人乳头瘤病毒检测在头颈部肿瘤中的应用：美国临床肿瘤学会临床实践指南对美国病理学家学会指南的认可。
Human Papillomavirus Testing in Head and Neck Carcinomas: ASCO Clinical Practice Guideline Endorsement of the College of American Pathologists Guideline.
机构信息
Carole Fakhry and Lisa M. Rooper, Johns Hopkins School of Medicine, Baltimore, MD; Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Richard C. Jordan, University of California, San Francisco, San Francisco, CA; Danny Rischin, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Erich M. Sturgis and Diana Bell, MD Anderson Cancer Center, Houston, TX; Mark W. Lingen, University of Chicago, Chicago, IL; Seema Harichand-Herdt, Mid Florida Cancer Center, Orange City, FL; John Thibo, Support for People with Oral and Head and Neck Cancer, Cleveland, OH; Jose Zevallos, Washington University School of Medicine, St. Louis, MO; and Bayardo Perez-Ordonez, University Health Network, Toronto, Ontario, Canada.
出版信息
J Clin Oncol. 2018 Nov 1;36(31):3152-3161. doi: 10.1200/JCO.18.00684. Epub 2018 Sep 6.
PURPOSE
The 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.
METHODS
The 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.
RESULTS
The 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.
RECOMMENDATIONS
It 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 .
目的
美国病理学家学院制定了一项基于证据的指南，涉及头颈部癌中人乳头瘤病毒（HPV）和替代标志物检测的检测、应用、解释和报告，该指南被认为与美国临床肿瘤学会（ASCO）成员有关。
方法
ASCO 临床准确性内容专家对美国病理学家学院头颈部癌 HPV 检测指南进行了审查，方法学专家对其发展严谨性进行了审查。审查结果良好后，成立了一个 ASCO 专家小组来审查指南内容和建议。
结果
ASCO 专家小组确定，2018 年发布的头颈部癌 HPV 检测指南中的建议明确、全面，并基于最相关的科学证据。ASCO 认可了该指南，并添加了一些限定性声明。
建议
建议对新诊断的口咽鳞状细胞癌确定 HPV 肿瘤状态。如果存在口咽原发性肿瘤，可以通过替代标志物 p16 免疫组织化学检测在原发性肿瘤或颈部淋巴结转移中进行 HPV 肿瘤状态检测。阳性阈值为至少 70%的核和细胞质表达，至少为中度至强强度。病理学家和/或治疗临床医生可以根据需要进行额外的确认性检测。病理学家不应常规对头颈部的非鳞状细胞癌或非口咽的鳞状细胞癌确定 HPV 肿瘤状态。当组织学类型不确定或是否存在分化不良的口咽肿瘤是非鳞状细胞时，可能需要进行 HPV 肿瘤状态检测，这取决于病理学家和/或治疗临床医生的判断。更多信息请访问：www.asco.org/head-neck-cancer-guidelines。
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