Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma - a prospective cohort and interobserver variability study

James S. Lewis, Raja A. Khan, Ramya P. Masand, Rebecca D. Chernock, Qin Zhang, Nasser Said Al-Naief, Susan Muller, Jonathan B. Mchugh, Manju L. Prasad, Margaret Brandwein-Gensler, Bayardo Perez-Ordonez, Samir K. El-Mofty

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

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 1year 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.

Original languageEnglish (US)
Pages (from-to)427-436
Number of pages10
JournalHistopathology
Volume60
Issue number3
DOIs
StatePublished - Feb 2012

Keywords

  • Morphology
  • Nonkeratinizing
  • Oropharyngeal
  • P16
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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    Lewis, J. S., 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). Recognition of nonkeratinizing morphology in oropharyngeal squamous cell carcinoma - a prospective cohort and interobserver variability study. Histopathology, 60(3), 427-436. https://doi.org/10.1111/j.1365-2559.2011.04092.x