title: High-risk human papillomavirus in nasopharyngeal carcinoma.
abstract: BACKGROUND
  Human papillomavirus (HPV), a cause of oropharyngeal carcinoma, has also been implicated as an etiologic agent in nasopharyngeal carcinomas.
  
  
  METHODS
  We performed p16 immunohistochemistry and in situ hybridization for Epstein-Barr virus (EBV) and HPV on 45 carcinomas of the nasopharynx.
  
  
  RESULTS
  Thirty-four (76%) carcinomas were EBV-positive/HPV-negative, 7 (16%) were EBV-negative/HPV-negative, and 4 (9%) were EBV-negative/HPV-positive. HPV was more likely to be detected in carcinomas from white patients than non-white patients (16% vs 0%; p = .03). Of the 3 patients with HPV-positive carcinomas and available staging information, all were found to have extension into the oropharynx. All HPV-positive carcinomas were p16 positive, but none of the HPV-negative carcinomas were p16 positive (p < .001).
  
  
  CONCLUSIONS
  HPV can be detected in a subset of carcinomas involving the nasopharynx, but many of these may represent extension from an oropharyngeal primary. P16 immunohistochemistry is a reliable marker for separating EBV-related and HPV-related carcinomas of Waldheyer's ring.
authors.affiliation: Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Aatur D
authors.initials: AD
authors.lastname: Singhi
authors.forename: Joseph
authors.initials: J
authors.lastname: Califano
authors.forename: William H
authors.initials: WH
authors.lastname: Westra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D002294:Carcinoma, Squamous Cell; D019941:Cyclin-Dependent Kinase Inhibitor p16; D005260:Female; D006258:Head and Neck Neoplasms; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000821:virology*; D009363:Neoplasm Proteins / Q000378:metabolism; D027383:Papillomaviridae / Q000302:isolation & purification*; D000077195:Squamous Cell Carcinoma of Head and Neck; D055815:Young Adult
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D009363:Neoplasm Proteins