scholarly journals Correlation of p16 immunohistochemistry with clinical and epidemiological features in oropharyngeal squamous-cell carcinoma

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253418
Author(s):  
Chrystiano de C. Ferreira ◽  
Rozany Dufloth ◽  
Ana C. de Carvalho ◽  
Rui M. Reis ◽  
Iara Santana ◽  
...  
Keyword(s):  
Higher Education ◽  
Squamous Cell ◽  
Clinical Stage ◽  
Public Health Problem ◽  
Education Level ◽  
Female Sex ◽  
Epidemiological Features ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Early Clinical Stage

Background Oropharyngeal cancer is an important public health problem. The aim of our study was to correlatep16 immunohistochemistry in oropharynx squamous cell carcinomas(OPSCC) with clinical and epidemiological features. Material and methods We conducted across-sectional study on patients with OPSCC treated at a single institution from 2014 to 2019. Epidemiological and clinical-pathological data were collected from medical records and a questionnaire was applied to determine alcohol consumption, smoking, and sexual behavior. The HPV status was determined by p16 immunohistochemistry. Results A total of 252 patients participated in the study, of these 221 (87.7%) were male. There were 81 (32.14%) p16 positive cases and 171 (67.85%) p16 negative cases. The p16positive group was significantly associated with younger patients (50–59 years), higher education level, lower clinical stage and patients who never drank or smoked. Through univariate logistic regression, we observed that female sex (OR, 3.47; 95% CI, 1.60–7.51) and higher education level (OR, 9.39; 95% CI, 2, 81–31,38) were significantly more likely to be p16 positive. Early clinical stage (AJCC8ed) was more associated with p16 positivity both in univariate (OR, 0.14; 95% CI, 0.07–0.26, p<0.001) and multivariate analysis (OR, 0.18; 95% CI, 0.06–0.49, p = 0.001). Conclusion This study showed that drinkers and current smokers were less likely to be p16+. Female sex, higher education level and younger age at diagnosis were associated with a higher probability of being p16+. Additionally, there was a higher proportion of patients with early clinical stage (I or II) in the p16 positive group when compared to the p16 negative group.

Utilization of P16 in Head and Neck Cytology and Surgical Specimens After the Release of CAP Guidelines

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S22-S22
Author(s):  
H Laharwani ◽  
V Manucha ◽  
G Jefferson ◽  
L Jackson
Keyword(s):  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Common Reason ◽  
Unknown Primary ◽  
Hpv Testing ◽  
Neck Masses ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Wrong Site

Abstract Introduction/Objective HPV-positive oropharyngeal squamous cell carcinoma is biologically and clinically unique and has a survival advantage over other head and neck squamous cell carcinomas. In December 2017 College of American Pathologist published guidelines for testing HPV status in head and neck cancer. It was recommended that pathologists perform HR-HPV testing on head and neck squamous cell carcinomas from all patients with known oropharyngeal SCC not previously tested for HR-HPV, with suspected oropharyngeal SCC, or with metastatic SCC of unknown primary. The aim of this study was to determine the compliance of pathologists following the CAP guidelines. Methods Cases that underwent HPV testing using p16 immunohistochemistry for the years 2017 and 2019 were retrieved. Based on the guidelines, p16 testing was designated as “indicated” or “not indicated”. Results There were 196 cases in which p16 testing was performed in a period of 3 consecutive years. Of these, 175 were FNA/ biopsies and 21 were surgical resections. In 69 cases (56 FNAs and 13 biopsies) the biopsy was performed on neck masses with unknown primary. The compliance for p16 testing in OPC and Lymph nodes with metastatic SCC of unknown primary was 100%. In 34 (17.3%) cases p16 testing was not indicated, the most common reason being wrong site (85%) including the larynx, oral tongue, the floor of the mouth, buccal mucosa, and nasal mass. Of the unindicated p16s, 20 (58%) were received in consultation for continuity of care. Conclusion Not being clear about the site of the tumor is the most common reason for unindicated p16 testing. A clear designation of biopsy site and proper communication between pathologist and surgeon can improve utilization of p16 testing in head and neck carcinomas.

