HPV检测在原发部位不明的宫颈淋巴结转移鳞状细胞癌中的诊断价值(附6例报告)

中华放射肿瘤学杂志 Pub Date : 2020-04-15 DOI:10.3760/CMA.J.CN113030-20190304-00002

Chenxue Jiang, Tingting Xu, Cuihong Wang, G. Sun, Qifeng Wang, Chunying Shen, Chaosu Hu, Xueguan Lu

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引用次数: 0

摘要

目的评价人乳头状瘤病毒（HPV）检测对不明原发部位颈淋巴结转移的鳞状细胞癌的诊断价值。方法收集6例初诊断为不明原发灶颈淋巴结转移鳞状细胞癌，最终诊断为HPV相关口咽鳞状细胞癌的患者的临床资料，并对诊断过程进行分析。结果所有患者在初次入院时均被诊断为颈淋巴结转移鳞状细胞癌，p16阳性表达，HPV-16亚型阳性，EBER阴性表达。综合检查未发现明显的原发性病变。随后，其中4人接受了同侧tonsollar盲活检（n=2）和同侧扁桃体切除术（n=2。这4例患者均经病理诊断为扁桃体鳞状细胞癌。另外两例分别在随访D149和D545后，MRI检测到口咽和舌根同侧壁增厚并增强。活检分别证实诊断为扁桃体和舌根鳞状细胞癌。结论对于原发灶不明的宫颈淋巴结转移的HPV阳性鳞状细胞癌患者，应高度怀疑原发灶起源于口咽部位，尤其是扁桃体和舌根的可能性。关键词：肿瘤、颈淋巴结转移；人乳头瘤病毒；p16；口咽癌

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The diagnostic value of HPV detection in squamous cell carcinoma of cervical lymph node metastasis from an unknown primary site (with report of 6 cases)

Objective To evaluate the diagnostic value of HPV detection in squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site. Methods Clinical data of 6 patients who were initially diagnosed with squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site and eventually diagnosed with HPV-related oropharyngeal squamous cell carcinoma were collected, and the process of diagnosis was analyzed. Results Upon the initial admission, all patients were diagnosed with squamous cell carcinoma of the cervical lymph node metastasis with positive p16 expression, positive HPV-16 subtype and negative EBER expression. No obvious primary lesion was found after comprehensive examination. Subsequently, four of them underwent ipsilateral tonsollar blind biopsy (n=2) and ipsilateral tonsillectomy (n=2). All these four patients were pathologically diagnosed with tonsillar squamous cell carcinoma. For the other two cases, MRI detected the thickening complicated with enhancement of ipsilateral wall of oropharynx and tongue root after follow-up for D149 and D545 , respectively. Biopsy confirmed the diagnosis of squamous cell carcinoma of the tonsil and tongue root, respectively. Conclusion For patients with HPV-positive squamous cell carcinoma of the cervical lymph node metastasis from an unknown primary site, the possibility that the primary lesion originates from the oropharyngeal site, especially the tonsil and tongue root, should be highly suspected. Key words: Neoplasm, cervical lymph node metastasis; Human papillomavirus; p16; Oropharyngeal carcinoma

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来源期刊

中华放射肿瘤学杂志

自引率

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发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.