title: Detection and genotype of high-risk human papillomavirus in fine-needle aspirates of patients with metastatic squamous cell carcinoma is helpful in determining tumor origin.
abstract: OBJECTIVE
  Recent studies have shown that human papillomavirus (HPV) is associated with a certain subset of head and neck squamous cell carcinoma (HNSCC)-namely, those arising in the oropharynx. The objective of this study is to determine the efficacy, detection, and genotype of high-risk (HR) HPV using the Roche cobas 4800 system (Roche Molecular System, Pleasanton, CA).
  
  
  METHODS
  Forty-two fine-needle aspirate (FNA) specimens from 37 patients with cervical (n = 36) or mediastinal (n = 5) lymphadenopathy or a left parapharyngeal mass (n =1) were included in this prospective study. HR-HPV testing was performed on residual FNA material after direct smear preparation and, if positive, was further delineated into HPV 16/18 genotypes using the Roche cobas 4800 system. Follow-up included review of histologic material and/or electronic health records.
  
  
  RESULTS
  Among those HNSCCs that were positive for HR-HPV, 18 (100%) of 18 originated from the oropharynx, whereas only two (13%) of 15 HR-HPV-negative HNSCCs originated from the oropharynx (χ(2) test, P < .05). p16 immunohistochemical assay and HPV 16 in situ hybridization on corresponding histologic specimens were concordant with cytologic HR-HPV results.
  
  
  CONCLUSIONS
  HR-HPV detection and genotyping can be performed on lymph node FNAs with metastatic squamous cell carcinoma using the Roche cobas 4800 system. The presence of HR-HPV and/or HPV 16 is a reliable indicator of the metastatic squamous cell carcinoma originating from the oropharynx.
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors: Rebecca
authors: R
authors: Baldassarri
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors: Ryan
authors: R
authors: Aronberg
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors: Angelique W
authors: AW
authors: Levi
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors: Wendell G
authors: WG
authors: Yarbrough
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT.
authors: Diane
authors: D
authors: Kowalski
authors: From the Department of Pathology, Yale University School of Medicine, New Haven, CT. David.Chhieng@yale.edu.
authors: David
authors: D
authors: Chhieng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D005260:Female; D005838:Genotype; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Cytology; Cytopathology; Head/neck; Molecular diagnostics