Jakscha, Jens;Zlobec, Inti;Fischer, Claude A.
淋巴结转移是头颈部鳞状细胞癌（HNSCC）患者最具决定性的临床因素。颈部超声和细针穿刺（FNA）细胞学检查是最早的诊断程序之一，也是颈部最准确的诊断分期工具。与HPV阴性的口咽癌相比，HPV阳性的口咽癌（OPSCC）患者的预后明显更好。P16过表达被认为是OPSCC中HPV阳性的替代标志物。这些HPV/p16阳性的OPSCC位于腭扁桃体或舌根，经常出现淋巴结转移。分析淋巴结转移灶FNA p16表达与同一淋巴结转移灶及相应原发灶p16免疫组化表达的相关性和可靠性，对原发灶的定位和预后判断有重要意义。对54例HNSCC患者进行了分析，发现原发肿瘤的p16表达与其淋巴结转移密切相关。在54例HNSCC患者中，有25例在治疗前进行了淋巴结转移的FNA。细胞学和免疫组化p16阳性表达完全相关。在17例组织学p16阴性的淋巴结转移中，15例FNA为p16阴性，而2例为p16阳性。在我们看来，p16细胞学分析颈部淋巴结转移可以促进原发肿瘤的正确定位，并可靠地区分HPV阳性OPSCC和HPV阴性HNSCC，其预后显著不同。
Lymph node involvement is prognostically the most determinant clinical factor for patients with head and neck squamous cell carcinomas (HNSCCs). Ultrasound of the neck and fine-needle aspiration (FNA) cytology is one of the first diagnostic procedures and the most accurate diagnostic staging tool for the neck. Patients with HPV-positive oropharyngeal carcinomas (OPSCC) show a significantly better prognosis when compared with HPV-negative OPSCC. P16 overexpression is accepted as surrogate marker for HPV-positive in OPSCC. These HPV/p16-positive OPSCC are localized either in the palatal tonsils or the base of tongue and frequently present with lymph node metastases. We analyzed the correlation and reliability of p16 expression of the FNA of the lymph node metastasis with the immunohistochemical expression of p16 of the same lymph node metastasis and its corresponding primary tumor, as it could be of importance for determining the localization and different prognosis of the primary tumor. 54 HNSCC patients were evaluated, p16 expression of the primary tumors and their lymph node metastases correlated precisely. In 25 of the 54 HNSCC patients, a FNA of the lymph node metastases was taken before the treatment. The positive cytological and immunohistochemical p16 staining correlated exactly. Of the 17 histologically p16-negative lymph node metastases 15 FNA were p16-negative, whereas two samples were p16-positive. In our view, a cytological p16 analysis of cervical lymph node metastasis can facilitate the correct localization of the primary tumor and discriminate reliably HPV-positive OPSCC from HPV-negative HNSCC with their significantly diverse prognosis.