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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Histopathologic findings of HPV and p16 positive HNSCC.
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Histopathologic findings of HPV and p16 positive HNSCC.

机译：HPV和p16阳性HNSCC的组织病理学发现。

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OBJECTIVE: Human papilloma virus (HPV) and p16INKa (p16) positivity in head and neck squamous cell carcinomas (HNSCCs) is currently thought to be an encouraging prognostic indicator. However, the histopathologic changes responsible for this behavior are poorly understood. It is our objective to elucidate these histopathologic characteristics to help define the clinical utility of these markers. DESIGN: Retrospective cohort study. METHODS: 71 HNSCC tumors between July 1, 2008 and August 30, 2009 were examined for HPV, p16, and epidermal growth factor receptor (EGFR). Specified pathologic features were examined: perivascular invasion (PVI), perineural invasion (PNI), grade of squamous differentiation, basaloid classification. RESULTS: HPV and p16 had no direct impact on perineural or perivascular invasion. However, HPV and p16 were strongly predictive of poorly differentiated tumors, as well as basaloid squamous cell carcinoma (SCCA) (P < .001). Additionally, upon multivariate analysis, HPV(+) and p16(+) tumors had an increased risk of nodal metastasis (HPV: odds ratio [OR] = 23.9 (2.2, 265.1) p = .01; p16: OR = 6.5 (1.4, 31.2) p = .02; PVI: OR = 6.0 (1.6, 22.8) p < .01). The area under the curve (AUC) of receiver operating characteristic (ROC) curves demonstrated improved predictive value for lymph node metastasis above standard H&E histopathologic features (76.7%) for both HPV (83.2%) and p16 (81.3%) individually. CONCLUSIONS: HPV(+) and p16(+) are highly predictive for poorly differentiated tumors and basaloid SCCA. Additionally, HPV and p16 positivity demonstrate superior predictive value for lymph node metastasis above standard H&E histopathologic features. Although exact recommendations should be tempered by considerations of primary tumor subsite, T-stage, and depth of invasion, head and neck multidisciplinary teams should strongly consider aggressive lymph node treatment for any HPV(+) or p16(+) tumor.
机译：目的：目前认为头颈部鳞状细胞癌（HNSCC）中的人乳头瘤病毒（HPV）和p16INKa（p16）阳性是令人鼓舞的预后指标。然而，导致这种行为的组织病理学改变知之甚少。我们的目标是阐明这些组织病理学特征，以帮助定义这些标志物的临床用途。设计：回顾性队列研究。方法：检查2008年7月1日至2009年8月30日之间的71例HNSCC肿瘤的HPV，p16和表皮生长因子受体（EGFR）。检查了特定的病理特征：血管周围浸润（PVI），神经周围浸润（PNI），鳞状分化等级，基底基底分类。结果：HPV和p16对神经周或血管周浸润没有直接影响。但是，HPV和p16强烈预示着低分化肿瘤以及基底样鳞状细胞癌（SCCA）（P <.001）。此外，经过多变量分析，HPV（+）和p16（+）肿瘤的淋巴结转移风险增加（HPV：优势比[OR] = 23.9（2.2，265.1）p = 0.01; p16：OR = 6.5（1.4 ，31.2）p = .02; PVI：OR = 6.0（1.6，22.8）p <.01）。接受者操作特征（ROC）曲线的曲线下面积（AUC）对HPV（83.2％）和p16（81.3％）单独显示高于标准H＆E组织病理学特征（76.7％）的淋巴结转移预测价值。结论：HPV（+）和p16（+）对低分化肿瘤和基底膜SCCA具有高度预测性。此外，HPV和p16阳性显示出高于标准H＆E组织病理学特征的淋巴结转移预测价值。尽管应根据原发肿瘤亚部位，T期和浸润深度来考虑确切的建议，但头颈部多学科团队应强烈考虑对任何HPV（+）或p16（+）肿瘤进行积极的淋巴结治疗。

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