Analysis of clinicopathological features of human papilloma virus-associated oropharyngeal squamous cell carcinoma

Yan ZHANG; Tongzhen CHEN; Xiaoli ZHU; Xiaoqiu LI

doi:10.19401/j.cnki.1007-3639.2022.01.006

您当前的位置：

首页 >

文章列表页 >

Analysis of clinicopathological features of human papilloma virus-associated oropharyngeal squamous cell carcinoma

Article | 更新时间：2025-12-31

- Analysis of clinicopathological features of human papilloma virus-associated oropharyngeal squamous cell carcinoma
- China Oncology Vol. 32, Issue 1, Pages: 47-53(2022)
- 作者机构：
  
  复旦大学附属肿瘤医院病理科,复旦大学医学院肿瘤学系,复旦大学病理研究所,上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.01.006
  CLC： R739.63
- Received：05 July 2021，
  
  Revised：2021-12-01，
  
  Published：30 January 2022
- 稿件说明：
移动端阅览
Yan ZHANG, Tongzhen CHEN, Xiaoli ZHU, et al. Analysis of clinicopathological features of human papilloma virus-associated oropharyngeal squamous cell carcinoma[J]. China Oncology, 2022, 32(1): 47-53.
DOI：

Yan ZHANG, Tongzhen CHEN, Xiaoli ZHU, et al. Analysis of clinicopathological features of human papilloma virus-associated oropharyngeal squamous cell carcinoma[J]. China Oncology, 2022, 32(1): 47-53. DOI： 10.19401/j.cnki.1007-3639.2022.01.006.

摘要

背景与目的：

人乳头状瘤病毒相关性口咽鳞状细胞癌（human papilloma virus-associated oropharyngeal squamous cell carcinoma

OPSCC-HPV）是一种独立的肿瘤类型

发病率有明显上升趋势。探讨OPSCC-HPV的临床病理学特征。

方法：

对复旦大学附属肿瘤医院2013年10月

#x02014;2019年7月诊断的64例OPSCC-HPV患者的临床特征、组织学形态及免疫组织化学表型加以分析

并分别以聚合酶链反应和原位杂交的方法检测肿瘤组织中HPV及Epstein-Barr病毒（Epstein-Barr virus

EBV）的感染情况。

结果：

男性50例

女性14例;发病年龄33~76岁。发病部位以扁桃体最为常见

其次为口咽壁和舌根。36例以进行性增大的颈部包块为首发症状

57例伴颈部淋巴结转移（30例伴囊性变）。55例可知美国癌症联合会（American Joint Committee on Cancer

AJCC）临床TNM总分期

与第7版分期相比

第8版分期明显降级

52例系TNM分期

#x02160;~

#x02161;期病变

3例系

#x02162

;期病变。

#x02160;~

#x02161;期增加85.4%

#x02162;期降低52.7%

#x02163;期降低32.7%

新旧两版临床TNM总分期一致率仅为3.6%（2/55）。随访2~77个月

2例局部复发

6例颈部淋巴结转移

3例死亡。63例为非角化性鳞状细胞癌

1例为腺鳞癌。肿瘤细胞核浆比高

核分裂象易见。免疫组织化学染色显示

60例受检患者中

59例P16弥漫强阳性

24例Ki-67增殖指数较高。39例均为高危型HPV感染

HPV-16型占92.3%

35例患者同时行P16和HPV检测

二者一致率达到97.1%。

结论：

OPSCC-HPV具有独特的临床病理学特征。所有原发性OPSCC及原发部位不明的颈淋巴结转移性鳞状细胞癌均应行P16或HPV检测。

Abstract

Background and purpose:

Human papilloma virus-associated oropharyngeal squamous cell carcinoma (OPSCC-HPV) is a distinct entity with a significantly increasing incidence. This study aimed to observe the clinicopathological features of OPSCC-HPV.

Methods:

The clinical characteristics

histological morphology and immunohistochemical phenotypes of 64 cases of OPSCC-HPV who were diagnosed in Fudan University Shanghai Cancer Center from October 2013 to July 2019 were analyzed. The status of HPV and Epstein-Barr virus (EBV) in tumor tissue was detected respectively by polymerase chain reaction (PCR) and

in situ

hybridization.

