title: HPV-related Oropharyngeal Squamous Cell Carcinoma: p16INK4A Immunohistochemistry or HPV Genotyping?
abstract: BACKGROUND
  Infection with high-risk human papillomavirus (HPV) is linked to a sub-group of squamous cell oropharyngeal tumors (OPSCC). Our aim was to compare an HPV Polymerase Chain Reaction (PCR) assay and p16(INK4A) expression status by immunohistochemistry (IHC) as a surrogate marker.
  
  
  METHODS
  This was a retrospective study considering patients affected by squamous cell oropharyngeal tumors. All included samples were processed for IHC for p16(INK4A) and tested by PCR for detection of HPV DNA and HPV genotyping.
  
  
  RESULTS
  A total of 84 patients affected by squamous cell oropharyngeal tumors were included and tested. A significant positive correlation was found between HPV PCR and p16(INK4A) IHC but the agreement was poor (k coefficient of 0.25). In fact, the sensitivity of p16(INK4A) IHC positivity in detecting HPV PCR positivity was low (28.21%, 95% confidence interval=16.54% - 43.78%).
  
  
  CONCLUSIONS
  Positivity of p16(INK4A) by IHC had a low sensitivity in detecting HPV DNA and our results suggest the need at least to test p16(INK4A) IHC- negative samples using HPV PCR to increase detection accuracy and provide valuable information for the clinical management of these patients.
authors.affiliation: Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy mariaorsaria@yahoo.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Orsaria
authors.affiliation: Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Marzinotto
authors.affiliation: Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: De Marchi
authors.affiliation: Division of Otorhinolaryngology, Sant' Antonio Abate Hospital, Tolmezzo, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Giacomarra
authors.affiliation: Division of Otorhinolaryngology, Sant' Antonio Abate Hospital, Tolmezzo, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Boria
authors.affiliation: Department of Pathologic Anatomy and Histopathology, Marche Polytechnic University, Ancona, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Rubini
authors.affiliation: Unit of Obstetrics and Gynecology, S. Polo's Hospital, Monfalcone, Italy.
authors.forename: Ambrogio Pietro
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Di Loreto
authors.affiliation: Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Mariuzzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D005260:Female; D005838:Genotype; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics*
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: HPV PCR assay; HPV infection; diagnostic assay; p16 immunohistochemistry; squamous cell oropharyngeal tumors