原文題目

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口腔病理科 On-Line KMU Student Bulletin

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原文題目(出處)： Changing trends in human papillomavirus–associated head and neck squamous cell carcinoma. Annals Diagnost Pathol 2012;16:7-12

原文作者姓名： Xiaohong Iris Wang, MD, PhD, Jaiyeola Thomas, MD, Songlin Zhang, MD, PhD

通訊作者學校： Department of Pathology, Louisiana State University Health Science Center, Shreveport, LA 71130, USA

報告者姓名(組別)：陳柏屹 Intern L 組

報告日期： 101.08.07

內文：

1. Introduction

head and neck squamous cell carcinoma→ (HNSCC) high-risk HPV →(hrHPV)

1.Human papillomaviruses (HPVs) are small nonenveloped DNA viruses that infect squamous epithelial cells

2. more than 100 different genotypes, approximately 15 are considered oncogenic 3. low-risk HPV subtypes→benign neoplasms,ex ： papillomas ； high-risk

subtypes→malignant neoplasms

4.HPV-positive HNSCC is a biologically distinct entity different from tobacco- and alcohol-associated carcinom→oral and oropharyngeal ； better patient survival because increased sensitivity to radiation therapy

5. in situ hybridization(ISH) technique→allows for the visualization of HPV localization within the tumor cells.

2. Materials and methods

1.Time ：January 2000 and December 2004；January 2009 and October 2010 2.excluded 1. tissue specimens were too small 2. no tumor tissue was identified

3.The probe used is capable of hybridizing with hrHPV genotypes 16, 18, 33, 35, 45, 51, 52, 56, and 66.

4.Positive→dark blue punctate (dotlike) or diffuse nuclear signals in confluent groups of tumor cells

5.Locations：oral cavity, larynx, oropharynx(soft palate, the tonsil, and the base of tongue), hypopharynx, and nasopharynx

6.histologic types ： nonkeratinizing squamous cell carcinoma (NKSCC) and keratinizing squamous cell carcinoma (KSCC)

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1. Nonkeratinizing squamous cell carcinoma composed of invasive sheets, nests, or trabeculae of tumor cells with squamous differentiation but no evidence of distinct keratinization (A).

2. Keratinizing squamous cell carcinoma composed of recognizable squamous tumor cells with pronounced keratinization (B) (original magnification ×200).

3.Results

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Fig. 2. Dark blue punctate (dotlike, A) or diffuse nuclear staining patterns(single or multiple intranuclear spots of variable size, B) of hrHPV-positive tumor cells (original magnification ×400).

1. Discussion

1. 85% of humans will have HPV infection of any subtype during their lifetime 2.in situ hybridization(ISH) technique

→routine use、localization of HPV DNA in a specimen、high specificity polymerase chain reaction (PCR)

→sensitive、expensive

3. demographics→tobacco and alcohol widespread in our patient 、no age difference 4. increased prevalence of HPVassociated head and neck cancers：

from13% in the 2000-to-2004 series to 40% in the 2009-to-2010 series.

→2000-to-2004： low percentage of tumors from the oropharyngeal sites and high frequency of smoking and drinking history in our patients;

→2009-to-2010： increasing community awareness and screening coupled with the

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introduction of routine testing for hrHPV DNA

5. oropharynx than other head and neck sites→The low rate (8%) of HPV-positive nonoropharyngeal SCC due to smoking and drinking habits