Squamous cell carcinoma of the head and neck outside the oropharynx is rarely human papillomavirus related

Navdeep S Upile, Richard J Shaw, Terry M Jones, Paul Goodyear, Triantafillos Liloglou, Janet M Risk, Mark T Boyd, Jon Sheard, Phil Sloan, Max Robinson, Andrew G Schache

Research output: Contribution to journalArticle (journal)peer-review

52 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)2739-44
Number of pages6
Issue number12
Publication statusPublished - 1 Dec 2014


  • Biomarkers, Tumor/analysis
  • Carcinoma, Squamous Cell/diagnosis
  • DNA, Viral/analysis
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms/diagnosis
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization
  • Male
  • Middle Aged
  • Oropharynx
  • Papillomaviridae/genetics
  • Papillomavirus Infections/diagnosis
  • Polymerase Chain Reaction
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck


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