title: Oropharyngeal cancers: significance of HPV16 detection in neck lymph nodes.
abstract: BACKGROUND
  An increasing proportion of oropharyngeal squamous cell carcinomas (OPSCCs) is associated with human papillomavirus (HPV) type 16 infection. Several authors have suggested that HR-HPV DNA could be used as a marker of metastases in cervical cancers. Although HPV16 DNA has been detected in neck lymph node (LN) metastases of HPV16-positive OPSCC, its significance remains controversial. Does this presence correlate to metastatic involvement or is it just the consequence of LN filter function?
  
  
  OBJECTIVE
  This study aims to analyse the relationship between HPV16 detection in neck LNs of HPV16-positive OPSCC and their pathological status.
  
  
  METHODS
  HP16-viral load (VL) was quantified by real-time-polymerase-chain reaction in primary tumours and neck LNs, in 11 patients with HPV16-positive OPSCC and in three patients with HPV16-negative OPSCC. HPV16 in situ hybridisation and p16 immunohistochemistry were performed in all LNs.
  
  
  RESULTS
  A total of 45 LN levels were assessed. HPV16 DNA was not identified in HPV16-negative OPSCC LNs. All metastatic LNs from HPV16-positive OPSCC had a high VL and the viral DNA was located within tumoural cells. Among 27 pathologically tumour-free LN (PTFLN) levels 16/27 had no detectable VL, whereas the VL was low or medium (<10(5)copies/million cells) in 8/27 and high (>10(5)copies/million cells) in 3/27 PTFLN. In the latter group, no metastatic cell was identified and the viral DNA was located in immune cells.
  
  
  CONCLUSIONS
  HPV16 detection in LN is explained by its presence within either metastatic cells or immune cells. HPV16 detection in PTFLN is not necessarily correlated to occult LN metastases.
authors.affiliation: Department of Head and Neck, Institut de Cancérologie Gustave Roussy, Villejuif, France. mirghani_fr@yahoo.fr
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Malek
authors.initials: M
authors.lastname: Ferchiou
authors.forename: Frederique
authors.initials: F
authors.lastname: Moreau
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Vourexakis
authors.forename: Furrat
authors.initials: F
authors.lastname: Amen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Breuskin
authors.forename: Marine
authors.initials: M
authors.lastname: Lefèvre
authors.forename: Odile
authors.initials: O
authors.lastname: Casiraghi
authors.forename: Françoise
authors.initials: F
authors.lastname: Drusch
authors.forename: Patrick
authors.initials: P
authors.lastname: Soussan
authors.forename: Philippe
authors.initials: P
authors.lastname: Vielh
authors.forename: Jean Lacau
authors.initials: JL
authors.lastname: St Guily
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000821:virology*; D052162:Human papillomavirus 16 / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology*; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000235:genetics*; D008297:Male; D009333:Neck / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology / Q000821:virology; D060888:Real-Time Polymerase Chain Reaction; D000077195:Squamous Cell Carcinoma of Head and Neck; D019562:Viral Load
chemical_list: D004279:DNA, Viral