Results:

There were 50 male and 14 female patients

with the age at presentation ranging from 33 to 76 years. The tonsil was the most frequently involved site

followed by the oropharyngeal wall and the base of tongue. A total of 36 patients presented with a progressively enlarged neck mass as an initial symptom

and 57 patients had cervical lymph node metastases (30 with cystic changes). The overall TNM clinical staging of American Joint Committee on Cancer (AJCC) were obtained in 55 cases. Compared to the 7th edition staging rules

the 8th edition overall clinical staging was significantly degraded. Fifty-two cases and 3 cases were diagnosed as stage

#x02160;-

#x02161; and

#x02162;

respectively. Proportion of stage

#x02160;-

#x02161; disease increased by 85.4%

and stage

#x02162; and

#x02163; diseases reduced by 52.7% and 32.7%

respectively. The consistency

rate of the 7th and 8th edition clinical TNM staging was only 3.6% (2/55). During the follow-up time ranging from 2 months to 77 months

2 patients developed local recurrence

6 patients had cervical lymph node metastasis and 3 patients died. Sixty-three cases were non-keratinizing squamous cell carcinoma (SCC) and 1 case was adenosquamous carcinoma. Tumor cells displayed a high nuclear/cytoplasmic ratio and increased mitotic activity. Immunohistochemical staining showed that P16 was diffusely and strongly positive in 59 of 60 tested cases

and Ki-67 proliferation index was high in 24 cases. High-risk virus infection was found in all 39 patients with HPV-16 type accounting for 92.3%. A total of 35 patients underwent P16 and HPV tests simultaneously with a consistency of 97.1%.

Conclusion:

OPSCC-HPV has unique clinicopathological features. P16 or HPV detection should be performed on all primary OPSSC and cervical lymph node metastasis of unknown primary.

关键词

Keywords

references

CHATURVEDI A K , ENGELS E A , PFEIFFER R M , et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States [J ] . J Clin Oncol , 2011 , 29 ( 32 ): 4294 - 4301 . DOI: 10.1200/JCO.2011.36.4596 http://doi.org/10.1200/JCO.2011.36.4596 http://ascopubs.org/doi/10.1200/JCO.2011.36.4596 http://ascopubs.org/doi/10.1200/JCO.2011.36.4596

D’SOUZA G , KREIMER A R , VISCIDI R , et al. Case-control study of human papillomavirus and oropharyngeal cancer [J ] . N Engl J Med , 2007 , 356 ( 19 ): 1944 - 1956 . DOI: 10.1056/NEJMoa065497 http://doi.org/10.1056/NEJMoa065497 http://www.nejm.org/doi/abs/10.1056/NEJMoa065497 http://www.nejm.org/doi/abs/10.1056/NEJMoa065497

TERMINE N , PANZARELLA V , FALASCHINI S , et al. HPV in oral squamous cell carcinoma vs head and neck squamous cell carcinoma biopsies: a meta-analysis (1988-2007) [J ] . Ann Oncol , 2008 , 19 ( 10 ): 1681 - 1690 . DOI: 10.1093/annonc/mdn372 http://doi.org/10.1093/annonc/mdn372 https://linkinghub.elsevier.com/retrieve/pii/S0923753419401877 https://linkinghub.elsevier.com/retrieve/pii/S0923753419401877

ADELSTEIN D J , RIDGE J A , GILLISON M L , et al. Head and neck squamous cell cancer and the human papillomavirus: summary of a National Cancer Institute State of the Science Meeting, November 9-10, 2008, Washington, D.C [J ] . Head Neck , 2009 , 31 ( 11 ): 1393 - 1422 . DOI: 10.1002/hed.v31:11 http://doi.org/10.1002/hed.v31:11 http://doi.wiley.com/10.1002/hed.v31%3A11 http://doi.wiley.com/10.1002/hed.v31%3A11

STURGIS E M , CINCIRIPINI P M . Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers ?[J ] . Cancer , 2007 , 110 ( 7 ): 1429 - 1435 . DOI: 10.1002/(ISSN)1097-0142 http://doi.org/10.1002/(ISSN)1097-0142 http://doi.wiley.com/10.1002/%28ISSN%291097-0142 http://doi.wiley.com/10.1002/%28ISSN%291097-0142

GILLISON M L , KOCH W M , CAPONE R B , et al. Evidence for a causal association between human papillomavirus and a subset of head and neck cancers [J ] . J Natl Cancer Inst , 2000 , 92 ( 9 ): 709 - 720 . DOI: 10.1093/jnci/92.9.709 http://doi.org/10.1093/jnci/92.9.709 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/92.9.709 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/92.9.709

EL-NAGGAR A K , CHAN J K C , GRANDIS J R , et al. WHO classification of head and neck tumours [M ] . Lyon : IARC , 2017 .

