Utility of p53 and p16 immunohistochemistry in the diagnosis of human papillomavirus-associated oral epithelial dysplasia: a retrospective study of 105 patients

IF 3.9 2区医学 Q2 CELL BIOLOGY

Histopathology Pub Date : 2025-02-04 DOI:10.1111/his.15413

Damir Rosic, Zia A Khan, Linda Jackson-Boeters, Mark R Darling, Erin Chapman, Lawrence Lee, Kelly Yi Ping Liu, Tony L Ng, Yen Chen Kevin Ko, Christina McCord

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Abstract

Aims

This study investigated the utility of combined p16 and p53 immunohistochemistry (IHC) for diagnosing high-risk human papillomavirus (HR HPV)-associated oral epithelial dysplasia (OED) and its associated clinical behaviour, including disease recurrence and transformation to malignancy.

Methods and Results

The expression of p53 was evaluated in 105 cases of HR HPV-positive oral cavity OED, of which 104 were scored as positive for p16. HPV status was confirmed by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) for E6 mRNA or RNA in situ hybridization (ISH). Seven cases of p16-positive oral cavity OED with abnormal p53 expression and/or TP53 mutation and negative HPV RNA ISH were excluded. Most cases (93%) demonstrated classic HPV-associated basaloid morphology, and 7% were keratinizing. The most affected sites were the floor of the mouth/ventral tongue (61%), followed by the lateral tongue (18%) and gingiva (13%). p53 IHC showed that 76% of cases demonstrated a null-like / basal-sparing pattern, while 24% demonstrated a mid-epithelial/basal sparing pattern. Ten cases exhibited an invasive or suspicious for microinvasive component on biopsy. Dysplasia recurred in 14 cases, and a single case transformed to squamous cell carcinoma.

Conclusion

The combination of p16 positivity and a basal-sparing pattern of p53 is predictive of HR HPV in OED, eliminating the need for further HPV-specific testing. Although HPV OED may co-occur with invasive squamous cell carcinoma on biopsy, the transformation to malignancy is low.

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p53和p16免疫组织化学在诊断人乳头瘤病毒相关口腔上皮发育不良中的应用：一项105例患者的回顾性研究

目的：本研究探讨p16和p53联合免疫组织化学（IHC）在诊断高危人乳头瘤病毒（HR HPV）相关口腔上皮发育不良（OED）及其相关临床行为（包括疾病复发和向恶性肿瘤转化）中的应用。方法与结果：105例HR hpv阳性口腔OED检测p53表达，其中p16阳性104例。采用逆转录酶定量聚合酶链反应（RT-qPCR）对E6 mRNA或RNA原位杂交（ISH）证实HPV状态。排除7例p16阳性、p53表达异常和/或TP53突变、HPV RNA ISH阴性的口腔OED。大多数病例（93%）表现为典型的hpv相关基底样形态，7%为角化。受影响最大的部位是口腔底/舌腹（61%），其次是舌侧（18%）和牙龈（13%）。p53免疫组化显示76%的病例表现为空样/基底保留模式，而24%表现为中上皮/基底保留模式。10例活检显示侵入性或可疑的微创成分。14例复发异常增生，1例转化为鳞状细胞癌。结论：p16阳性和p53的基底保留模式的结合可预测OED中HR HPV，无需进一步的HPV特异性检测。虽然活检显示HPV OED可能与浸润性鳞状细胞癌同时发生，但向恶性肿瘤的转化率很低。

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来源期刊

Histopathology 医学-病理学

CiteScore

10.20

自引率

4.70%

发文量

239

审稿时长

1 months

期刊介绍： Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.