Fine needle aspiration cytology including the analysis of human papilloma virus (HPV) DNA enhances the diagnostic workup of solitary cystic neck lesions in a population with a high incidence of HPV positive oropharyngeal cancer.

IF 2.7 3区 医学 Q3 ONCOLOGY
Evelina Jörtsö, Linda Marklund, Martin Harper Hysek, Anders Näsman, Lalle Hammarstedt-Nordenvall, Mathias Von Beckerath, Tina Dalianis, Rusana Bark
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引用次数: 0

Abstract

Background and purpose: Distinguishing branchial cleft cysts (BrCCs) from cystic metastases of human papillomavirus (HPV) positive tonsillar or base of tongue squamous cell carcinoma and cancer of unknown primary (CUP) is challenging. Fine needle aspiration cytology (FNAC) from cystic metastasis can be nonrepresentative, while reactive squamous cells from BrCC can be atypical. It is unclear whether benign characteristics and the absence of HPV-DNA in FNAC can enhance distinguishing BrCC from a cystic metastasis; therefore, we investigated here.

Patients/materials and methods: Morphology and HPV-DNA in FNAC were reevaluated preoperatively and correlated to final diagnosis of 304 BrCC and CUP patients at Karolinska University Hospital during 2016-2023.

Results and interpretation: All 176 cases finally diagnosed as BrCC were HPV-DNA negative in the preoperative FNAC. HPV-DNA was present in 100/128 (78.1%) of the FNAC with a solitary cystic neck metastasis and in 3/3 CUPs separately investigated on surgical specimens, which is distributed in 40/58 (69.0%) CUP, 40/41 (97.6%) tonsillar cancer, 21/22 (95.5%) base of tongue cancer, 2/2 uterine cervical cancer, and 0/5 non-HPV-related cancers.

Interpretation: All cases with final BrCC diagnosis were HPV-DNA negative in FNAC. HPV-DNA was only present in FNAC of malignant cystic neck masses of HPV-related tumors or CUP. The data suggest that HPV-DNA analysis in FNAC enhances the diagnostics of cystic masses of the neck. A FNAC with a benign morphology and the absence of HPV-DNA indicated a BrCC, while an HPV-DNA positive aspirate irrespective of morphology suggested an HPV-DNA positive cancer or CUP.

细针抽吸细胞学包括人乳头瘤病毒(HPV) DNA的分析,提高了HPV阳性口咽癌高发人群中孤立性囊性颈部病变的诊断工作。
背景和目的:区分鳃裂囊肿(brcc)与人乳头瘤病毒(HPV)阳性扁桃体或舌底鳞状细胞癌和未知原发癌(CUP)的囊性转移是具有挑战性的。来自囊性转移的细针吸细胞学(FNAC)可能不具有代表性,而来自BrCC的反应性鳞状细胞可能不典型。目前尚不清楚FNAC的良性特征和HPV-DNA的缺失是否可以增强BrCC与囊性转移的区分;因此,我们在这里进行了调查。患者/材料和方法:2016-2023年在卡罗林斯卡大学医院304例BrCC和CUP患者术前对FNAC形态学和HPV-DNA进行重新评估,并与最终诊断进行相关性分析。结果和解释:176例最终诊断为BrCC的患者术前FNAC均为HPV-DNA阴性。单纯囊性颈部转移的FNAC中有100/128(78.1%)存在HPV-DNA,手术标本中有3/3的CUPs存在HPV-DNA,分布在40/58(69.0%)的CUP、40/41(97.6%)的扁桃体癌、21/22(95.5%)的舌癌基底、2/2的子宫颈癌和0/5的非hpv相关癌症中。解释:所有最终诊断为BrCC的病例在FNAC中均为HPV-DNA阴性。HPV-DNA仅存在于hpv相关肿瘤或CUP的恶性囊性颈部肿块的FNAC中。数据提示FNAC中HPV-DNA分析提高了颈部囊性肿块的诊断。形态学为良性且没有HPV-DNA的FNAC提示BrCC,而形态学为HPV-DNA阳性的抽吸提示HPV-DNA阳性癌或CUP。
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来源期刊
Acta Oncologica
Acta Oncologica 医学-肿瘤学
CiteScore
4.30
自引率
3.20%
发文量
301
审稿时长
3 months
期刊介绍: Acta Oncologica is a journal for the clinical oncologist and accepts articles within all fields of clinical cancer research. Articles on tumour pathology, experimental oncology, radiobiology, cancer epidemiology and medical radio physics are also welcome, especially if they have a clinical aim or interest. Scientific articles on cancer nursing and psychological or social aspects of cancer are also welcomed. Extensive material may be published as Supplements, for which special conditions apply.
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