scholarly journals Ancillary Studies in Determining Human Papillomavirus Status of Squamous Cell Carcinoma of the Oropharynx: A Review

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Richard L. Cantley ◽  
Eleonora Gabrielli ◽  
Francesco Montebelli ◽  
David Cimbaluk ◽  
Paolo Gattuso ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Significant Proportion ◽  
Hpv Infection ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
High Risk Hpv ◽  
Ancillary Studies

Squamous cell carcinoma (SCC) of the oral cavity and pharynx represents the sixth most common form of malignancy worldwide. A significant proportion of these cases are related to human papillomavirus (HPV) infection. In general, HPV-associated SCC is more commonly nonkeratinizing and poorly differentiated, whereas non-HPV-associated SCC is typically keratinizing and moderately differentiated. Nevertheless, significant overlap in morphology is seen between these two forms of SCC. The purpose of this paper is to highlight the utility of ancillary studies in the establishment of HPV status of oropharyngeal SCC, including p16 immunohistochemistry, high-risk HPV in situ hybridization, polymerase chain reaction, and newer HPV detection modalities.

Papillary Squamous Cell Carcinoma of the Cervix: Human Papillomavirus (HPV) Status and Clinicopathologic Features

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S24-S24
Author(s):  
S A Schechter ◽  
A Elshaikh ◽  
H Walline ◽  
S L Skala
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Clinical Stage ◽  
Hpv Infection ◽  
Low Grade ◽  
Cervical Neoplasm ◽  
Hpv Status ◽  
Papillary Squamous Cell Carcinoma

Abstract Introduction/Objective Papillary squamous cell carcinoma (PSCC) is a rare cervical neoplasm composed of papillae lined by atypical squamous/transitional cells without koilocytosis. It is unclear whether PSCC is related to human papillomavirus (HPV) infection, though rare cases were reportedly associated with HPV type 16. PSCC is thought to be more common in postmenopausal women. Some authors have suggested that PSCC may be understaged due to the prominent exophytic nature of the superficial aspect and relatively deep location of underlying infiltrative nests. It has also been suggested that PSCC has a tendency to recur and/or metastasize late. Methods The surgical pathology database of a single large academic institution was searched for squamous cell carcinoma (or squamous cell carcinoma in situ) with papillary features from the cervix, sampled between 1996 and 2018. PCR for human papillomavirus (HPV) L1 protein was run, with sequencing of positive samples. Results 5 cases diagnosed as “papillary squamous cell carcinoma” were identified. Patient age ranged from 21–63 years (mean 46 years). All tumors showed papillary architecture, often with complex branching and/or fusion. The neoplastic cells had a squamous/transitional appearance with moderate to marked cytologic atypia and at most focal keratinization. Stage ranged from pT1b1 to pT3b (clinical stage IB1 to IVB). HPV L1 PCR was positive in only one case; sequencing confirmed HPV type 16. Upon closer review, the HPV-positive case was from the youngest patient and showed adjacent low-grade squamous intraepithelial lesion (LSIL) as well as focal koilocytic change within the papillary tumor. Conclusion Our findings suggest that even in patients with HPV infection, PSCC may be an HPV-independent malignancy. In multiple cases, it was difficult to obtain definitive histologic evidence of invasion prior to resection.

