1
|
Iqbal MS, Jackson M, Paterson C. Radiotherapy to the neck after neck dissection for head and neck squamous cell carcinoma from an unknown primary: A narrative review. Clin Otolaryngol 2024; 49:376-383. [PMID: 38545823 DOI: 10.1111/coa.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE To conduct a comprehensive narrative review of the evidence for radiotherapy target volumes to the neck, after neck dissection, for head and neck squamous cell carcinoma from an unknown primary (HNSCCUP). Inclusion or exclusion of mucosal irradiation is not the focus of interest for this review article. MATERIALS AND METHODS Literature (PubMed-Medline, EMBASE database and Cochrane library) was searched using the relevant keywords. The search results were limited to the studies published in year 2000 or after. RESULTS Eight studies met the inclusion criteria. All studies were retrospective in nature. The incidence of contralateral recurrence rates in the untreated neck when the involved neck only is treated remains very low (0%-10%). Survival has improved over the past two decades, most likely due to improved diagnostic techniques and the increase in incidence of HPV-related disease. CONCLUSION Given the rarity of disease, level one evidence from randomised controlled trials is lacking. Available data are retrospective but support unilateral post-operative radiotherapy as a treatment option in selected cases.
Collapse
Affiliation(s)
- Muhammad Shahid Iqbal
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Department of Clinical Oncology, Newcastle University, Newcastle upon Tyne, UK
| | - Malcolm Jackson
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Claire Paterson
- Department of Clinical Oncology, The Beatson West of Scotland Cancer Centre, Glasgow, UK
| |
Collapse
|
2
|
Balgobind S, Cheung VKY, Luk P, Low THH, Wykes J, Wu R, Lee J, Ch'ng S, Palme CE, Clark JR, Gupta R. Prognostic and predictive biomarkers in head and neck cancer: something old, something new, something borrowed, something blue and a sixpence in your shoe. Pathology 2024; 56:170-185. [PMID: 38218691 DOI: 10.1016/j.pathol.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
A biomarker is a measurable indicator of biological or pathological processes or the response to an exposure or intervention and is used to guide management decisions. In head and neck pathology, biomarkers are assessed by histological criteria and immunohistochemical and molecular studies. Surgical resection remains the mainstay of management of many head and neck malignancies. Adjuvant radiotherapy and/or systemic therapy may be administered depending on the presence of adverse prognostic factors identified on histopathological or immunohistochemical examination. In this review, we outline the clinically relevant prognostic and predictive factors in head and neck malignancies including conventionally recognised factors such as tumour size, depth of invasion, lymphovascular and perineural invasion and margin status as well as novel evolving factors such as recurrent genetic rearrangements and assessment of immune checkpoints. Practical issues are discussed to assist with recognising and reporting of these factors. A summary of useful tools such as structured pathology report formats is also included to assist with comprehensive reporting of all clinically relevant parameters, minimise risk and improve workflow efficiencies.
Collapse
Affiliation(s)
- Sapna Balgobind
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia.
| | - Veronica K Y Cheung
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia
| | - Peter Luk
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tsu-Hui Hubert Low
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - James Wykes
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Raymond Wu
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jenny Lee
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Melanoma Institute Australia, University of Sydney, Sydney, NSW, Australia; Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Sydney Ch'ng
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Carsten E Palme
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jonathan R Clark
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Cocuz IG, Cocuz ME, Repanovici A, Sabău AH, Niculescu R, Tinca AC, Vunvulea V, Budin CE, Szoke AR, Popelea MC, Moraru R, Cotoi TC, Cotoi OS. Scientific Research Directions on the Histopathology and Immunohistochemistry of the Cutaneous Squamous Cell Carcinoma: A Scientometric Study. Medicina (B Aires) 2022; 58:medicina58101449. [PMID: 36295609 PMCID: PMC9611311 DOI: 10.3390/medicina58101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cutaneous squamous cell carcinoma (cSCC) is one of the most frequently occurring types of cancer in humans. Scientometric research is an innovative method for analyzing the research trends in various domains, with great implications in the field of medicine. Materials and Methods: We searched the Web of Science database with the following established query terms: “Squamous cell carcinoma”, “skin”, and “immunohistochemistry”. After applying the inclusion and exclusion criteria, a total of 76 articles were selected. The present study aims to analyze, based on the frequency of use of keywords with scientometric algorithms and map-based distributions, the trends of the research concerning cSCCs in 2017–2022. Results: A graphical representation based on 11 scientometric maps presented the division of the keywords into seven clusters, from which seven categories of research interest were defined. The clusters represent a multidisciplinary approach to the diagnosis and treatment of cSCCs, cancer diagnostics, patient outcomes, histopathological importance, management of cSCCs, role of progression, and adequate treatment of and importance of immunohistochemistry for cSCCs. The distribution of the citations shows the importance of the available research on cSCCs by analyzing the first five most-cited articles included in our study in direct concordance with the seven defined clusters. Conclusion: The scientometric research method reveals the interest of research in the multidisciplinary approach used to obtain the best outcomes for the patient, including a targeted investigation, as well as diagnostic and treatment options. The trends in the research reveal that histopathological diagnostics and immunohistochemistry, combined with molecular techniques, are the most important tools used to establish a personalized diagnosis, thus increasing the quality of life and life expectancy for patients with cSCCs.