AMIN M B , EDGE S B , GREENE F L , et al. AJCC Cancer Staging Manual, 8th ed [M ] . New York : Springer , 2017 .

EDGE S B , BYRD D R , COMPTON C C , et al. AJCC Cancer Staging Manual,7th ed [M ] . New York : Springer , 2010 .

LAM E W , CHAN J Y , CHAN A B , et al. Prevalence, clinicopathological characteristics, and outcome of human papillomavirus-associated oropharyngeal cancer in southern Chinese patients [J ] . Cancer Epidemiol Biomarkers Prev , 2016 , 25 ( 1 ): 165 - 173 . DOI: 10.1158/1055-9965.EPI-15-0869 http://doi.org/10.1158/1055-9965.EPI-15-0869 http://cebp.aacrjournals.org/lookup/doi/10.1158/1055-9965.EPI-15-0869 http://cebp.aacrjournals.org/lookup/doi/10.1158/1055-9965.EPI-15-0869

ANG K K , HARRIS J , WHEELER R , et al. Human papillomavirus and survival of patients with oropharyngeal cancer [J ] . N Engl J Med , 2010 , 363 ( 1 ): 24 - 35 . DOI: 10.1056/NEJMoa0912217 http://doi.org/10.1056/NEJMoa0912217 http://www.nejm.org/doi/abs/10.1056/NEJMoa0912217 http://www.nejm.org/doi/abs/10.1056/NEJMoa0912217

CIANCHETTI M , MANCUSO A A , AMDUR R J , et al. Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site [J ] . Laryngoscope , 2009 , 119 ( 12 ): 2348 - 2354 . DOI: 10.1002/lary.20638 http://doi.org/10.1002/lary.20638 https://onlinelibrary.wiley.com/doi/10.1002/lary.20638 https://onlinelibrary.wiley.com/doi/10.1002/lary.20638

GOLDENBERG D , BEGUM S , WESTRA W H , et al. Cystic lymph node metastasis in patients with head and neck cancer: an HPV-associated phenomenon [J ] . Head Neck , 2008 , 30 ( 7 ): 898 - 903 . DOI: 10.1002/(ISSN)1097-0347 http://doi.org/10.1002/(ISSN)1097-0347 http://doi.wiley.com/10.1002/%28ISSN%291097-0347 http://doi.wiley.com/10.1002/%28ISSN%291097-0347

CHERNOCK R D , EL-MOFTY S K , THORSTAD W L , et al. HPV-related nonkeratinizing squamous cell carcinoma of the oropharynx: utility of microscopic features in predicting patient outcome [J ] . Head Neck Pathol , 2009 , 3 ( 3 ): 186 - 194 . DOI: 10.1007/s12105-009-0126-1 http://doi.org/10.1007/s12105-009-0126-1 https://link.springer.com/10.1007/s12105-009-0126-1 https://link.springer.com/10.1007/s12105-009-0126-1

FUJIMAKI M , FUKUMURA Y , MITANI K , et al. Histological subtypes and characteristic structures of HPV-associated oropharyngeal carcinoma: study with Japanese cases [J ] . Diagn Pathol , 2013 , 8 : 211 . DOI: 10.1186/1746-1596-8-211 http://doi.org/10.1186/1746-1596-8-211 https://doi.org/10.1186/1746-1596-8-211 https://doi.org/10.1186/1746-1596-8-211

ZHAO Y H , BAI Y P , MAO M L , et al. Clinicopathological characteristics of HPV(+) oropharyngeal squamous cell carcinoma [J ] . Chin J Pathol , 2019 , 48 ( 2 ): 127 - 131 .