Epistemologi Pendidikan Islam: Melacak Metodologi Pengetahuan Perguruan Tinggi Islam Klasik

1970 ◽  
Vol 13 (3) ◽  
pp. 453-473
Author(s):  
Musnur Hery
Keyword(s):  
Higher Education ◽  
Learning Process ◽  
Education Level ◽  
Formal Institutions ◽  
Islamic History ◽  
Formal Institution

Islamic higher college not only limited to higher education that famous at Islamic history like madrasah (e.g. Nizamiyah), and al-Jami’ah (e.g. al-Azhar). Yet, Islamic higher college is the implementation of learning process that can be categorized in higher education stage, that being practiced in Moslem society, even still in non-formal or informal form before madrasah existence. Several epistemologies branch indeed take place at formal institution, while some epistemologies branch theoretically applied at formal institution, but it’s practiced at non-formal institutions. These non-formal institutions were still reflecting Islamic higher education level. 

To Investigate the Critical Influencing Factors for Decision Making Process of Students Who Want to Study Abroad

2019 ◽  
Vol 118 (11) ◽  
pp. 619-624
Author(s):  
JueJueMyint Toe ◽  
Ali Abdulbaqi Ameen ◽  
Sui Reng Liana ◽  
Amiya Bhaumik
Keyword(s):  
Higher Education ◽  
Decision Making ◽  
Study Abroad ◽  
Education Level ◽  
Decision Making Process ◽  
International Level ◽  
Continuing Higher Education ◽  
Clear Trend ◽  
The People ◽  
Study Overseas

Myanmar is the developing country and its education system is not yet to international level. Hence, most of the young adults, who like to upgrade their knowledge global wide and to gain international recognized higher educational certificates, choose to study overseas rather than continuing higher education after their high education nowadays, that becomes the trend of young people to study overseas since the competency among the people is getting intense based on the education level in every industry. The purpose of this research is to understand that students’ decision making process of selecting university. The study will be conducted to see clear trend of Myanmar students’ decision making of studying in abroad. This research will cover the context of what is Myanmar students’ perception of abroad, how they consider among other countries and explaining those factors which determine Myanmar students’ choice and how they decide to study abroad.

Awareness, Attitude and Health Practices Among Parents of Children with Ear Infection: A National Study in Saudi Arabia (Preprint)

2018 ◽  
Author(s):  
Saleh Saad Algamdi ◽  
Mutasim Hussain Alkhalifah ◽  
Mohammed H. Shawosh ◽  
Khalid Ali Alshehri ◽  
Hajar Fahad Alghamdi ◽  
...  
Keyword(s):  
Higher Education ◽  
Saudi Arabia ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Education Level ◽  
National Study ◽  
Health Practices ◽  
Monthly Income ◽  
Health Seeking ◽  
Ear Infection

BACKGROUND Otitis media (OM) is a very common childhood problem. It is inflammation of the middle ear usually caused by viral or bacterial infection. Otitis media is a main cause of antibiotic use in children. The primary treatment for acute otitis media (AOM) is watchful waiting: 80% of cases resolve without intervention. Southeast Asia, the Western Pacific region, and Africa have the highest prevalence of OM. Prevalence studies on OM are scant in Saudi Arabia. Only a few studies have been conducted in some cities. OBJECTIVE The aim of this study was to determine the knowledge, attitude, and health-seeking practices of parents with regard to OM. METHODS A national study was conducted September 19, 2018–October 9, 2018 in the Kingdom of Saudi Arabia. Data were collected using an electronic online questionnaire. It was culturally adopted, validated, and translated into Arabic. Items on the questionnaire included demographics, knowledge, attitude, and health practices about ear infection among parents of children <5 years old. The calculated representative sample size of the Saudi population was 9600 individuals (95% confidence interval and 1% margin of error). The aim was for 10,000 responses. Stratified sampling was used with each administrative area considered as independent strata. Statistical analysis was conducted using Excel software (Microsoft, Redmond, WA). Data were coded, grouped, arranged, and cleaned. Statistical Package for Social Sciences (version 23.0; Armonk, NY: IBM Corporation) was used for data analysis. RESULTS This study included 10,004 participants. Most were females. The mean age was 37.93 years (standard deviation, 10.20 years). Overall, 81.9% of parents were knowledgeable about ear infection. Parents who were knowledgeable about ear infections were significantly older (P = .005), female (P < .001), had a higher education level (P < .001), were married (P < .001), had a monthly income of 10,000–20,000 Saudi riyals (P < .001), and lived in the Al-Baha region (P < .001). The scores of 90.0% of parents indicated they had a good attitude about ear infection; and 58.6% of parents believed that ignorance is why children do not go to a healthcare facility for ear infection treatment. Parents with positive overall health practices represent 81.2%. Parents with good health practices were significantly associated with female sex (P = .009), higher education level (P < .001), being married (P < .001), a monthly income of 5000–1000 Saudi riyals (SR; P < .001), and living in the Al-Baha region (P < .001). CONCLUSIONS Knowledge, attitude, and health-seeking practices in Saudi Arabia were overall adequate. However, more integrated educational materials are needed for the general population. The development of a broad national awareness program, especially in low socioeconomic areas, could significantly contribute to the early detection and management of OM.

