Cytologic evaluation of p16 staining in head and neck squamous cell carcinoma in CytoLyt versus formalin-fixed material Journal Article
| Authors: | Buonocore, D. J.; Fowle, E.; Lin, O.; Xu, B.; Katabi, N.; Cohen, J. M. |
| Article Title: | Cytologic evaluation of p16 staining in head and neck squamous cell carcinoma in CytoLyt versus formalin-fixed material |
| Abstract: | Background: The management of high-risk human papillomavirus (HR-HPV)–related oropharyngeal head and neck squamous cell carcinomas (HNSCCs) are distinct from HNSCC linked to smoking and alcohol use. HR-HPV–positive HNSCC frequently presents as a cervical lymph node metastasis. Because fine-needle aspiration (FNA) is often the initial diagnostic procedure, evaluating HR-HPV status in cytology specimens is important. The overexpression of p16 is a surrogate for HR-HPV; however, the evaluation of p16 in FNAs remains controversial. Methods: From September 2015 to December 2016, cytopathologists performed 25 FNAs of neck lymph nodes that were suspicious for HR-HPV–positive HNSCC. Initial passes produced smears for on-site evaluation and CytoLyt material. Additional passes were formalin-fixed. A CytoLyt cell block (CCB) and a formalin-fixed cell block (FFCB) were prepared, and p16 immunocytochemistry was performed. Results: In 24 of 25 cases, the FFCB had diffuse (≥70% of cells), strong nuclear/cytoplasmic p16 staining. In all 24 of these cases, HR-HPV was detected by in situ hybridization. The corresponding CCB had weak-to-moderate p16 staining in <70% of cells (range, 5%-60% of cells) in 17 cases, 4 had weak-to-moderate diffuse staining, and 4 were acellular. The percentage of p16-positive cells was significantly higher with FFCB than with CCB (formalin: 94% ± 2%; CytoLyt, 38% ± 7%; 2-tailed, paired Student t test; P <.001; Fisher exact test, P <.001). Conclusions: The fixative used had a drastic impact on p16 staining, which explained the staining variability reported in the literature. FFCBs show a diffuse staining pattern, which correlates with HR-HPV status, whereas CCBs show a weaker and inconsistent staining pattern, which is more difficult to interpret. © 2019 American Cancer Society |
| Keywords: | adult; clinical article; human tissue; protein expression; aged; middle aged; cytology; protein p16; in situ hybridization; immunocytochemistry; fisher exact test; student t test; p16; head and neck squamous cell carcinoma; fine needle aspiration biopsy; squamous carcinoma; human papillomavirus (hpv); human; male; female; priority journal; article |
| Journal Title: | Cancer Cytopathology |
| Volume: | 127 |
| Issue: | 12 |
| ISSN: | 1934-662X |
| Publisher: | John Wiley & Sons |
| Date Published: | 2019-12-01 |
| Start Page: | 750 |
| End Page: | 756 |
| Language: | English |
| DOI: | 10.1002/cncy.22191 |
| PUBMED: | 31600033 |
| PROVIDER: | scopus |
| PMCID: | PMC6906234 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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