Collapse
Affiliation(s)
- Iuliu Gabriel Cocuz
- Doctoral School of Medicine and Pharmacy, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Maria Elena Cocuz
- Fundamental Prophylactic and Clinical Disciplines Department, Faculty of Medicine, Transilvania University of Brasov, 500003 Brașov, Romania
- Clinical Infectious Diseases Hospital of Brasov, 500174 Brasov, Romania
- Correspondence:
| | - Angela Repanovici
- Faculty of Product Design and Environment, Transilvania University of Brasov, 500036 Brasov, Romania
| | - Adrian-Horațiu Sabău
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Raluca Niculescu
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Andreea-Cătălina Tinca
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Vlad Vunvulea
- Anatomy and Embryology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Corina Eugenia Budin
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | - Andreea Raluca Szoke
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| | | | - Raluca Moraru
- Anatomy and Embryology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
- Department of Plastic Surgery, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Titiana Cornelia Cotoi
- Pharmaceutical Technique Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
- Pharmacy No. 2, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Ovidiu Simion Cotoi
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
- Pathophysiology Department, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Targu Mures, 540142 Targu Mures, Romania
| |
Collapse
|
4
|
Csekes E, Račková L. Skin Aging, Cellular Senescence and Natural Polyphenols. Int J Mol Sci 2021; 22:12641. [PMID: 34884444 PMCID: PMC8657738 DOI: 10.3390/ijms222312641] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/13/2021] [Accepted: 11/18/2021] [Indexed: 01/10/2023] Open
Abstract
The skin, being the barrier organ of the body, is constitutively exposed to various stimuli impacting its morphology and function. Senescent cells have been found to accumulate with age and may contribute to age-related skin changes and pathologies. Natural polyphenols exert many health benefits, including ameliorative effects on skin aging. By affecting molecular pathways of senescence, polyphenols are able to prevent or delay the senescence formation and, consequently, avoid or ameliorate aging and age-associated pathologies of the skin. This review aims to provide an overview of the current state of knowledge in skin aging and cellular senescence, and to summarize the recent in vitro studies related to the anti-senescent mechanisms of natural polyphenols carried out on keratinocytes, melanocytes and fibroblasts. Aged skin in the context of the COVID-19 pandemic will be also discussed.
Collapse
Affiliation(s)
- Erika Csekes
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská Cesta 9, 841 04 Bratislava, Slovakia
| | - Lucia Račková
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy of Sciences, Dúbravská Cesta 9, 841 04 Bratislava, Slovakia
| |
Collapse
|
5
|
Kanber Y, Pusztaszeri M, Auger M. Immunocytochemistry for diagnostic cytopathology-A practical guide. Cytopathology 2021; 32:562-587. [PMID: 34033162 DOI: 10.1111/cyt.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Abstract
Cytological specimens, which are obtained by minimally invasive methods, are an excellent source of diagnostic material. Sometimes they are the only material available for diagnosis as well as for prognostic/predictive markers. When cytomorphology is not straightforward, ancillary tests may be required for a definitive diagnosis to guide clinical management. Immunocytochemistry (ICC) is the most common and practical ancillary tool used to reach a diagnosis when cytomorphology is equivocal, to differentiate entities with overlapping morphological features, and to determine the cell lineage and the site of origin of a metastatic neoplasm. Numerous immunomarkers are available, and some are expressed in multiple neoplasms. To rule out entities within a differential diagnosis, the use of more than one marker, sometimes panels, is necessary. ICC panels for diagnostic purposes should be customised based on the clinical context and cytomorphology, and the markers should be used judiciously to preserve material for additional tests for targeted therapies in the appropriate setting. This review offers a practical guide for the use of ICC for diagnostic cytopathology, covering the most commonly encountered non-hematolymphoid diagnostic scenarios in various body sites.
