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Publication
Squamous and Neuroendocrine Specific Immunohistochemical Markers in Head and
Neck Squamous Cell Carcinoma: A Tissue Microarray Study.
Authors Lewis JS, Chernock RD, Bishop JA
Submitted By Submitted Externally on 4/9/2018
Status Published
Journal Head and neck pathology
Year 2018
Date Published 3/1/2018
Volume : Pages 12 : 62 - 70
PubMed Reference 28528398
Abstract The performance characteristics of neuroendocrine-specific and squamous-specific
immunohistochemical markers in head and neck squamous cell carcinomas (SCC), in
particular in oropharyngeal tumors in this era of human
papillomavirus (HPV)-induced cases, are not well-established. The differential
diagnosis for poorly differentiated SCCs, for nonkeratinizing oropharyngeal
SCCs, and for other specific SCC variants such as basaloid SCC and
undifferentiated (or lymphoepithelial-like) carcinomas includes neuroendocrine
carcinomas. Given that neuroendocrine carcinomas of the head and neck are
aggressive regardless of HPV status, separating them from SCC is critically
important. In this study, we examined the neuroendocrine markers CD56,
synaptophysin, and chromogranin-A along with the squamous markers p40 and
cytokeratin 5/6 in a large tissue microarray cohort of oral, oropharyngeal,
laryngeal, and hypopharyngeal SCCs with known HPV results by RNA in situ
hybridization for the oropharyngeal tumors. Results were stratified by site and
specific SCC variant. The neuroendocrine stains were rarely expressed in SCC
(<1% overall) with CD56 the least, and chromogranin-A the most, specific
markers. Further, p40 and cytokeratin 5/6 were very consistently expressed in
all head and neck SCC (>98% overall), including very strong, consistent staining
in oropharyngeal HPV-related nonkeratinizing SCC. Undifferentiated (or
lymphoepithelial-like) carcinomas of the oropharynx are more frequently p40 or
cytokeratin 5/6 negative or show only weak or focal expression. In summary,
markers of neuroendocrine and squamous differentiation show very high
specificity and sensitivity, respectively, across the different types of head
and neck SCC.




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