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Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma – a prospective cohort and interobserver variability study *
Author(s) -
Lewis Jr James S,
Khan Raja A,
Masand Ramya P,
Chernock Rebecca D,
Zhang Qin,
AlNaief Nasser Said,
Muller Susan,
McHugh Jonathan B,
Prasad Manju L,
BrandweinGensler Margaret,
PerezOrdonez Bayardo,
ElMofty Samir K
Publication year - 2012
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2011.04092.x
Subject(s) - medicine , kappa , pathology , head and neck squamous cell carcinoma , carcinoma , immunohistochemistry , basal cell , prospective cohort study , head and neck cancer , cancer , philosophy , linguistics
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.