Collapse
Affiliation(s)
- Yonca Kanber
- Department of Pathology, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Marc Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, Montréal, QC, Canada
| | - Manon Auger
- Department of Pathology, McGill University Health Center, McGill University, Montreal, QC, Canada
| |
Collapse
|
6
|
Mulvaney PM, Massey PR, Yu KK, Drinan JE, Schmults CD. Differential Molecular Expression Patterns Associated with Metastasis in Cutaneous Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. J Invest Dermatol 2021; 141:2161-2169. [PMID: 33771528 DOI: 10.1016/j.jid.2021.02.741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/24/2021] [Accepted: 02/16/2021] [Indexed: 12/23/2022]
Abstract
The majority of cutaneous squamous cell carcinomas are treated by surgical removal; however, approximately 4% of tumors will metastasize. Molecular expression testing may improve accuracy in estimating the prognosis and defining the mechanisms important in the disease progression, which may impact response to therapy. Using PubMed (MEDLINE) and EMBASE, a systematic review was performed to evaluate studies published from January 2005 to August 2019 reporting tumor protein or RNA expression along with either outcomes (metastasis or death) or a comparison of primary with metastatic tumor samples. Inclusion criteria were met by 45 studies containing 81 comparisons of 44 distinct proteins and 25 microRNAs. On meta-analysis of studies analyzing primary tumor samples in terms of later outcomes, high primary tumor expression of PD-L1 (OR = 2.34, 95% confidence interval = 1.09-5.02, P = 0.030), EGFR (OR = 2.57, 95% confidence interval = 1.24-5.33, P = 0.011), and podoplanin (OR = 2.33, 95% confidence interval = 1.00-5.41, P = 0.049) conferred increased odds for metastasis. In comparison, metastatic tissue was more likely to have a high expression of PD-L1 than primary tissue (OR = 3.13, 95% confidence interval = 1.00-9.75, P = 0.049). Further studies are needed to confirm whether testing for PD-L1, EGFR, and podoplanin expression aids in cutaneous squamous cell carcinomas prognostic estimation of metastasis or death or predicts response to therapy.
Collapse
Affiliation(s)
- Patrick M Mulvaney
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul R Massey
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth K Yu
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jack E Drinan
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chryslayne D Schmults
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| |
Collapse
|
7
|
Civantos FJ, Vermorken JB, Shah JP, Rinaldo A, Suárez C, Kowalski LP, Rodrigo JP, Olsen K, Strojan P, Mäkitie AA, Takes RP, de Bree R, Corry J, Paleri V, Shaha AR, Hartl DM, Mendenhall W, Piazza C, Hinni M, Robbins KT, Tong NW, Sanabria A, Coca-Pelaz A, Langendijk JA, Hernandez-Prera J, Ferlito A. Metastatic Squamous Cell Carcinoma to the Cervical Lymph Nodes From an Unknown Primary Cancer: Management in the HPV Era. Front Oncol 2020; 10:593164. [PMID: 33244460 PMCID: PMC7685177 DOI: 10.3389/fonc.2020.593164] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background Patients with metastases in the lymph nodes of the neck and no obvious primary tumor, neck cancer with unknown primary (NCUP), represent a management challenge. A majority of patients have metastatic squamous cell carcinoma (SCC), although other histologies do occur. Methods We comprehensively reviewed the literature, compared available guidelines, and conferred with an international team of experts. Results Positron emission tomography-computed tomography (PET-CT) and fine needle aspiration (FNA) under ultrasound guidance increase accuracy of diagnosis. Immunohistochemistry (IHC), determination of human papilloma virus (HPV) status, by p16 staining or by in situ hybridization (ISH), and next-generation gene sequencing can guide us regarding probable primary sites and tumor biology. Narrow Band Imaging (NBI) has been introduced for the early detection of subtle mucosal lesions. Direct laryngoscopy (DL) and tonsillectomy have long been procedures used in the search for a primary site. More recently, TransOral Robotic Surgery (TORS) or Transoral LASER Microsurgery (TLM) have been introduced for lingual tonsillectomy. Conclusions New technologies have been developed which can better detect, diagnose, and treat occult primary tumors. Decisions regarding therapy are based on the primary tumor site (if discovered) and N stage. Options include neck dissection with or without postoperative adjuvant therapy, primary irradiation, or combined chemotherapy with irradiation. The preferred treatment of patients whose primary remains unidentified is controversial.
