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

• Published in: American journal of clinical pathology Vol. 143; no. 5; pp. 694 - 700
• Main Authors: Baldassarri, Rebecca, Aronberg, Ryan, Levi, Angelique W., Yarbrough, Wendell G., Kowalski, Diane, Chhieng, David
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford University Press 01-05-2015
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Female; Genotype; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - virology; Human papillomavirus 16 - genetics; Human papillomavirus 16 - isolation & purification; Humans; Lymphatic Metastasis; Male; Middle Aged; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnosis; Papillomavirus Infections - virology; Squamous Cell Carcinoma of Head and Neck; Cytopathology; Molecular diagnostics; Head/neck; Cytology
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/AJCPCZA4PSZCFHQ4

Objectives:
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.