SINGHI A D , STELOW E B , MILLS S E , et al. Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma [J ] . Am J Surg Pathol , 2010 , 34 ( 6 ): 800 - 805 . DOI: 10.1097/PAS.0b013e3181d9ba21 http://doi.org/10.1097/PAS.0b013e3181d9ba21 https://journals.lww.com/00000478-201006000-00006 https://journals.lww.com/00000478-201006000-00006

DAMATO S , THAVARAJ S , WINTER S , et al. Human papillomavirus-associated adenocarcinoma of the palatine tonsil [J ] . Hum Pathol , 2014 , 45 ( 4 ): 893 - 894 . DOI: 10.1016/j.humpath.2013.09.023 http://doi.org/10.1016/j.humpath.2013.09.023 https://linkinghub.elsevier.com/retrieve/pii/S0046817713005273 https://linkinghub.elsevier.com/retrieve/pii/S0046817713005273

KRAFT S , FAQUIN W C , KRANE J F . HPV-associated neuroendocrine carcinoma of the oropharynx: a rare new entity with potentially aggressive clinical behavior [J ] . Am J Surg Pathol , 2012 , 36 ( 3 ): 321 - 330 . DOI: 10.1097/PAS.0b013e31823f2f17 http://doi.org/10.1097/PAS.0b013e31823f2f17 https://journals.lww.com/00000478-201203000-00001 https://journals.lww.com/00000478-201203000-00001

MAXWELL J H , KUMAR B , FENG F Y , et al. HPV-positive/p16-positive/EBV-negative nasopharyngeal carcinoma in white North Americans [J ] . Head Neck , 2010 , 32 ( 5 ): 562 - 567 .

POLZ-GRUSZKA D , MORSHED K , STEC A , et al. Prevalence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) in oral and oropharyngeal squamous cell carcinoma in south-eastern Poland [J ] . Infect Agent Cancer , 2015 , 10 : 37 . DOI: 10.1186/s13027-015-0031-z http://doi.org/10.1186/s13027-015-0031-z http://www.infectagentscancer.com/content/10/1/37 http://www.infectagentscancer.com/content/10/1/37

FAKHRY C , WESTRA W H , LI S G , et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial [J ] . J Natl Cancer Inst , 2008 , 100 ( 4 ): 261 - 269 . DOI: 10.1093/jnci/djn011 http://doi.org/10.1093/jnci/djn011 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djn011 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djn011

National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology. Head And Neck Cancer Version 3, 2021 [EB/OL ] .[2021-04-27 ] . http://www.nccn.org http://www.nccn.org http://www.nccn.org .

中国临床肿瘤学会指南工作委员会 . 中国临床肿瘤学会(CSCO)头颈部肿瘤诊疗指南(2021版) [M ] . 北京 : 人民卫生出版社 , 2021 .

Guidelines Working Committee of Chinese Society of Clinical Oncology . Head and Neck Cancer Guidelines of Chinese Society of Clinical Oncology (CSCO) (2021 ed) [M ] . Beijing : People’s Medical Publishing House , 2021 .

Views

1390

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Guidelines for breast cancer diagnosis and treatment by China Anti-Cancer Association (2026 edition)

Exploration of the efficacy and safety of indocyanine green in the evaluation and localization of breast cancer surgical margins: a single-center, observational cohort study

Artificial intelligence in gastric cancer diagnosis, treatment and prognostic prediction: current application and future perspective

China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasms (2025 edition)

The unique value and controversy of nuclear medicine molecular imaging in the evaluation of radioiodine-refractory differentiated thyroid cancer

Related Author

The Society of Breast Cancer China Anti-Cancer Association

Breast Oncology Group of the Oncology Branch of the Chinese Medical Association

Gang LÜ

Guangqing WANG

Yan ZHENG

Qin TANG

Fei CHEN

Xudong YU

Related Institution

General Practice, Hefei First People’s Hospital

Department of Thyroid and Breast Surgery, The Fourth Affiliated Hospital of Anhui Medical University (Affiliated Chaohu Hospital)

Pathology Department, The Fourth Affiliated Hospital of Anhui Medical University (Affiliated Chaohu Hospital)

Department of Oncology, Xinjiang Military Region General Hospital of the Chinese People’s Liberation Army, Urumqi 830000, Xinjiang Uygur Autonomous Region

Graduate School of Xinjiang Medical university, Urumqi 830000, Xinjiang Uygur Autonomous Region

AI问答

⁰