Westra William H
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, Maryland; Department of Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland.
Semin Diagn Pathol. 2015 Jan;32(1):42-53. doi: 10.1053/j.semdp.2015.02.023. Epub 2015 Feb 27.
A subset of head and neck squamous cell carcinomas are caused by the human papillomavirus (HPV). This HPV-related form of head and neck squamous cell carcinoma (HPV-HNSCC) has captured the attention of the oncology community for its rising incidence, its link to non-traditional risk factors, and its divergent clinical behavior. To diagnose this special form of head and neck squamous cell carcinoma is to provide important prognostic information and, in some instances, redirect clinical therapy. The diagnosis of HPV-HNSCC is aided by a strong appreciation for its characteristic microscopic findings and by an awareness of aberrant features that set apart a growing list of HPV-HNSCC morphologic variants. This review will delineate the microscopic appearance of HPV-HNSCC, spotlight ways in which the misinterpretation of these microscopic features can lead to diagnostic confusion, offer recommendations for appropriate terminology when diagnosing HPV-HNSCC, and provide examples of specific diagnostic scenarios where HPV testing can inform the diagnostic process.
一部分头颈部鳞状细胞癌是由人乳头瘤病毒（HPV）引起的。这种与HPV相关的头颈部鳞状细胞癌（HPV-HNSCC）因其发病率不断上升、与非传统风险因素的关联以及不同的临床行为而引起了肿瘤学界的关注。诊断这种特殊形式的头颈部鳞状细胞癌可以提供重要的预后信息，并且在某些情况下可以调整临床治疗方案。对HPV-HNSCC特征性显微镜下表现的深入理解以及对越来越多的HPV-HNSCC形态学变异所具有的异常特征的认识，有助于HPV-HNSCC的诊断。本综述将描述HPV-HNSCC的显微镜下表现，强调对这些显微镜下特征的错误解读可能导致诊断混淆的方式，为诊断HPV-HNSCC时使用适当的术语提供建议，并提供HPV检测可为诊断过程提供信息的具体诊断场景示例。
