Chernock Rebecca D, El-Mofty Samir K, Thorstad Wade L, Parvin Curtis A, Lewis James S
Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid, Campus Box 8118, St. Louis, MO 63110, USA.
Head Neck Pathol. 2009 Sep;3(3):186-94. doi: 10.1007/s12105-009-0126-1. Epub 2009 Jul 11.
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.
人乳头瘤病毒（HPV）是一部分口咽鳞状细胞癌（SCC）的致病因子。本研究的目的是根据组织学特征将口咽SCC分为非角化（NK）SCC、角化（K）SCC和混合性SCC，并确定每组中HPV的感染率及患者生存率。从1997年至2004年的放射肿瘤学数据库中识别出具有至少2年临床随访的口咽SCC患者。所有患者均接受了术前手术加术后放疗或确定性放疗。进行了高危HPV亚型的原位杂交（ISH）和p16的免疫组织化学检测，p16是一种在HPV相关癌中经常上调的蛋白质。评估了总生存率和疾病特异性生存率。在118例病例中，46.6%为NK SCC，24.6%为K SCC，28.8%为混合性SCC。NK SCC多见于年龄稍小的男性患者。与K SCC相比，它更常出现淋巴结转移且接受手术切除。NK SCC比K SCC更有可能HPV和p16呈阳性（P < 0.001），并且总生存率和疾病特异性生存率更高（分别为P = 0.0002；P = 0.0142）。混合性SCC也比K SCC更有可能HPV和p16呈阳性（分别为P = 0.003；P = 0.002），并且总生存率更高（P = 0.0105）。根据组织学类型对口咽SCC进行亚分类可提供有用的临床信息。与K SCC相比，NK SCC组织学强烈预测HPV相关性及更好的患者生存率。混合性SCC似乎具有中等频率的HPV相关性及患者生存率。
