HPV-associated oropharyngeal squamous cell carcinoma

Images

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HPV

Human papillomavirus (HPV) is established as causative in oropharyngeal squamous cell carcinomas (OSCCs), being detected in 50% to 80% of tumors by DNA in situ hybridization (ISH) and/or polymerase chain reaction.

 mRNA

• However, these tests do not assess viral transcription. Many consider E6/E7 messenger ribonucleic acid (mRNA) the best indicator of HPV status.
• RNA ISH is more sensitive than DNA ISH in detecting HPV in OSCC, and it correlates strongly with p16. Although both tests were comparable, p16 more strongly stratified patient outcomes. (21836494)

 Partial p16 staining in oropharyngeal squamous cell carcinoma: extent and pattern correlate with human papillomavirus RNA status. (22596101)

• Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma has unique biology and better outcomes.
• p16 immunostaining is used as a surrogate marker for transcriptionally active HPV.
• Although diffuse staining is generally accepted as positive, the significance of partial staining has not been established, nor has the cutoff for extent of p16 staining that should be used to identify a tumor as HPV-related.
• Greater than 75% p16 staining or, alternatively, >50% staining combined with >25% confluent areas, are suitable cutoffs for defining positivity. (22596101)

Immunohistochemistry

 p16

• Retinoblastoma (Rb) downregulation by HPV E7 results in p16 upregulation. We hypothesized that p16 overexpression in OSCC defines HPV-induced tumors with favorable prognosis.
• Using this system for classification, it has been defined the molecular profile of HPV+ OSCC with favorable prognosis, namely HPV+/p16 high (class III). (16401683)

Metastasis

 Transcriptionally-active human papillomavirus is consistently retained in the distant metastases of primary oropharyngeal carcinomas. (24271958) (Free)

Open reviews

 Human papillomavirus in head and neck cancer. Garbuglia AR. Cancers (Basel). 2014 Aug 18;6(3):1705-26. doi : 10.3390/cancers6031705 Review. PMID: 25256828 [Free]

 An updated overview of HPV-associated head and neck carcinomas. Zaravinos A. Oncotarget. 2014 Jun 30;5(12):3956-69. PMID: 24970795 [Free]

Open references

 Transcriptionally-active human papillomavirus is consistently retained in the distant metastases of primary oropharyngeal carcinomas. Mehrad M, Zhao H, Gao G, Wang X, Lewis JS Jr. Head Neck Pathol. 2014 Jun;8(2):157-63. doi : 10.1007/s12105-013-0509-1 PMID: 24271958 (Free)

 Impact of HPV-associated p16-expression on radiotherapy outcome in advanced oropharynx and non-oropharynx cancer. Lassen P, Primdahl H, Johansen J, Kristensen CA, Andersen E, Andersen LJ, Evensen JF, Eriksen JG, Overgaard J; Danish Head and Neck Cancer Group (DAHANCA). Radiother Oncol. 2014 Dec;113(3):310-6. doi : 10.1016/j.radonc.2014.11.032 PMID: 25544647 [Free]

 HPV16 DNA status is a strong prognosticator of loco-regional control after postoperative radiochemotherapy of locally advanced oropharyngeal carcinoma: Results from a multicentre explorative study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG). Lohaus F, Linge A, Tinhofer I, Budach V, Gkika E, Stuschke M, Balermpas P, Rödel C, Avlar M, Grosu AL, Abdollahi A, Debus J, Bayer C, Belka C, Pigorsch S, Combs SE, Mönnich D, Zips D, von Neubeck C, Baretton GB, Löck S, Thames HD, Krause M, Baumann M; DKTK-ROG. Radiother Oncol. 2014 Dec;113(3):317-23. doi : 10.1016/j.radonc.2014.11.011 PMID: 25480095 [Free]

 Epidemiology and survival of HPV-related tonsillar carcinoma. Psychogios G, Alexiou C, Agaimy A, Brunner K, Koch M, Mantsopoulos K, Tomppert A, Iro H. Cancer Med. 2014 Jun;3(3):652-9. doi : 10.1002/cam4.212 PMID: 24616325 [Free]

 Virology and molecular pathogenesis of HPV (human papillomavirus)-associated oropharyngeal squamous cell carcinoma. Miller DL, Puricelli MD, Stack MS. Biochem J. 2012 Apr 15;443(2):339-53. doi : 10.1042/BJ20112017 PMID: 22452816 [Free]

 Molecular classification identifies a subset of human papillomavirus—associated oropharyngeal cancers with favorable prognosis. Weinberger PM, Yu Z, Haffty BG, Kowalski D, Harigopal M, Brandsma J, Sasaki C, Joe J, Camp RL, Rimm DL, Psyrri A. J Clin Oncol. 2006 Feb 10;24(5):736-47. PMID: 16401683 [Free]

References

 Tumor cell anaplasia and multinucleation are predictors of disease recurrence in oropharyngeal squamous cell carcinoma, including among just the human papillomavirus-related cancers. Lewis JS Jr, Scantlebury JB, Luo J, Thorstad WL. Am J Surg Pathol. 2012 Jul;36(7):1036-46. PMID: 22743286

 Validation of Methods for Oropharyngeal Cancer HPV Status Determination in US Cooperative Group Trials. Jordan RC, Lingen MW, Perez-Ordonez B, He X, Pickard R, Koluder M, Jiang B, Wakely P, Xiao W, Gillison ML. Am J Surg Pathol. 2012 Jul;36(7):945-954. PMID: 22743284

 Partial p16 staining in oropharyngeal squamous cell carcinoma: extent and pattern correlate with human papillomavirus RNA status. Lewis JS Jr, Chernock RD, Ma XJ, Flanagan JJ, Luo Y, Gao G, Wang X, El-Mofty SK. Mod Pathol. 2012 May 18. PMID: 22596101

 High-Risk Human Papillomavirus E6/E7 mRNA Detection by a Novel In Situ Hybridization Assay Strongly Correlates With p16 Expression and Patient Outcomes in Oropharyngeal Squamous Cell Carcinoma. Ukpo OC, Flanagan JJ, Ma XJ, Luo Y, Thorstad WL, Lewis JS. Am J Surg Pathol. 2011 Sep;35(9):1343-50. PMID: 21836494