HPV 相关口咽鳞状细胞癌病例伴有块状、部分 p16 表达缺失。
A Case of HPV-Associated Oropharyngeal Squamous Cell Carcinoma with Block-Like, Partial Loss of p16 Expression.
机构信息
Division of Anatomical Pathology, Queen Elizabeth II Health Science Centre, and Department of Pathology, Dalhousie University, 7th floor, MacKenzie Building, 5788 University Ave, Halifax, NS, B3H 1V8, Canada.
Departments of Otolaryngology - Head and Neck Surgery, Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Head Neck Pathol. 2022 Dec;16(4):1251-1256. doi: 10.1007/s12105-022-01463-4. Epub 2022 Jun 30.
BACKGROUND
Oropharyngeal squamous cell carcinoma is frequently associated with high-risk HPV infection, which confers a good prognosis. Immunohistochemistry for p16 is used as a surrogate for HPV status, but discrepant results are occasionally seen. Here, we report a case with a unique pattern of partial loss of p16.
METHODS
A 63 year old male presented with a base of tongue nonkeratinizing squamous cell carcinoma and a large metastatic neck mass. The primary lesion and multiple regions of the metastatic mass were assessed with p16 immunohistochemistry, RNA in situ hybridization for high-risk HPV, and HPV16 genome sequencing.
RESULTS
The primary lesion was p16 negative, and the metastatic neck mass had large, confluent regions that were either strongly p16 positive or entirely p16 negative. All of these regions were positive for high-risk HPV with identical HPV16 genomes.
CONCLUSION
This unusual case illustrates a potential diagnostic pitfall, and it raises important questions regarding molecular mechanisms and prognostic implications of p16 staining in oropharyngeal squamous cell carcinoma.
背景
口咽鳞状细胞癌常与高危 HPV 感染相关，具有良好的预后。p16 的免疫组化被用作 HPV 状态的替代指标，但偶尔会出现不一致的结果。在这里，我们报告了一例具有独特部分缺失 p16 模式的病例。
方法
一名 63 岁男性因舌根非角化性鳞状细胞癌和大的转移性颈部肿块就诊。对原发性病变和转移性肿块的多个区域进行了 p16 免疫组化、高危 HPV 的 RNA 原位杂交和 HPV16 基因组测序检测。
结果
原发性病变 p16 阴性，转移性颈部肿块有大片融合区域，p16 要么强阳性，要么完全阴性。所有这些区域均为高危 HPV 阳性，HPV16 基因组相同。
结论
这个不寻常的病例说明了一个潜在的诊断陷阱，并提出了关于口咽鳞状细胞癌中 p16 染色的分子机制和预后意义的重要问题。
Zotero 插件