Human Papillomavirus Testing in Head and Neck Carcinomas: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists Guideline
Human Papillomavirus Testing in Head and Neck Carcinomas: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists Guideline
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DOI：
10.1200/jco.18.00684
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发表时间：
2018-11-01
影响因子：
45.3
通讯作者：
Perez-Ordonez, Bayardo
中科院分区：
文献类型：
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作者：
Fakhry, Carole;Lacchetti, Christina;Perez-Ordonez, Bayardo
目的：美国病理学家学会制定了一份以证据为基础的关于人乳头瘤病毒（HPV）和替代标志物检测在头颈癌中的检测、应用、解释和报告的指南，该指南被确定为与美国临床肿瘤学会（ASCO）会员资格相关。方法美国病理学家学会头颈癌HPV检测指南由ASCO内容专家对临床准确性和方法学家对发展严谨性进行了审查。在有利的审查下，ASCO专家小组被召集来审查指南的内容和建议。结果ASCO专家小组确定，2018年发布的头颈癌HPV检测指南的建议是明确、彻底的，并且基于最相关的科学证据。ASCO批准了该指南，并增加了次要的资格声明。建议对于新诊断的口咽鳞状细胞癌，应确定HPV肿瘤状态。只有当口咽原发肿瘤存在时，HPV肿瘤状态检测可以通过替代标记物p16免疫组化对原发肿瘤或宫颈淋巴结转移进行。阳性的阈值是至少70%的核和细胞质表达，至少有中等到强的强度。在病理学家和/或治疗临床医生的判断下，可以进行额外的确认性检查。病理学家不应该常规地确定口咽非鳞状癌或头颈部非口咽鳞状细胞癌的HPV肿瘤状态。当不确定组织学类型或低分化口咽肿瘤是否为非鳞状时，可以根据病理学家和/或治疗临床医生的判断进行HPV肿瘤状态检测。更多信息请访问：www.asco.org/head-neck-cancer-guidelines。
PurposeThe College of American Pathologists produced an evidence-based guideline on testing, application, interpretation, and reporting of human papillomavirus (HPV) and surrogate marker tests in head and neck carcinomas that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership.MethodsThe College of American Pathologists HPV Testing in Head and Neck Carcinomas guideline was reviewed by ASCO content experts for clinical accuracy and by methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations.ResultsThe ASCO Expert Panel determined that the recommendations from the HPV Testing in Head and Neck Carcinomas guideline, published in 2018, are clear, thorough, and based upon the most relevant scientific evidence. ASCO endorsed the guideline and added minor qualifying statements.RecommendationsIt is recommended that HPV tumor status should be determined for newly diagnosed oropharyngeal squamous cell carcinomas. HPV tumor status testing may be performed by surrogate marker p16 immunohistochemistry either on the primary tumor or from cervical nodal metastases only if an oropharyngeal primary tumor is present. The threshold for positivity is at least 70% nuclear and cytoplasmic expression with at least moderate to strong intensity. Additional confirmatory testing may be done at the discretion of the pathologist and/or treating clinician. Pathologists should not routinely determine HPV tumor status in nonsquamous carcinomas of the oropharynx or non-oropharyngeal squamous cell carcinomas of the head and neck. When there is uncertainty of histologic type or whether a poorly differentiated oropharyngeal tumor is nonsquamous, HPV tumor status testing may be warranted and at the discretion of the pathologist and/or treating clinician. Additional information is available at: www.asco.org/head-neck-cancer-guidelines.