PDF(Pubmed)
Abstract：
To assess the exact role of high-risk HPV testing in patients of carcinoma unknown primary with secondary metastasis to the neck who underwent TORS and neck dissection for identification of the primary site. A prospective study was carried out at a tertiary care centre over one year. Patients with unilateral neck swelling, which was cytologically proven squamous cell carcinoma neck metastasis, were included in the study. After clinicopathological evaluation, they underwent TORS-assisted ipsilateral radical tonsillectomy, tongue base mucosal wedge biopsy for primary site identification, and ipsilateral neck dissection. They underwent HPV RNA ISH from the tonsil, the base of the tongue and blood. They also underwent HPV DNA testing from the blood. P16 was done in the base of tongue, tonsil, and lymph node specimens. In the study cohort of 18 patients who underwent ipsilateral radical tonsillectomy, mucosal tongue base wedge biopsy and neck dissection, p16 positivity was isolated in 5.56%, 0% and 2.78% of patients, respectively. (n = 1/18, 0/18, 5/18). Interestingly, HPV E7 mRNA expression was absent in the tonsil /base of tongue specimens, but metastatic lymph nodes displayed expression in 11.11%. HPV DNA was undetected in all analysed tissues and patients\' blood. In the Indian subcontinent, it is not essential to do detailed high-risk HPV analysis in cases of carcinoma unknown primary with secondary metastasis to the neck.
摘要：
评估高危型HPV检测在原发灶未知且继发颈部转移的患者中的确切作用，这些患者接受了TORS和颈部淋巴结清扫术以确定原发灶。在三级护理中心进行了为期一年的前瞻性研究。单侧颈部肿胀的患者，细胞学证实鳞状细胞癌颈部转移，包括在研究中。经过临床病理评估，他们接受了TORS辅助的同侧根治性扁桃体切除术，舌根粘膜楔形活检的原发部位鉴定，和同侧颈淋巴结清扫术。他们接受了扁桃体的HPVRNAISH，舌头和血液的底部。他们还接受了血液中的HPVDNA检测。P16是在舌根完成的，扁桃体,和淋巴结标本.在18例接受同侧根治性扁桃体切除术的患者的研究队列中，粘膜舌根楔形活检和颈清扫术，p16阳性分离为5.56%，0%和2.78%的患者，分别。（n=1/18，0/18，5/18）。有趣的是,人乳头瘤病毒E7mRNA表达在扁桃体/舌根标本中缺失，但转移淋巴结表达为11.11%。在所有分析的组织和患者血液中均未检测到HPVDNA。在印度次大陆,对于原发灶不明并继发颈部转移的病例,不需要进行详细的高危型HPV分析.
