HPV-related squamous cell carcinoma of the head and neck: An update on testing in routine pathology practice.
Oropharyngeal squamous cell carcinoma caused by high-risk types of human papillomavirus (HPV) is now a well-recognized tumor entity whose incidence is on the rise. Most HPV-related oropharyngeal squamous cell carcinomas have a distinct histomorphology, and most patients fit a typical clinical profile. Importantly, HPV-related oropharyngeal carcinoma patients overall have significantly improved outcomes when compared to their HPV-negative counterparts, and the differences in tumor biology may soon lead to modifications in how they are treated. While high-risk HPV can be detected in a significant minority of head and neck squamous cell carcinomas across anatomic subsites in the head and neck, it has become clear in recent years that the biologically and clinically favorable features are limited to tumors that harbor transcriptionally active, high-risk HPV, something that occurs predominantly (but certainly not exclusively) in the oropharynx. It is now acknowledged that detecting transcriptionally active, high-risk HPV is a necessity in routine clinical practice, but there is considerable confusion among pathologists and clinicians alike about the subsites and settings in which HPV testing should be performed. Compounding this lack of clarity is the fact that there are multiple HPV testing options available, but currently there is no clear consensus on which test or combination of tests is optimal for routine diagnostic use. This review serves as an update for practicing pathologists on the current status of HPV (and surrogate marker) testing in head and neck cancers.
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Justin A
JA
Bishop
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri; Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
James S
JS
Lewis
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Cancer Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
James W
JW
Rocco
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Pathology, Massachusetts General Hospital, Warren 219, 55 Fruit St, Boston, Massachusetts 02114; Harvard Medical School, Boston, Massachusetts. Electronic address: wfaquin@mgh.harvard.edu.
William C
WC
Faquin
D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D004279:DNA, Viral / Q000235:genetics*; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D000077195:Squamous Cell Carcinoma of Head and Neck
D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral
HPV; Head and neck; Human papillomavirus; In situ hybridization; Non-keratinizing squamous cell carcinoma; p16