PDF(Pubmed)
Abstract：
BACKGROUND: HPV-associated oral cavity squamous cell carcinoma (SCC) is not well-characterized in the literature, and also has a clinical significance that is poorly understood.
METHODS: We gathered a cohort of oral cavity (OC) SCC with nonkeratinizing morphology, either in the invasive or in situ carcinoma (or both), tested for p16 by immunohistochemistry and high risk HPV E6/E7 mRNA by RTPCR (reference standard for transcriptionally-active high risk HPV) and gathered detailed morphologic and clinicopathologic data.
RESULTS: Thirteen patients from two institutions were proven to be HPV-associated by combined p16 and high risk HPV mRNA positivity. All 13 patients (100%) were males, all were heavy smokers (average 57 pack/year), and most were active drinkers (9/11 or 81.8%). All 13 (100%) involved the tongue and/or floor of mouth. All had nonkeratinizing features, but maturing squamous differentiation varied widely (0-90%; mean 37.3%). Nonkeratinizing areas had high N:C ratios and larger nests, frequently with pushing borders, and minimal (or no) stromal desmoplasia. The carcinoma in situ, when present, was Bowenoid/nonkeratinizing with cells with high N:C ratios, full thickness loss of maturation, and abundant apoptosis and mitosis. HPV was type 16 in 11 patients (84.6%) and type 33 in two (15.4%). Nine patients had treatment data available. These underwent primary surgical resection with tumors ranging from 1.6 to 5.2 cm. Most had bone invasion (6/9-66.7% were T4a tumors), and most (6/9-66.7%) had extensive SCC in situ with all 6 of these patients having final margins positive for in situ carcinoma.
CONCLUSIONS: HPV-associated OCSCC is an uncommon entity that shows certain distinct clinical and pathologic features. Recognition of these features may help pathologic diagnosis and could potentially help guide clinical management.
METHODS: We gathered a cohort of oral cavity (OC) SCC with nonkeratinizing morphology, either in the invasive or in situ carcinoma (or both), tested for p16 by immunohistochemistry and high risk HPV E6/E7 mRNA by RTPCR (reference standard for transcriptionally-active high risk HPV) and gathered detailed morphologic and clinicopathologic data.
RESULTS: Thirteen patients from two institutions were proven to be HPV-associated by combined p16 and high risk HPV mRNA positivity. All 13 patients (100%) were males, all were heavy smokers (average 57 pack/year), and most were active drinkers (9/11 or 81.8%). All 13 (100%) involved the tongue and/or floor of mouth. All had nonkeratinizing features, but maturing squamous differentiation varied widely (0-90%; mean 37.3%). Nonkeratinizing areas had high N:C ratios and larger nests, frequently with pushing borders, and minimal (or no) stromal desmoplasia. The carcinoma in situ, when present, was Bowenoid/nonkeratinizing with cells with high N:C ratios, full thickness loss of maturation, and abundant apoptosis and mitosis. HPV was type 16 in 11 patients (84.6%) and type 33 in two (15.4%). Nine patients had treatment data available. These underwent primary surgical resection with tumors ranging from 1.6 to 5.2 cm. Most had bone invasion (6/9-66.7% were T4a tumors), and most (6/9-66.7%) had extensive SCC in situ with all 6 of these patients having final margins positive for in situ carcinoma.
CONCLUSIONS: HPV-associated OCSCC is an uncommon entity that shows certain distinct clinical and pathologic features. Recognition of these features may help pathologic diagnosis and could potentially help guide clinical management.
摘要：
背景：HPV相关的口腔鳞状细胞癌（SCC）在文献中没有得到很好的表征，并且还具有很少理解的临床意义。
方法：我们收集了一组具有非角质化形态的口腔（OC）SCC，在浸润性或原位癌（或两者）中，通过免疫组织化学检测p16,通过RTPCR(转录活性高危型HPV的参考标准)检测高危型HPVE6/E7mRNA,并收集详细的形态学和临床病理数据.
结果：来自两个机构的13例患者通过p16和高危HPVmRNA阳性被证明与HPV相关。13例患者（100%）均为男性，都是重度吸烟者（平均57包/年），大多数是活跃饮酒者(9/11或81.8%)。所有13人（100％）都涉及舌头和/或口底。都有非角化特征，但是成熟的鳞状分化差异很大（0-90％；平均37.3％）。非角化区域的N：C比率很高，巢较大，经常推进边界，和最小的（或没有）基质增生。原位癌，当存在时,是Bowenole/nonkatinizing，具有高N:C比率的细胞，成熟的全厚度损失，丰富的细胞凋亡和有丝分裂。11例（84.6%）HPV为16型，2例（15.4%）HPV为33型。9名患者有可用的治疗数据。这些患者接受了原发性手术切除，肿瘤范围为1.6至5.2cm。大多数有骨侵犯（6/9-66.7%为T4a肿瘤），大多数（6/9-66.7％）患有广泛的原位SCC，所有6例患者的最终切缘均为原位癌阳性。
结论：HPV相关的OCSCC是一种不常见的实体，表现出某些明显的临床和病理特征。识别这些特征可能有助于病理诊断，并可能有助于指导临床管理。
方法：我们收集了一组具有非角质化形态的口腔（OC）SCC，在浸润性或原位癌（或两者）中，通过免疫组织化学检测p16,通过RTPCR(转录活性高危型HPV的参考标准)检测高危型HPVE6/E7mRNA,并收集详细的形态学和临床病理数据.
结果：来自两个机构的13例患者通过p16和高危HPVmRNA阳性被证明与HPV相关。13例患者（100%）均为男性，都是重度吸烟者（平均57包/年），大多数是活跃饮酒者(9/11或81.8%)。所有13人（100％）都涉及舌头和/或口底。都有非角化特征，但是成熟的鳞状分化差异很大（0-90％；平均37.3％）。非角化区域的N：C比率很高，巢较大，经常推进边界，和最小的（或没有）基质增生。原位癌，当存在时,是Bowenole/nonkatinizing，具有高N:C比率的细胞，成熟的全厚度损失，丰富的细胞凋亡和有丝分裂。11例（84.6%）HPV为16型，2例（15.4%）HPV为33型。9名患者有可用的治疗数据。这些患者接受了原发性手术切除，肿瘤范围为1.6至5.2cm。大多数有骨侵犯（6/9-66.7%为T4a肿瘤），大多数（6/9-66.7％）患有广泛的原位SCC，所有6例患者的最终切缘均为原位癌阳性。
结论：HPV相关的OCSCC是一种不常见的实体，表现出某些明显的临床和病理特征。识别这些特征可能有助于病理诊断，并可能有助于指导临床管理。