Collapse
Affiliation(s)
- Francisco J Civantos
- Department of Otolaryngology, Sylvester Cancer Center, University of Miami, Miami, FL, United States
| | - Jan B Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Luiz P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paolo, Brazil.,Head and Neck Surgery Department, University of São Paulo Medical School, São Paulo, Brazil
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Kerry Olsen
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Primoz Strojan
- Department of Radiation Oncology Institute of Oncology, University of Ljubljana, Ljubljana, Slovenia
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Robert P Takes
- Department of Otolaryngology/Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - June Corry
- Department of Medicine Division Radiation Oncology, St. Vincent's Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Vinidh Paleri
- Head and Neck Unit, The Royal Marsden Hospitals NHS Foundation Trust, London, United Kingdom
| | - Ashok R Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Dana M Hartl
- Division of Surgical Oncology, Gustave Roussy Cancer Center and Paris-Sud University, Paris, France
| | - William Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, United States
| | - Cesare Piazza
- Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michael Hinni
- Department of Otolaryngology, Mayo Clinic, Phoenix, AZ, United States
| | - K Thomas Robbins
- Southern Illinois University School of Medicine, Department of Otolaryngology, Springfield, IL, United States
| | - Ng Wai Tong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Hospital Universitario San Vicente Fundacion. CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Universidad de Antioquia, Medellín, Colombia
| | - Andres Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
| |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Cutaneous squamous cell carcinoma (cSCC) is a highly prevalent malignancy frequently occurring on body surfaces chronically exposed to ultraviolet radiation. While a large majority of tumors remain localized to the skin and immediate subcutaneous tissue and are cured with surgical excision, a small subset of patients with cSCC will develop metastatic disease. Risk stratification for cSCC is performed using clinical staging systems, but given a high mutational burden and advances in targeted and immunotherapy, there is growing interest in molecular predictors of high-risk disease. RECENT FINDINGS Recent literature on the risk for metastasis in cSCC includes notable findings in genes involved in cell-cycle regulation, tumor suppression, tissue invasion and microenvironment, interactions with the host-immune system, and epigenetic regulation. SUMMARY cSCC is a highly mutated tumor with complex carcinogenesis. Regulators of tumor growth and local invasion are numerous and increasingly well-understood but drivers of metastasis are less established. Areas of importance include central system regulators (NOTCH, miRNAs), proteins involved in tissue invasion (podoplanin, E-cadherin), and targets of existing and emerging therapeutics (PD-1, epidermal growth factor receptor). Given the complexity of cSCC carcinogenesis, the use of machine learning algorithms and computational genomics may provide ultimate insight and prospective studies are needed to verify clinical relevance.
Collapse
|
9
|
Ren H, Pors J, Chow C, Ta M, Stolnicu S, Soslow R, Huntsman D, Hoang L. Evaluation of human papillomavirus (HPV) prediction using the International Endocervical Adenocarcinoma Criteria and Classification system, compared to p16 immunohistochemistry and HPV RNA in-situ hybridization. J Pathol Transl Med 2020; 54:480-488. [PMID: 32854489 PMCID: PMC7674758 DOI: 10.4132/jptm.2020.07.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/17/2020] [Indexed: 11/18/2022] Open
Abstract
Background The International Endocervical Adenocarcinoma Criteria and Classification (IECC) separated endocervical adenocarcinomas into human papillomavirus (HPV) associated (HPVA) and non–HPV-associated (NHPVA) categories by morphology alone. Our primary objective was to assess the accuracy of HPV prediction by the IECC system compared to p16 immunohistochemistry and HPV RNA in-situ hybridization (RISH). Our secondary goal was to directly compare p16 and HPV RISH concordance. Methods Cases were classified by IECC and stained for p16 and HPV RISH on tissue microarray, with discordant p16/HPV RISH cases re-stained on whole tissue sections. Remaining discordant cases (p16/HPV, IECC/p16, IECC/HPV discordances) were re-reviewed by the original pathologists (n = 3) and external expert pathologists (n = 2) blinded to the p16 and HPV RISH results. Final IECC diagnosis was assigned upon independent agreement between all reviewers. Results One hundred and eleven endocervical adenocarcinomas were classified originally into 94 HPVA and 17 NHPVA cases. p16 and HPV RISH was concordant in 108/111 cases (97%) independent of the IECC. HPV RISH and p16 was concordant with IECC in 103/111 (93%) and 106/111 (95%), respectively. After expert review, concordance improved to 107/111 (96%) for HPV RISH. After review of the eight discordant cases, one remained as HPVA, four were reclassified to NHPVA from HPVA, two were unclassifiable, and one possibly represented a mixed usual and gastric-type adenocarcinoma. Conclusions p16 and HPV RISH have excellent concordance in endocervical adenocarcinomas, and IECC can predict HPV status in most cases. Focal apical mitoses and apoptotic debris on original review led to the misclassification of several NHPVA as HPVA.
