Lars Sivars1, David Landin2, Marzia Rizzo1, Linnea Haeggblom1, Cinzia Bersani1, Eva Munck-Wikland2, Anders Näsman3, Tina Dalianis4, Linda Marklund2. 1. a Department of Oncology-Pathology, Karolinska Institutet , Karolinska University Hospital , Stockholm , Sweden. 2. b Department of Clinical Science, Intervention and Technology, Otorhinolaryngology Head and Neck Surgery , Karolinska University Hospital , Stockholm , Sweden. 3. c Department of Oncology-Pathology, Department of Clinical Pathology, Cancer Center Karolinska , Karolinska Institutet , Stockholm , Sweden. 4. d Department of Oncology-Pathology, Karolinska Institutet , Karolinska University Hospital CCK , Stockholm , Sweden.
Abstract
BACKGROUND: Distinguishing branchial cleft cysts (BCCs) from cystic metastases of a human papillomavirus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC) is challenging. Fine needle aspirates (FNAs) from cystic metastasis may be non-representative, while reactive squamous cells from BCC can be atypic. Based on cytology and with the support of HPV DNA positivity many centers treat cystic metastasis oncological and thus patients are spared neck dissection. To do so safely, one must investigate whether HPV DNA and p16INK4a overexpression is found exclusively in cystic metastases and not in BCC. PATIENTS AND METHODS: DNA was extracted from formalin fixed paraffin embedded (FFPE) surgically resected BCCs from 112 patients diagnosed 2007-2015 at Karolinska University Hospital and amplified by PCR. A multiplex bead-based assay used to detect 27 HPV-types and p16INK4a expression was analyzed by immunohistochemistry (IHC). RESULTS: All 112 BCCs were HPV DNA negative, and of 105 BCCs possible to evaluate for p16INK4a, none overexpressed p16INK4a. CONCLUSIONS: HPV DNA and p16INK4a overexpression were absent in BCCs. Lack of HPV DNA and p16 protein overexpression in BCCs is helpful to discriminate benign BCCs from HPV+ OPSCC metastasis. HPV testing definitely has a role in the diagnostics of cystic masses of the neck.
BACKGROUND: Distinguishing branchial cleft cysts (BCCs) from cystic metastases of a human papillomavirus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC) is challenging. Fine needle aspirates (FNAs) from cystic metastasis may be non-representative, while reactive squamous cells from BCC can be atypic. Based on cytology and with the support of HPV DNA positivity many centers treat cystic metastasis oncological and thus patients are spared neck dissection. To do so safely, one must investigate whether HPV DNA and p16INK4a overexpression is found exclusively in cystic metastases and not in BCC. PATIENTS AND METHODS: DNA was extracted from formalin fixed paraffin embedded (FFPE) surgically resected BCCs from 112 patients diagnosed 2007-2015 at Karolinska University Hospital and amplified by PCR. A multiplex bead-based assay used to detect 27 HPV-types and p16INK4a expression was analyzed by immunohistochemistry (IHC). RESULTS: All 112 BCCs were HPV DNA negative, and of 105 BCCs possible to evaluate for p16INK4a, none overexpressed p16INK4a. CONCLUSIONS:HPV DNA and p16INK4a overexpression were absent in BCCs. Lack of HPV DNA and p16 protein overexpression in BCCs is helpful to discriminate benign BCCs from HPV+ OPSCC metastasis. HPV testing definitely has a role in the diagnostics of cystic masses of the neck.
Entities:
Keywords:
HPV; base of tongue cancer; branchial cleft cyst; oropharyngeal cancer; prevalence; tonsillar cancer
Authors: Mark Zupancic; Stefan Holzhauser; Liquin Cheng; Torbjörn Ramqvist; Juan Du; Signe Friesland; Anders Näsman; Tina Dalianis Journal: Viruses Date: 2022-05-13 Impact factor: 5.818