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- Title
Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma - a prospective cohort and interobserver variability study.
- Authors
Lewis Jr, James S; Khan, Raja A; Masand, Ramya P; Chernock, Rebecca D; Zhang, Qin; Al-Naief, Nasser Said; Muller, Susan; McHugh, Jonathan B; Prasad, Manju L; Brandwein-Gensler, Margaret; Perez-Ordonez, Bayardo; El-Mofty, Samir K
- Abstract
Lewis J S Jr, Khan R A, Masand R P, Chernock R D, Zhang Q, Al-Naief N S, Muller S, McHugh J B, Prasad M L, Brandwein-Gensler M, Perez-Ordonez B & El-Mofty S K (2012) Histopathology 60, 427-436 Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma - a prospective cohort and interobserver variability study Aims: Nonkeratinizing morphology in oropharyngeal squamous cell carcinoma (NKSCC) strongly correlates with human papillomavirus and p16 status, but as a unique diagnostic entity is not widely recognized by pathologists. We sought to prospectively examine the performance of a new histological typing system during 1 year of routine clinical practice ( Aim 1) and also its reproducibility amongst six head and neck pathologists using a 40 case test set ( Aim 2). Methods and Results: The three histological types were: Type 1 (keratinizing), Type 2 (nonkeratinizing with maturation) and Type 3 (nonkeratinizing). For Aim 1, there were 85 cases. p16 immunohistochemistry was positive in five of the 18 (27.8%) cases classified as Type 1, 18 of the 19 (94.7%) as Type 2, and 47 of the 48 (97.9%) as Type 3. For Aim 2, agreement among pathologists on the test cases was best for types 1 and 3 (kappa values 0.62 and 0.56; P < 0.0001) and lowest for type 2 (kappa 0.35; P < 0.0001). All 21 cases classified as NK SCC (type 3) by any of the reviewers was p16 positive. Conclusions: Pathologists can recognize NK SCC with good agreement, and when a pathologist classifies a tumour as NK SCC, this reliably predicts p16 positivity.
- Subjects
PHARYNGEAL cancer; SQUAMOUS cell carcinoma; COHORT analysis; PAPILLOMAVIRUSES; HISTOPATHOLOGY; GENE expression
- Publication
Histopathology, 2012, Vol 60, Issue 3, p427
- ISSN
0309-0167
- Publication type
Article
- DOI
10.1111/j.1365-2559.2011.04092.x