Collapse
Affiliation(s)
- Hezhen Ren
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Pors
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Center (GPEC), Vancouver, BC, Canada
| | - Monica Ta
- Genetic Pathology Evaluation Center (GPEC), Vancouver, BC, Canada
| | - Simona Stolnicu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mures, Romania
| | - Robert Soslow
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Lynn Hoang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Genetic Pathology Evaluation Center (GPEC), Vancouver, BC, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, BC, Canada
| |
Collapse
|
10
|
Dekker H, Bun RJ, Mulder DC, Breeuwsma N, van der Rhee JI, Guimerà N, Quint W, Vermeer MH, Bouwes Bavinck JN. Human papillomavirus 16-positive supraclavicular cutaneous squamous cell carcinoma metastatic to the level IV supraclavicular lymph nodes. JAAD Case Rep 2020; 6:822-825. [PMID: 32875029 PMCID: PMC7452168 DOI: 10.1016/j.jdcr.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Hannah Dekker
- Department of Oral and Maxillofacial Surgery, Noord-West Ziekenhuisgroep, Alkmaar, Netherlands
| | - Rolf J Bun
- Department of Oral and Maxillofacial Surgery, Noord-West Ziekenhuisgroep, Alkmaar, Netherlands
| | - Doriene C Mulder
- Department of Oral and Maxillofacial Surgery, Noord-West Ziekenhuisgroep, Alkmaar, Netherlands
| | - Nelly Breeuwsma
- Department of Pathology, Noord-West Ziekenhuisgroep, Alkmaar, Netherlands
| | | | - Núria Guimerà
- DDL Diagnostic Laboratory, Research and Development, Rijswijk, Netherlands
| | - Wim Quint
- DDL Diagnostic Laboratory, Research and Development, Rijswijk, Netherlands
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
| | - Jan N Bouwes Bavinck
- Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
| |
Collapse
|
11
|
Hsieh JCH, Wang HM, Wu MH, Chang KP, Chang PH, Liao CT, Liau CT. Review of emerging biomarkers in head and neck squamous cell carcinoma in the era of immunotherapy and targeted therapy. Head Neck 2020; 41 Suppl 1:19-45. [PMID: 31573749 DOI: 10.1002/hed.25932] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Biomarkers in head and neck squamous cell carcinoma (HNSCC) emerge rapidly in recent years, especially for new targeted therapies and immunotherapies. METHODS Recent, relevant peer-reviewed evidence were critically reviewed and summarized. RESULTS This review article briefly introduces essential biomarker concepts, including purposes and classifications (predictive, prognostic, and diagnostic markers), and the phases of biomarker development. We summarize current biomarkers in order of clinical utility; p16 and human papillomavirus status remain the most important and validated biomarkers in HNSCC. The rationale for biomarker study design continues to evolve with technological advances, especially whole-exome or whole-genomic sequencing. Noninvasive body fluid and liquid biopsy biomarkers appear to hold strong potential for development as tools for early cancer detection, cancer diagnosis, monitoring of disease recurrence, and outcome prediction. In light of discrepancies among different technologies, standardized approaches are needed. CONCLUSION Biomarkers from cancer tissue or blood in HNSCC could direct new anticancer therapies.
