title: Human Papillomavirus as a Diagnostic and Prognostic Tool in Cancer of Unknown Primary in the Head and Neck Region.
abstract: Human papillomavirus (HPV) is recognized as a risk factor for oropharyngeal squamous cell carcinomas (SCC), especially tonsillar and base of tongue cancer. Furthermore, HPV-positive tonsillar and base of tongue SCC have a significantly better prognosis than their HPV-negative counterparts and head and neck cancer (HNSCC) in general. HPV has recently also been implicated in cancer of unknown primary (CUP) in the head and neck region, where a primary tumour is not found despite extensive workup. Using fine-needle aspiration cytology to determine CUP HPV status in cervical lymph nodes could be of advantage, since it is minimally invasive and it is assumed that an HPV-positive lymph node metastasis likely has an HPV-positive otopharyngeal SCC origin. We review the current knowledge of HPV in HNSCC, with an emphasis on CUP of the head and neck region, its relation to oropharyngeal, tonsillar and base of tongue SCC and implications of HPV status for diagnosis, prognosis and treatment.
authors: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors: Lars
authors: L
authors: Sivars
authors: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.
authors: Edneia
authors: E
authors: Tani
authors: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.
authors: Anders
authors: A
authors: Näsman
authors: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
authors: Torbjörn
authors: T
authors: Ramqvist
authors: Department of Oto-rhino-laryngology, Head and Neck Surgery Karolinska University Hospital and Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors: Eva
authors: E
authors: Munck-Wikland
authors: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden Tina.Dalianis@ki.se.
authors: Tina
authors: T
authors: Dalianis
mesh_terms: D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D061809:Human Papillomavirus DNA Tests / Q000379:methods*; D006801:Humans; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology
keywords: HPV; base of tongue cancer; cancer of unknown primary; fine-needle aspiration cytology; head and neck cancer; oropharyngeal cancer; review; tonsillar cancer