p16 Positive Oropharyngeal Squamous Cell Carcinoma:An Entity With a Favorable Prognosis Regardless of Tumor HPV Status
Male
Chi-Square Distribution
Kaplan-Meier Estimate
Middle Aged
Immunohistochemistry
Polymerase Chain Reaction
Risk Assessment
3. Good health
Oropharyngeal Neoplasms
Predictive Value of Tests
DNA, Viral
Biomarkers, Tumor
Carcinoma, Squamous Cell
Humans
Female
Papillomaviridae
Cyclin-Dependent Kinase Inhibitor p16
In Situ Hybridization
Aged
Proportional Hazards Models
Retrospective Studies
DOI:
10.1097/pas.0b013e3181e84652
Publication Date:
2010-06-29T07:38:58Z
AUTHORS (7)
ABSTRACT
In the human papillomavirus (HPV) era, the best way to assess oropharyngeal squamous carcinomas (SCC) for risk stratification is not clear. Many recommend use of both p16 immunohistochemistry and HPV in situ hybridization (ISH). A significant minority of tumors are p16 positive and HPV ISH negative, the significance of which is unclear.Two hundred thirty-nine oropharyngeal SCC were tested by immunohistochemistry for p16 and by ISH for high-risk HPV. For p16 positive, HPV ISH negative cases, PCR was conducted for HPV. The findings were correlated with pathologic and clinical findings.Of the 239 cases, 187 (78%) were positive for p16. Of these, 139 (74%) were positive for HPV by ISH. Of the remaining 48 cases, 45 had material for PCR. Nineteen were positive for HPV, leaving a group of 26 p16 positive and HPV undetectable SCCs. In the p16 positive cohort, there was no difference in survival between HPV ISH positive and negative cases. Comparing the HPV ISH positive and HPV ISH and PCR negative SCC, there was again no difference in survival. p16 positive, HPV negative SCC still had significantly better survival than p16 negative SCC in univariate and multivariate analysis.Outcomes for p16 positive, HPV negative oropharyngeal SCC are not significantly different from p16 positive, HPV positive tumors and are significantly better than for p16 negative tumors. These results suggest that p16 immunohistochemistry alone is the best test to use for risk stratification in oropharyngeal SCC.
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