Department of Pathology & Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA.
Cytopathology. 2021 Jan;32(1):100-107. doi: 10.1111/cyt.12911. Epub 2020 Oct 6.
The goal of this study was to evaluate the performance of p16 staining in cell-blocks vs tissue specimens as a surrogate marker for human papillomavirus (HPV) status in oropharyngeal squamous cell carcinomas.
Head and neck squamous cell carcinoma cases presenting as a neck mass with a p16 result on cytology and corresponding tissue specimens (1 January 2014 to 30 June 1920) were included in the study. The following were assessed from cell-block material: number of tumour clusters, percentage of tumour cells with p16 staining, and presence of staining in clusters vs single cells. Results were compared to tissue p16 status. Results of any other ancillary HPV testing were also noted.
Forty-two head and neck squamous cell carcinoma neck metastases (35 oropharyngeal, five non-oropharyngeal, and 2 unknown primaries) were identified. The p16 staining pattern in cell-blocks was seen in single cells (27.6%), clusters (44.8%), or both (27.6%). The percentage of tumour cells staining for p16 in cell-blocks was much lower than in corresponding tissue specimens. There were four false negatives and one false positive (concurrent HPV DNA polymerase chain reaction testing was positive in cytology and surgical material).
Compared to tissue, the cut-off for p16 interpretation in cell-blocks is substantially lower and staining may be present in single cells or clusters. In 96.9% of cases, any p16 staining in cell-blocks correlated with positive p16 staining in surgical specimens. However, a negative or discrepant p16 result on cell-block should prompt confirmatory HPV studies, as false negative p16 staining in cell-blocks is high.
本研究旨在评估细胞块中的 p16 染色作为人乳头瘤病毒（HPV）状态的替代标志物在口咽鳞状细胞癌中的表现。
纳入了细胞学结果为 p16 阳性且伴有颈部肿块的头颈部鳞状细胞癌病例和相应的组织标本（2014 年 1 月 1 日至 1920 年 6 月 30 日）。从细胞块材料中评估以下内容：肿瘤细胞簇的数量、p16 染色的肿瘤细胞百分比，以及簇与单个细胞中染色的存在。结果与组织 p16 状态进行比较。还记录了任何其他辅助 HPV 检测的结果。
共确定了 42 例头颈部鳞状细胞癌颈部转移（35 例口咽癌、5 例非口咽癌和 2 例未知原发灶）。细胞块中 p16 染色模式见于单个细胞（27.6%）、细胞簇（44.8%）或两者兼有（27.6%）。细胞块中肿瘤细胞 p16 染色的百分比明显低于相应的组织标本。有 4 例假阴性和 1 例假阳性（细胞学和手术材料中的 HPV DNA 聚合酶链反应检测均为阳性）。
与组织相比，细胞块中 p16 解读的截止值要低得多，且染色可能存在于单个细胞或细胞簇中。在 96.9%的病例中，细胞块中的任何 p16 染色与手术标本中的阳性 p16 染色相关。然而，细胞块中 p16 结果为阴性或不一致时应提示进行 HPV 确证性研究，因为细胞块中 p16 染色的假阴性率较高。