Collapse
Affiliation(s)
- Jason Chia-Hsun Hsieh
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Hung-Ming Wang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Min-Hsien Wu
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
| | - Kai-Ping Chang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Pei-Hung Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan and Chang Gung University, Taoyuan, Taiwan.,Cancer Center, Chang Gung Memorial Hospital, Keelung, and Chang Gung University, Taoyuan, Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chi-Ting Liau
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
12
|
Wright MF, Weiss VL, Lewis JS, Schmitz JE, Ely KA. Determination of high-risk HPV status of head and neck squamous cell carcinoma using the Roche cobas HPV test on cytologic specimens and acellular supernatant fluid. Cancer Cytopathol 2020; 128:482-490. [PMID: 32129949 PMCID: PMC10030066 DOI: 10.1002/cncy.22258] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/04/2020] [Accepted: 02/11/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND High-risk human papillomavirus-positive (hrHPV+) oropharyngeal squamous cell carcinomas comprise a subset of head and neck squamous cell carcinomas (HNSCCs) with a distinct biology and prognosis. Commonly, the diagnosis of HNSCC is rendered on fine-needle aspiration (FNA). Because cell blocks may be insufficient for determining HPV status using microscopy-based techniques, the ability of liquid-based assays was examined in the current study. METHODS The performance of the Roche cobas 4800 platform was evaluated on the FNA material from the cell pellet and corresponding cell-free supernatant fluid specimens of primary and metastatic HNSCCs. These results were compared with the p16 immunostain result from the histologic material obtained from the same patient. Discrepant cases were adjudicated using hrHPV RNA in situ hybridization. RESULTS A total of 41 samples (23 primary tumors and 18 lymph node metastases) were acquired from 34 patients with HNSCC. Primary tumors included the oropharynx (20 samples), oral cavity (13 samples), larynx (3 samples), and skin (3 samples). In 2 cases, a primary tumor could not be identified. Twenty-three samples (56%) were found to be p16 positive by immunohistochemistry. Twenty-two samples were found to be positive on cobas hrHPV testing from both cell pellet and cell-free supernatant fluid. Two cell-free supernatant fluid specimens yielded indeterminate cobas results. At the time additional hrHPV RNA in situ hybridization analysis was performed, one cobas-positive cell pellet was deemed to be a false-positive result. The sensitivity of the cobas assay was 100% for pellet material and cell-free supernatant fluid, with specificities of 94.7% and 100%, respectively. CONCLUSIONS cobas hrHPV testing of HNSCC specimens demonstrated high concordance with p16 immunohistochemistry on the corresponding cell block and/or tissue specimen. Using the cell-free supernatant fluid in this platform could provide accurate HPV results while conserving material for cytomorphologic analyses.
Collapse
Affiliation(s)
- Martha Frances Wright
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Vivian L. Weiss
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - James S. Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan E. Schmitz
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kim Adams Ely
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
13
|
Smith AP, Dueber JC, Allison DB. A diagnostic review of carcinomas and sarcomas of the mediastinum: making the diagnosis on fine-needle aspiration and core needle biopsy specimens. Semin Diagn Pathol 2020; 37:187-198. [PMID: 32532552 DOI: 10.1053/j.semdp.2020.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/14/2020] [Accepted: 04/17/2020] [Indexed: 11/11/2022]
Abstract
The mediastinum is a complex anatomic region that can pose many diagnostic challenges on fine-needle aspiration (FNA) and core needle biopsy (CNB). With the recent technological advancements in EBUS-TBNA and EUS-guided procedures, FNA/CNB is being increasingly utilized to obtain the initial and, in many cases, the only diagnosis. As a result, it is imperative to have an understanding of the pearls and pitfalls associated with both the more common and rarer malignancies that occur at this site. Although the vast majority of mediastinal malignancies encountered in routine clinical practice are metastatic carcinomas to mediastinal lymph nodes, primary tumors and tumors that directly extend into the mediastinum are also encountered. As always, a multimodal approach with clinical and radiographic correlation, a targeted IHC panel, and molecular testing when indicated are indisposable and necessary tools in the diagnostic workup of mediastinal malignancies. This review focuses on the salient diagnostic features of malignancies of epithelial and mesenchymal origin, excluding tumors of neurogenic, thymic, hematolymphoid, and germ cell origins, which are discussed in separate articles of this issue.
Collapse
Affiliation(s)
- Alexander P Smith
- Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, 800 Rose Street, MS 117, Lexington, KY 40536, USA
| | - Julie C Dueber
- Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, 800 Rose Street, MS 117, Lexington, KY 40536, USA
| | - Derek B Allison
- Department of Pathology and Laboratory Medicine, Markey Cancer Center, University of Kentucky, 800 Rose Street, MS 117, Lexington, KY 40536, USA.