Do Deeper Levels of Cervical Biopsies Preceded by a Pap Smear Diagnosis of LSIL, ASCUS, or NILM/HPV+ Increase the Yield of Identifying Clinically Significant Lesions?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin
Keyword(s):  
Pap Smear ◽  
Past History ◽  
Prior History ◽  
Cervical Biopsy ◽  
P16 Immunohistochemistry ◽  
Hpv Status ◽  
Significant Difference ◽  
History Of ◽  
Clinically Significant ◽  
Almost All

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.

scholarly journals Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  
Keyword(s):  
Higher Education ◽  
Health Insurance ◽  
Health Services ◽  
Sex Education ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Education Level ◽  
Noncommunicable Diseases ◽  
Use Of Health Services

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.

scholarly journals Tumor-Associated Trypsin Inhibitor (TATI) as a Biomarker of Poor Prognosis in Oropharyngeal Squamous Cell Carcinoma Irrespective of HPV Status

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2811
Author(s):  
Anni Sjöblom ◽  
Ulf-Håkan Stenman ◽  
Jaana Hagström ◽  
Lauri Jouhi ◽  
Caj Haglund ◽  
...  
Keyword(s):  
Trypsin Inhibitor ◽  
Poor Prognosis ◽  
Tissue Expression ◽  
University Hospital ◽  
Study Cohort ◽  
Hpv Dna ◽  
P16 Immunohistochemistry ◽  
Tumor Tissues ◽  
Hpv Status ◽  
Survival Endpoints

Background: We studied the role of tumor-associated trypsin inhibitor (TATI) in serum and in tumor tissues among human papillomavirus (HPV)-positive and HPV-negative OPSCC patients. Materials and methods: The study cohort included 90 OPSCC patients treated at the Helsinki University Hospital (HUS), Helsinki, Finland, in 2012–2016. TATI serum concentrations (S-TATIs) were determined by an immunofluorometric assay. Immunostaining was used to assess tissue expression. HPV status was determined with a combination of p16 immunohistochemistry and HPV DNA PCR genotyping. The survival endpoints were overall survival (OS) and disease-specific survival (DSS). Results: A significant correlation was found between S-TATI positivity and poor OS (p < 0.001) and DSS (p = 0.04) in all patients. In HPV-negative cases, S-TATI positivity was linked to poor OS (p = 0.01) and DSS (p = 0.05). In HPV-positive disease, S-TATI positivity correlated with poor DSS (p = 0.01). S-TATI positivity was strongly associated with HPV negativity. TATI serum was negatively linked to a lower cancer stage. TATI expression in peritumoral lymphocytes was associated with favorable OS (p < 0.025) and HPV positivity. TATI expression in tumor and in peritumoral lymphocytes correlated with lower cancer stages. Conclusion: Our results suggest that S-TATI positivity may be a biomarker of poor prognosis in both HPV-positive and HPV-negative OPSCC.

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