F-FDG PET/CT versus Human Papillomavirus, p16, and Epstein-Barr Virus Detection in Cervical Metastatic Lymph Nodes for identifying primary tumors.

F-FDG PET/CT versus Human Papillomavirus, p16, and Epstein-Barr Virus Detection in Cervical Metastatic Lymph Nodes for identifying primary tumors.

Int J Cancer. 2016 Dec 10;:

Authors: Park GC, Roh JL, Cho KJ, Kim JS, Jin MH, Choi SH, Nam SY, Kim SY

Abstract
Squamous cell carcinoma of unknown primary of the head and neck (SCCUP) is a heterogeneous disease entity that requires careful examination to locate the occult primary. We examined the diagnostic value of expression of biomarkers, such as human papillomavirus (HPV), p16, and Epstein-Barr virus (EBV), in metastatic lymph nodes versus (18) F-fluorodeoxyglucose ((18) F-FDG) positron emission tomography/computed tomography (PET/CT). We prospectively enrolled 54 consecutive SCCUP patients who received HPV, p16, and EBV analyses of lymph node fine-needle aspirates and (18) F-FDG PET/CT scans and subsequently underwent examinations and biopsies under general anesthesia to detect primary tumors. The diagnostic performance of the biomarkers and (18) F-FDG PET/CT were compared by using receiver operating characteristics (ROC) curve analyses with histopathological results for identification of primary tumors. Primary tumors were identified in 28 (51.9%) of 54 patients: the palatine tonsil in 24, base of the tongue in 1, nasopharynx in 2, and hypopharynx in 1. The sensitivity of p16 (85.7%) and accuracy of HPV (85.2%) were higher than those (42.9% and 68.5%) of (18) F-FDG PET/CT (P < 0.05). The area under the ROC curve of HPV was higher than that of (18) F-FDG PET/CT (0.857 vs. 0.666, P = 0.007). The disease-free survival rates were higher in the patients with primary tumor detection or p16 nodal immunopositivity than in the other patients (P < 0.05). The results showed that HPV and p16 detection in metastatic lymph nodes can help locate hidden primary tumors, guide definitive treatment, and predict patient survival. This article is protected by copyright. All rights reserved.

PMID: 27943271 [PubMed - as supplied by publisher]

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