| |
Collapse
|
14
|
Zhang DW, Wu HY, Zhu CR, Wu DD. CircRNA hsa_circ_0070934 functions as a competitive endogenous RNA to regulate HOXB7 expression by sponging miR‑1236‑3p in cutaneous squamous cell carcinoma. Int J Oncol 2020; 57:478-487. [PMID: 32626939 PMCID: PMC7307596 DOI: 10.3892/ijo.2020.5066] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 04/16/2020] [Indexed: 02/06/2023] Open
Abstract
Circular ribonucleic acids (circRNAs) serve a vital role in the pathological processes of a number of diseases. Previous microarray results of circRNA expression revealed that hsa_circ_0070933 and hsa_circ_0070934, two circRNAs associated with the La ribonucleoprotein 1B gene, were highly expressed in cutaneous squamous cell carcinoma (CSCC). The present study aimed to explore the specific role of these circRNAs in CSCC. Through reverse transcription-quantitative PCR, hsa_circ_0070933 and hsa_circ_0070934 expression levels in CSCC cell lines and a human keratino-cyte cell line were detected. Additionally, direct interactions between miR-1236-3p and HOXB7 or circ-0070934 were identified using RNA binding protein immunoprecipitation assays and dual-luciferase reporter assays. Cell Counting Kit-8, 5-ethynyl-2′-deoxyuridine, Transwell invasion and flow cytometry assays were used to assess the roles of miR-1236-3p or circ-0070934 in cell invasion, proliferation and apoptosis. Subsequently, in vivo tumor formation assays were used to verify the role of circ-0070934 in CSCC. The results demonstrated that the expression of circ-0070934 was stably upregulated in a number of CSCC cell lines compared with that in normal human keratinocytes. Knockdown of circ-0070934 inhibited the invasive and proliferative potential of CSCC cells and promoted apoptosis both in vivo and in vitro. In addition, circ-0070934 modulated HOXB7 expression through competitive binding with miR-1236-3p. In conclusion, the results of the present study demonstrated the effects of the circ-0070934/miR-1236-3p/HOXB7 regulatory axis on CSCC and provided a novel insight for the pathogenesis of CSCC.
Collapse
Affiliation(s)
- Da-Wei Zhang
- Department of Burn and Plastic Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu 223300, P.R. China
| | - Hai-Yan Wu
- Department of Burn and Plastic Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu 223300, P.R. China
| | - Chuan-Rong Zhu
- Department of Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu 223300, P.R. China
| | - Dong-Dong Wu
- Department of Burn and Plastic Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu 223300, P.R. China
| |
Collapse
|
15
|
Casswell G, Cavanagh K, Ravi Kumar AS, Giddings C, McDowell L. Setting the stage: Contemporary staging of non-melanomatous skin cancer and implementation of the new American Joint Committee on cancer eighth edition staging manual. Oral Oncol 2019; 98:102-108. [DOI: 10.1016/j.oraloncology.2019.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022]
|
16
|
Tumour Cell Anaplasia and Multinucleation as Prognosticators in Oropharyngeal Squamous Cell Carcinoma. Head Neck Pathol 2019; 14:606-615. [PMID: 31552619 PMCID: PMC7413948 DOI: 10.1007/s12105-019-01081-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/16/2019] [Indexed: 01/23/2023]
Abstract
Human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCC) tend to have good outcomes, however a subset does not share this favourable prognosis. The aim of this paper is to investigate the utility of tumour cell anaplasia and multinucleation as prognostic markers in oropharyngeal squamous cell carcinoma. Retrospective review of 104 patients with OPSCC or squamous cell carcinoma of unknown primary site (SCCUP) who underwent primary resection and/or lymph node dissection. Slides of both primary and nodal metastatic disease were assessed for the presence of anaplasia and multinucleation. 53 patients were HPV-positive. Anaplasia was more frequent in males (p = 0.005), smokers (p = 0.003), and HPV-negative disease (p = 0.04). HPV status and > 10 pack-year smoking history were independent predictors of recurrence-free survival (RFS) and disease-specific survival (DSS). Neither anaplasia, nor multinucleation, at the primary site or in cervical metastases, had any significant impact on RFS or DSS. We did not find either anaplasia or multinucleation to have any significant prognostic impact in OPSCC. However, given the small number of adverse events in the HPV-positive cohort, we may have lacked sufficient power to detect significance in what was the subgroup of primary interest. Our study highlights the challenge of identifying markers of poor prognosis in HPV-positive OPSCC.
