Human Papillomavirus Prevalence and Cell Cycle Related Protein Expression in Tonsillar Squamous Cell Carcinomas of Korean Patients with Clinicopathologic Analysis

BACKGROUND: Human papillomavirus (HPV)-related tonsillar squamous cell carcinoma (TSCC) has recently been characterized as a distinct subset with a favorable prognosis. The prevalence and clinicopathologic significance of HPV-related TSCC in Koreans are not well known. METHODS: HPV in situ hybridization (ISH) accompanied by p53, p16, pRb, and cyclin D1 immunohistochemical staining were performed on 89 resection cases of TSCC from 2000 through 2010. RESULTS: HPV was detected by ISH in 59 of 89 cases (66.3%). HPV-positive TSCCs were more common in younger ages (p=0.005), and tumor sizes were smaller in the HPV-positive compared to the HPV-negative group (p=0.040). Positive HPV staining was significantly correlated with p16 expression (p<0.001), pRb inactivation (p=0.003), and cyclin D1 down-regulation (p<0.001) but not with p53 expression (p=0.334). Seventeen cases that showed p16-immunopositivity with HPV-negativity by ISH were retested by HPV typing; HPV DNA was not detected in all cases. There was no significant difference between HPV-positive and HPV-negative patients either in the disease-specific survival (DSS, p=0.857) or overall survival (p=0.910). Furthermore, pRb-inactivated cases showed better DSS (p=0.023), and p53-positive cases showed worse DSS (p=0.001). CONCLUSIONS: Although high HPV prevalence was noted, it was not correlated with histopathologic findings or survival benefit. In addition to p53 expression, pRb inactivation along with p16 overexpression and down-regulation of cyclin D1 are thought to be important pathogenetic steps for developing TSCCs.

Management of Contralateral N0 Neck in Tonsillar Squamous Cell Carcinomas / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is well established that tonsillar squamous cell carcinoma has high probability to be disseminated to the neck. An ipsilateral neck treatment is mandatory during initial treatment stages of II-IV tonsillar carcinomas. However, no consensus exists as to whether an elective contralateral neck management should be performed. SUBJECTS AND METHOD: A retrospective analysis was performed on 43 N1-3 tonsillar cancer patients with contralateral negative necks who were treated between 1992 to 2002. All patients had a contralateral elective neck dissection. Surgical treatment was followed by postoperative radiotherapy in 33 patients. The follow-up period ranged from 2 to 120 months (mean, 38 months). The Kaplan-Meier method and log-rank test were used to calculate the disease-specific survival rates and prognostic significance of contralateral occult lymph node metastasis. RESULTS: Clinically occult, but pathologically positive contralateral lymph nodes were found in 16% (7 of 43). In cases of ipsilateral N (+) neck, contralateral occult lymph node metastases developed in 21% (7 of 33) and there was no incidence of that in the cases of ipsilateral N0 necks. Based on the clinical stages of the tumor, 5% (1 of 22) of the cases metastatically involved ymph nodes in the T2 tumors, 36% (5 of 14) in the T3, and 25% (1 of 4) in the T4. T1 tumors (3 cases) had no pathologically positive lymph nodes (T1+T2 vs T3+T4, p<.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific free survival rates over patients with any pathologically positive nodes (5 year disease specific survival rate, 92% vs 28%, p=<.05). CONCLUSION: The risk of contralateral occult neck involvement in above T3 staged tonsillar squamous cell carcinomas with unilateral metastases was high and patients who presented with contralateral metastatic neck have worse prognosis than those who are staged as N0. Therefore, we advocate a routine bilateral neck dissection in tonsillar squamous cell carcinoma patients with unilateral node metastases.

Clinical analysis of non-Hodgkin lymphoma of palatine tonsil-Report of 70 cases / 肿瘤研究与临床

Objective To investigate the treatment method and prognostic factors of patients with non-Hodgkin lymphoma(NHL)of palatine tonsil.Methods 70 patients with NHL of palatine tonsil were re- viewed.According to Ann Arbor staging classification,12 patients had stageⅠ,39 stageⅡ,15 stageⅢand 4 stageⅣ.Working formulation was used in pathologic classification which was low grade 8 cases,intermedi- ate grade 28 cases and high grade 34 cases.30 cases were treated by chemotherapy alone,3 cases by radio- therapy alone,37 cases by chemotherapy and radiotherapy.Results The overall survival rate was 56.3%. They were 82.5% in 1 year,67.3% in 2 years and 58.5% in 5 years,respectively.The overall survival rates in high grade cases of pathologic classification were 20.0% in chemotherapy alone,0 in radiotherapy alone, 52.6% in chemotherapy and radiotherapy(P