Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark.
Viruses. 2021 Jul 2;13(7):1297. doi: 10.3390/v13071297.
Squamous cell carcinoma of unknown primary (SCCUP) is a challenging diagnostic subgroup of oropharyngeal squamous cell carcinoma (OPSCC). The incidence of SCCUP is increasing in parallel with the well-documented increase in OPSCC and is likewise driven by the increase in human papillomavirus (HPV). The SCCUP patient often presents with a cystic lymph node metastasis and undergoes an aggressive diagnostic and treatment program. Detection of HPV in cytologic specimens indicates an oropharyngeal primary tumor origin and can guide the further diagnostic strategy. Advances in diagnostic modalities, e.g., transoral robotic surgery and transoral laser microsurgery, have increased the successful identification of the primary tumor site in HPV-induced SCCUP, and this harbors a potential for de-escalation treatment and increased survival. This review provides an overview of HPV-induced SCCUP, diagnostic modalities, and treatment options.
不明原发灶的鳞状细胞癌（SCCUP）是口咽鳞状细胞癌（OPSCC）中具有挑战性的诊断亚组。SCCUP 的发病率与 OPSCC 有记录的增加平行增加，同样也受到人乳头瘤病毒（HPV）的增加驱动。SCCUP 患者常表现为囊性淋巴结转移，并接受积极的诊断和治疗计划。细胞学标本中 HPV 的检测表明口咽原发性肿瘤起源，并可指导进一步的诊断策略。诊断方式的进步，例如经口机器人手术和经口激光微创手术，增加了 HPV 诱导的 SCCUP 中原发性肿瘤部位的成功识别，这为降低治疗强度和提高生存率提供了潜力。本文综述了 HPV 诱导的 SCCUP 的发病机制、诊断方法和治疗选择。
