OBJECTIVES/HYPOTHESIS: The incidence of human papillomavirus (HPV)-driven disease beyond the oropharynx varies greatly in the reported literature.
STUDY DESIGN: Case series.
METHODS: Two hundred twenty-one samples were strictly classified to the subsites of oral cavity, larynx, or hypopharynx at the time of primary surgery. Formalin-fixed paraffin-embedded samples were subjected to a validated, tiered, diagnostic algorithm of p16 immunohistochemistry, high-risk HPV in situ hybridization, and quantitative polymerase chain reaction for HPV E6 DNA. An additional 60 oropharyngeal cases acted as an internal biological control.
RESULTS: An incidence of 4% of HPV-driven cases was observed across the subsites outside the oropharynx compared to 70% of tumors confined within it.
CONCLUSIONS: This is the first reporting of a broad range of nonoropharyngeal HPV rates using this validated diagnostic algorithm. It remains unclear whether patients with HPV-driven disease originating outside the oropharynx enjoy the same survival advantage apparent in those patients with oropharyngeal squamous cell carcinomas.
LEVEL OF EVIDENCE: 4 Laryngoscope, 124:2739-2744, 2014.
- Biomarkers, Tumor/analysis
- Carcinoma, Squamous Cell/diagnosis
- DNA, Viral/analysis
- Diagnosis, Differential
- Follow-Up Studies
- Head and Neck Neoplasms/diagnosis
- In Situ Hybridization
- Middle Aged
- Papillomavirus Infections/diagnosis
- Polymerase Chain Reaction
- Real-Time Polymerase Chain Reaction
- Retrospective Studies
- Squamous Cell Carcinoma of Head and Neck