Papillary squamous cell carcinomas of the upper aerodigestive tract: A clinicopathologic and molecular study

Background. The limited studies and the small number of published cases of papillary squamous cell carcinoma have precluded accurate assessment of the biologic characteristics of this lesion. Methods. Thirty-eight of the carcinomas were studied. In-situ hybridization and polymerase chain reaction were performed to detect human papilloma vir us (HPV) and p53 expression. Results. HPV was found in 4 of 14 assessable carcinomas by in-situ hybridiz ation and in 5 of 14 by polymerase chain reaction. The most frequently iden tified HPVs were HPVs in 6/11 and 16/18 patients. In general, a reciprocal relationship was found between p53 and HPV prevalence. The most lethal site for this tumor was the sinonasal tract, whereas patients with papillary sq uamous cell carcinomas of the larynx had the best outlook. Eleven of 25 (44 %) assessable patients died of disease (mean time interval, 2 year). Conclusions. Papillary squamous cell carcinoma of the upper aerodigestive t ract is a distinct variant of squamous cell carcinoma. As such and because of its putative association with HPV, papillary squamous cell carcinoma cou ld be an informative model for defining how viral oncogenes cooperate with other factors in genomic instability, carcinogenesis, and tumor development . (C) 2000 John Wiley & Sons, Inc.