Human papillomavirus in metastatic lymph nodes from unknown primary head and neck squamous cell carcinoma.

Autor: Compton AM; Department of Otolaryngology–Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA., Moore-Medlin T, Herman-Ferdinandez L, Clark C, Caldito GC, Wang XI, Thomas J, Abreo FW, Nathan CO
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2011 Jul; Vol. 145 (1), pp. 51-7.
DOI: 10.1177/0194599811400385
Abstrakt: Objective: Determine human papillomavirus (HPV) incidence in unknown primary squamous cell carcinomas (SCCa) of the head and neck and assess if HPV status influenced survival.
Study Design: Historical cohort study.
Setting: Tertiary care center.
Subjects: Patients with unknown primary SCCa despite a complete workup who underwent neck dissection or excisional biopsy and postoperative comprehensive ± chemoradiotherapy between 2002 and 2009.
Methods: HPV fluorescence in situ hybridization (FISH) and p16(INK4a) immunohistochemistry (p16 IHC) were performed. Results were compared with survival, age, race, gender, tobacco use, alcohol use, and nodal stage.
Results: Twenty-five patients met the inclusion criteria, of whom 88% were >10 pack year tobacco users. Twenty-eight percent were HPV-positive defined by both p16+ and FISH+. Five-year overall survival was 66.7% in HPV-positive and 48.5% in HPV-negative patients (P = .35). Similarly, 5-year disease-free survival rates were 66.7% in HPV-positive and 48.5% in HPV-negative patients (P = .54). All 3 HPV-positive nonsmokers were survivors, but this was not significant because of the small sample size (P > .05). No other characteristics were associated with survival (P > .05).
Conclusion: Twenty-eight percent of metastatic lymph nodes from occult primary tumors were HPV positive. There was no survival difference associated with HPV status. Most of the HPV-positive patients in this study were tobacco users who had similar survival to HPV-negative patients, so caution should be used in interpreting HPV status in these patients.
Databáze: MEDLINE
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