Background/Objectives: Human papillomavirus (HPV) infection is a well-established risk factor for oropharyngeal squamous cell carcinoma (OPSCC), where p16 immunohistochemistry serves as a surrogate marker. However, the role of HPV in sinonasal squamous cell carcinoma (SNSCC) remains less defined, and the reliability of p16 as a standalone surrogate is under debate. This study aimed to assess the concordance between p16 expression and HPV-DNA status in SNSCC and characterize clinicopathologic features in HPV-associated cases. Methods: We retrospectively analyzed 111 SNSCC cases diagnosed between 2008 and 2024 at two German centers. p16 status was determined by immunohistochemistry using site-specific antibody protocols. HPV-DNA testing and genotyping were performed via PCR and reverse hybridization. Clinical and histopathological data were collected and compared between HPV-positive and -negative tumors. Results: HPV-DNA was detected in 31/111 cases (27.9%), with HPV16 and HPV33 (Site A) and HPV 16 and HPV18 (Site B) being the most frequent subtypes. Discordance between p16 and HPV-DNA status was observed in 29.7% of cases, with site-specific discordance rates of 44.6% and 14.5%. Patients with HPV-positive tumors were younger than their HPV-negative counterparts. Conclusions: Our findings underscore the limitations of p16 as a single surrogate marker for detecting HPV-associated sinonasal cancer. Future research on the role of HPV in sinonasal cancer should integrate complementary testing methods (like p16Ink4A immunohistochemistry and HPV DNA/mRNA analysis) and aim for test standardization.
背景/目的：人乳头瘤病毒（HPV）感染是口咽鳞状细胞癌（OPSCC）的明确风险因素，其中p16免疫组化可作为替代标志物。然而，HPV在鼻窦鳞状细胞癌（SNSCC）中的作用尚不明确，且p16作为独立替代标志物的可靠性存在争议。本研究旨在评估SNSCC中p16表达与HPV-DNA状态的一致性，并描述HPV相关病例的临床病理特征。方法：我们回顾性分析了2008年至2024年间在德国两个中心诊断的111例SNSCC病例。p16状态通过免疫组化检测，采用位点特异性抗体方案。HPV-DNA检测和分型通过PCR和反向杂交进行。收集临床和组织病理学数据，并在HPV阳性和阴性肿瘤之间进行比较。结果：在31/111例（27.9%）中检测到HPV-DNA，其中HPV16和HPV33（位点A）以及HPV16和HPV18（位点B）是最常见的亚型。在29.7%的病例中观察到p16与HPV-DNA状态不一致，位点特异性不一致率分别为44.6%和14.5%。HPV阳性肿瘤患者比HPV阴性患者更年轻。结论：我们的研究结果强调了p16作为检测HPV相关鼻窦癌的单一替代标志物的局限性。未来关于HPV在鼻窦癌中作用的研究应整合互补检测方法（如p16Ink4A免疫组化和HPV DNA/mRNA分析），并致力于检测标准化。
肿瘤(癌症)患者之家