Human papillomavirus in metastatic squamous carcinoma from unknown primaries in the head and neck: A retrospective 7 year study

Payal C. Desai, Michael V. Jaglal, Purva Gopal, Shin Je Ghim, Donald M. Miller, Hanan Farghaly, Alfred B. Jenson

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Goal: Human Papillomavirus (HPV) is found to be increasingly implicated in head and neck cancers. The objective of this study was to determine the primary site of origin of HPV positive squamous carcinomas metastatic to lymph nodes of the neck. Methods: Surgical pathology records from January 1, 2000 to July 31, 2007 were used to identify surgically removed neck lymph nodes with the diagnosis of metastatic squamous carcinoma. Specimens in formalin-fixed, paraffin-embedded blocks were examined for HPV (+) by analyzing sequencing data generated by PCR and immunostaining for the expression of the p16INK biomarker, which is overexpressed if Rb is not present. H & E stained slides were also reviewed for histological classification. The available retrospective demographics were extracted from the charts to determine trends of confounding factors. Results: Of the 43 patient samples, 41 contained adequate DNA to test for HPV. The mean age of the 41 patients was 62 years. All of the patients smoked and 39/41 patients consumed alcohol. The overall HPV (+) incident rate was 27% (11/41) by PCR with strongly diffuse or strong focal p16 staining. 9 of the 34 males and 2 of the 7 females had HPV (+) carcinomas. The average age of the 2 HPV (+) females was 44, compared to the HPV (-) females who averaged 70. The average age of the HPV (+) males was 56 compared with the average age 55 of the HPV (-) males. HPV (+) carcinomas appeared to arise from multiple sites in the oropharynx, particularly the tonsils and tongues, including unknown primaries. By histological exam, most metastatic HPV(+) squamous carcinomas were poorly differentiated (basaloid) microscopically and grossly cystic. Conclusion: The 27% HPV (+) squamous cancers metastatic to neck lymph node originated from multiple sites in the oropharynx. The HPV (+) female population, although a total of only 2, tended to be much younger than the HPV (-) ones, whereas the HPV (+) male population was similar in age to the HPV (-) male population.

Original languageEnglish (US)
Pages (from-to)94-98
Number of pages5
JournalExperimental and Molecular Pathology
Volume87
Issue number2
DOIs
StatePublished - Oct 2009

Fingerprint

Biomarkers
Pathology
Paraffin
Formaldehyde
Squamous Cell Carcinoma
Neck
Head
Alcohols
DNA
Oropharynx
Lymph Nodes
Human Papillomavirus DNA Tests
Population
Carcinoma
Polymerase Chain Reaction
Surgical Pathology
Palatine Tonsil
Head and Neck Neoplasms
Tongue

Keywords

  • Cervical lymph node metastases
  • Head and neck cancer
  • Human papillomavirus
  • Squamous carcinoma
  • Unknown primary

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Molecular Biology
  • Pathology and Forensic Medicine

Cite this

Human papillomavirus in metastatic squamous carcinoma from unknown primaries in the head and neck : A retrospective 7 year study. / Desai, Payal C.; Jaglal, Michael V.; Gopal, Purva; Ghim, Shin Je; Miller, Donald M.; Farghaly, Hanan; Jenson, Alfred B.

In: Experimental and Molecular Pathology, Vol. 87, No. 2, 10.2009, p. 94-98.

Research output: Contribution to journalArticle

Desai, Payal C. ; Jaglal, Michael V. ; Gopal, Purva ; Ghim, Shin Je ; Miller, Donald M. ; Farghaly, Hanan ; Jenson, Alfred B. / Human papillomavirus in metastatic squamous carcinoma from unknown primaries in the head and neck : A retrospective 7 year study. In: Experimental and Molecular Pathology. 2009 ; Vol. 87, No. 2. pp. 94-98.
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abstract = "Goal: Human Papillomavirus (HPV) is found to be increasingly implicated in head and neck cancers. The objective of this study was to determine the primary site of origin of HPV positive squamous carcinomas metastatic to lymph nodes of the neck. Methods: Surgical pathology records from January 1, 2000 to July 31, 2007 were used to identify surgically removed neck lymph nodes with the diagnosis of metastatic squamous carcinoma. Specimens in formalin-fixed, paraffin-embedded blocks were examined for HPV (+) by analyzing sequencing data generated by PCR and immunostaining for the expression of the p16INK biomarker, which is overexpressed if Rb is not present. H & E stained slides were also reviewed for histological classification. The available retrospective demographics were extracted from the charts to determine trends of confounding factors. Results: Of the 43 patient samples, 41 contained adequate DNA to test for HPV. The mean age of the 41 patients was 62 years. All of the patients smoked and 39/41 patients consumed alcohol. The overall HPV (+) incident rate was 27{\%} (11/41) by PCR with strongly diffuse or strong focal p16 staining. 9 of the 34 males and 2 of the 7 females had HPV (+) carcinomas. The average age of the 2 HPV (+) females was 44, compared to the HPV (-) females who averaged 70. The average age of the HPV (+) males was 56 compared with the average age 55 of the HPV (-) males. HPV (+) carcinomas appeared to arise from multiple sites in the oropharynx, particularly the tonsils and tongues, including unknown primaries. By histological exam, most metastatic HPV(+) squamous carcinomas were poorly differentiated (basaloid) microscopically and grossly cystic. Conclusion: The 27{\%} HPV (+) squamous cancers metastatic to neck lymph node originated from multiple sites in the oropharynx. The HPV (+) female population, although a total of only 2, tended to be much younger than the HPV (-) ones, whereas the HPV (+) male population was similar in age to the HPV (-) male population.",
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AU - Ghim, Shin Je

AU - Miller, Donald M.

AU - Farghaly, Hanan

AU - Jenson, Alfred B.

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