Collapse
|
17
|
Mutational Patterns in Metastatic Cutaneous Squamous Cell Carcinoma. J Invest Dermatol 2019; 139:1449-1458.e1. [DOI: 10.1016/j.jid.2019.01.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 01/01/2023]
|
18
|
High-Risk Human Papillomavirus E6/E7 mRNA Is Rarely Detected in Nonanogenital Cutaneous Squamous Cell Carcinoma: An RNA In Situ Hybridization-Based Tissue Microarray Study. Am J Dermatopathol 2019; 41:205-210. [PMID: 30640756 DOI: 10.1097/dad.0000000000001289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
High-risk human papillomavirus (HR-HPV) is known to play an oncogenic role in squamous cell carcinoma (SCC) at certain anatomical sites, namely the uterine cervix, oropharynx, and anogenital skin. However, the association between HR-HPV and nonanogenital cutaneous SCC (CSCC) remains controversial. In this study, we addressed this controversy by performing HR-HPV E6/E7 mRNA in situ hybridization (ISH) on 243 CSCC samples. A cocktail of E6/E7 mRNA ISH probes, recognizing 18 HR-HPV genotypes, was applied to a tissue microarray of paraffin-embedded sections of 154 invasive and 89 in situ CSCC specimens. The anatomical sites of CSCC included the head and neck (n = 100), extremities (n = 100), trunk (n = 25), and anogenitalia (n = 18). We also investigated the correlation between the p16 expression and HR-HPV status by immunohistochemistry. The results of HR-HPV E6/E7 mRNA ISH showed that 5.8% (14/243) of all CSCC samples were positive for HR-HPV, including 66.7% (12/18) of the anogenital and only 0.9% (2/225) of the nonanogenital CSCC samples (P < 0.01). For the detection of diffuse p16 expression by immunohistochemistry, the sensitivity was 100% (14/14 HR-HPV-positive CSCC samples), and the specificity was 72.1% (165/229 HR-HPV-negative specimens). Thus, HR-HPV E6/E7 mRNA was rarely detected in nonanogenital CSCC, making it unlikely that the virus contributes to the pathogenesis of this malignancy. In addition, p16 immunoreactivity has a limited value as a surrogate marker for transcriptionally active HR-HPV in nonanogenital CSCC.
Collapse
|
19
|
Clinical Utility of In Situ Hybridization Assays in Head and Neck Neoplasms. Head Neck Pathol 2018; 13:397-414. [PMID: 30467669 PMCID: PMC6684702 DOI: 10.1007/s12105-018-0988-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
Head and neck pathology present a unique set of challenges including the morphological diversity of the neoplasms and presentation of metastases of unknown primary origin. The detection of human papillomavirus and Epstein-Barr virus associated with squamous cell carcinoma and newer entities like HPV-related carcinoma with adenoid cystic like features have critical prognostic and management implications. In salivary gland neoplasms, differential diagnoses can be broad and include non-neoplastic conditions as well as benign and malignant neoplasms. The detection of specific gene rearrangements can be immensely helpful in reaching the diagnosis in pleomorphic adenoma, mucoepidermoid carcinoma, secretory carcinoma, hyalinizing clear cell carcinoma and adenoid cystic carcinoma. Furthermore, molecular techniques are essential in diagnosis of small round blue cell neoplasms and spindle cell neoplasms including Ewing sarcoma, rhabdomyosarcoma, synovial sarcoma, biphenotypic sinonasal sarcoma, dermatofibrosarcoma protuberans, nodular fasciitis and inflammatory myofibroblastic tumor. The detection of genetic rearrangements is also important in lymphomas particularly in identifying 'double-hit' and 'triple-hit' lymphomas in diffuse large B cell lymphoma. This article reviews the use of in situ hybridization in the diagnosis of these neoplasms.
Collapse
|
20
|
Schwartz MR, Bishop JA. New evidence-based guideline for HPV testing in head and neck cancers. J Am Soc Cytopathol 2018; 7:282-286. [PMID: 31043288 DOI: 10.1016/j.jasc.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 12/24/2022]
Abstract
It is now well established that a subset of head and neck carcinomas is defined by their association with high-risk types of human papillomavirus (HPV). These HPV-driven head and neck carcinomas are characterized by distinct histologic and clinical features, including an excellent prognosis and response to therapy. Although the recognition of this subtype of head and neck cancer has been a significant advancement in head and neck oncology, confusion has persisted regarding why, when, and how HPV testing should be carried out. The College of American Pathologists (CAP) recently published evidence-based guidelines addressing HPV testing in head and neck carcinomas, offering much-needed clarification on a complicated issue. This review will detail each CAP guideline while also explaining the rationale and methods for their creation.
Collapse
Affiliation(s)
- Mary R Schwartz
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|