HPV 相关鼻旁窦癌的形态学谱系。

Morphologic Spectrum of HPV-associated Sinonasal Carcinomas.

机构信息

Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA.

McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA.

出版信息

Head Neck Pathol. 2024 Aug 5;18(1):67. doi: 10.1007/s12105-024-01670-1.

DOI:10.1007/s12105-024-01670-1

PMID:39101976

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11300749/

Abstract

BACKGROUND

High-risk human papillomavirus (HR-HPV) infection has been increasingly recognized as a risk factor for sinonasal tract carcinomas. However the prevalence and prognostic significance of HPV-associated sinonasal carcinomas is not well known due to limited studies and inconsistency in HPV testing modalities in literatures. Morphologically, HPV-associated sinonasal carcinomas encompass a diverse group of tumors. HPV-associated sinonasal adenocarcinoma has not been reported. The purpose of this study was to determine the prevalence, morphologic spectrum and prognostic implication of HPV-associated sinonasal carcinomas.

METHODS

This cohort included 153 sinonasal carcinomas. Tissue microarrays were constructed. P16 immunohistochemistry and HR-HPV E6/7 in-situ Hybridization (ISH) were performed. Carcinomas were deemed HPV-associated based on a positive ISH testing. Clinicopathologic data was collected.

RESULTS

28/153 (18%) sinonasal carcinomas were HPV-associated. HPV-associated carcinomas consisted of 26 (93%) squamous cell carcinomas and variants, 1 (3.5%) HPV-related multiphenotypic sinonasal carcinoma and 1 (3.5%) adenocarcinoma. The HPV-associated adenocarcinoma closely resembled HPV-associated endocervical adenocarcinoma morphologically. HPV-associated carcinomas occurred in 8 (29%) women and 20 (71%) men with a median age of 66 years old. HPV-associated carcinomas were predominantly located at nasal cavity. A trend toward improved overall survival and progression free survival in HPV-associated carcinomas patients was observed, yet without statistical significance.

CONCLUSION

Our study identifies a novel HPV-associated sinonasal adenocarcinoma subtype, highlights the broad morphologic spectrum of HPV-associated sinonasal carcinomas, and supports routine p16 testing during pathology practice regardless of tumor subtype followed by a confirmatory HR-HPV testing. This practice is critical for studying the clinical behavior of HPV-associated sinonasal carcinomas.

摘要

背景

高危型人乳头瘤病毒（HR-HPV）感染已被越来越多地认为是鼻窦道癌的危险因素。然而，由于文献中 HPV 检测方法的研究有限且不一致，HPV 相关鼻窦癌的流行率和预后意义尚不清楚。从形态学上看，HPV 相关的鼻窦癌包括一组多样化的肿瘤。尚未报道 HPV 相关的鼻窦腺癌。本研究的目的是确定 HPV 相关鼻窦癌的流行率、形态谱和预后意义。

方法

本队列包括 153 例鼻窦癌。构建组织微阵列。进行 P16 免疫组化和 HR-HPV E6/7 原位杂交（ISH）。根据 ISH 检测阳性，将癌判定为 HPV 相关。收集临床病理数据。

结果

153 例鼻窦癌中有 28 例（18%）为 HPV 相关。HPV 相关癌由 26 例（93%）鳞状细胞癌及其变体、1 例（3.5%）HPV 相关多表型鼻窦癌和 1 例（3.5%）腺癌组成。HPV 相关腺癌在形态上与 HPV 相关的宫颈内膜腺癌非常相似。HPV 相关癌发生于 8 例（29%）女性和 20 例（71%）男性，中位年龄为 66 岁。HPV 相关癌主要位于鼻腔。HPV 相关癌患者的总生存和无进展生存有改善的趋势，但无统计学意义。