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HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome.
Head Neck Pathol. 2009 Sep; 3(3):186-94.HN

Abstract

Human papilloma virus (HPV) is an etiologic agent in a subset of oropharyngeal squamous cell carcinomas (SCCs). The aim of this study was to sub-classify SCC of the oropharynx based upon histologic features into nonkeratinizing (NK) SCC, keratinizing (K) SCC, and hybrid SCC, and determine the frequency of HPV and patient survival in each group. Patients with oropharyngeal SCC with a minimum of 2 years of clinical follow-up were identified from radiation oncology databases from 1997 to 2004. All patients received either up front surgery with postoperative radiation or definitive radiation based therapy. In situ hybridization (ISH) for high-risk HPV subtypes and immunohistochemistry for p16, a protein frequently up-regulated in HPV-associated carcinomas, were performed. Overall and disease-specific survival were assessed. Of 118 cases, 46.6% were NK SCC, 24.6% K SCC and 28.8% hybrid SCC. NK SCC occurred in slightly younger patients that were more often male. It more frequently presented with lymph node metastases and was surgically resected compared to K SCC. NK SCC was significantly more likely to be HPV and p16 positive than KSCC (P < 0.001) and to have better overall and disease-specific survival (P = 0.0002; P = 0.0142, respectively). Hybrid SCC was also more likely than K SCC to be HPV and p16 positive (P = 0.003; P = 0.002, respectively) and to have better overall survival (P = 0.0105). Sub-classification of oropharyngeal SCC by histologic type provides useful clinical information. NK SCC histology strongly predicts HPV-association and better patient survival compared to K SCC. Hybrid SCC appears to have an intermediate frequency of HPV-association and patient survival.

Authors+Show Affiliations

Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid, Campus Box 8118, St. Louis, MO 63110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20596971

Citation

Chernock, Rebecca D., et al. "HPV-related Nonkeratinizing Squamous Cell Carcinoma of the Oropharynx: Utility of Microscopic Features in Predicting Patient Outcome." Head and Neck Pathology, vol. 3, no. 3, 2009, pp. 186-94.
Chernock RD, El-Mofty SK, Thorstad WL, et al. HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome. Head Neck Pathol. 2009;3(3):186-94.
Chernock, R. D., El-Mofty, S. K., Thorstad, W. L., Parvin, C. A., & Lewis, J. S. (2009). HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome. Head and Neck Pathology, 3(3), 186-94. https://doi.org/10.1007/s12105-009-0126-1
Chernock RD, et al. HPV-related Nonkeratinizing Squamous Cell Carcinoma of the Oropharynx: Utility of Microscopic Features in Predicting Patient Outcome. Head Neck Pathol. 2009;3(3):186-94. PubMed PMID: 20596971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome. AU - Chernock,Rebecca D, AU - El-Mofty,Samir K, AU - Thorstad,Wade L, AU - Parvin,Curtis A, AU - Lewis,James S,Jr Y1 - 2009/07/11/ PY - 2009/04/06/received PY - 2009/06/26/accepted PY - 2010/7/3/entrez PY - 2010/7/3/pubmed PY - 2010/10/6/medline KW - Head and neck KW - Human papillomavirus KW - Hybrid squamous cell carcinoma KW - Immunohistochemistry KW - In situ hybridization KW - Intensity-modulated radiation therapy KW - Keratinizing squamous cell carcinoma KW - Nonkeratinizing squamous cell carcinoma KW - Oropharynx KW - p16 SP - 186 EP - 94 JF - Head and neck pathology JO - Head Neck Pathol VL - 3 IS - 3 N2 - Human papilloma virus (HPV) is an etiologic agent in a subset of oropharyngeal squamous cell carcinomas (SCCs). The aim of this study was to sub-classify SCC of the oropharynx based upon histologic features into nonkeratinizing (NK) SCC, keratinizing (K) SCC, and hybrid SCC, and determine the frequency of HPV and patient survival in each group. Patients with oropharyngeal SCC with a minimum of 2 years of clinical follow-up were identified from radiation oncology databases from 1997 to 2004. All patients received either up front surgery with postoperative radiation or definitive radiation based therapy. In situ hybridization (ISH) for high-risk HPV subtypes and immunohistochemistry for p16, a protein frequently up-regulated in HPV-associated carcinomas, were performed. Overall and disease-specific survival were assessed. Of 118 cases, 46.6% were NK SCC, 24.6% K SCC and 28.8% hybrid SCC. NK SCC occurred in slightly younger patients that were more often male. It more frequently presented with lymph node metastases and was surgically resected compared to K SCC. NK SCC was significantly more likely to be HPV and p16 positive than KSCC (P < 0.001) and to have better overall and disease-specific survival (P = 0.0002; P = 0.0142, respectively). Hybrid SCC was also more likely than K SCC to be HPV and p16 positive (P = 0.003; P = 0.002, respectively) and to have better overall survival (P = 0.0105). Sub-classification of oropharyngeal SCC by histologic type provides useful clinical information. NK SCC histology strongly predicts HPV-association and better patient survival compared to K SCC. Hybrid SCC appears to have an intermediate frequency of HPV-association and patient survival. SN - 1936-0568 UR - https://www.unboundmedicine.com/medline/citation/20596971/HPV_related_nonkeratinizing_squamous_cell_carcinoma_of_the_oropharynx:_utility_of_microscopic_features_in_predicting_patient_outcome_ L2 - https://dx.doi.org/10.1007/s12105-009-0126-1 DB - PRIME DP - Unbound Medicine ER -