Role of cytology in the diagnosis and management of HPV-associated head and neck carcinoma

Acta Cytologica

Volumn 57, Issue 2, 2013, Pages 117-126

  Krane, Jeffrey F ^a  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Fine needle aspiration; Human papillomavirus; Oropharynx; Squamous cell carcinoma

Indexed keywords

VIRUS DNA; VIRUS RNA;

CANCER DIAGNOSIS; CANCER SCREENING; CERVICAL LYMPH NODE; CYTOLOGY; FINE NEEDLE ASPIRATION BIOPSY; HEAD AND NECK SQUAMOUS CELL CARCINOMA; HUMAN; IMMUNOHISTOCHEMISTRY; IN SITU HYBRIDIZATION; OUTCOME ASSESSMENT; PAPILLOMAVIRUS INFECTION; POLYMERASE CHAIN REACTION; PRIORITY JOURNAL; REVIEW; SCREENING TEST; VIRUS DETECTION; WART VIRUS; CYTODIAGNOSIS; FEMALE; GENETICS; HEAD AND NECK TUMOR; HUMAN PAPILLOMAVIRUS DNA TEST; ISOLATION AND PURIFICATION; LYMPH NODE; LYMPH NODE METASTASIS; MALE; METASTASIS; METHODOLOGY; PAPILLOMA VIRUS; PATHOLOGY; PREDICTIVE VALUE; PROGNOSIS; SQUAMOUS CELL CARCINOMA; VIROLOGY;

HUMAN PAPILLOMAVIRUS;

BIOPSY, FINE-NEEDLE; CARCINOMA, SQUAMOUS CELL; CYTODIAGNOSIS; DNA, VIRAL; FEMALE; HEAD AND NECK NEOPLASMS; HUMAN PAPILLOMAVIRUS DNA TESTS; HUMANS; IMMUNOHISTOCHEMISTRY; IN SITU HYBRIDIZATION; LYMPH NODES; LYMPHATIC METASTASIS; MALE; PAPILLOMAVIRIDAE; PAPILLOMAVIRUS INFECTIONS; POLYMERASE CHAIN REACTION; PREDICTIVE VALUE OF TESTS; PROGNOSIS; RNA, VIRAL;

MLCS; MLOWN;

EID: 84873583759     PISSN: 00015547     EISSN: 19382650     Source Type: Journal    
DOI: 10.1159/000346715     Document Type: Review

References (83)

1. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML: Incidence trends for human papillomavirus-related and-unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 2008; 26: 612-619. (Pubitemid 351264356)
2. Sturgis EM, Cinciripini PM: Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers Cancer 2007; 110: 1429-1435. (Pubitemid 47463055)
3. Gillison ML, Koch WM, Capone RB, Spafford M, Westra WH, Wu L, Zahurak ML, Daniel RW, Viglione M, Symer DE, Shah KV, Sidransky D: Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 2000; 92: 709-720. (Pubitemid 30365531)
4. Paz IB, Cook N, Odom-Maryon T, Xie Y, Wilczynski SP: Human papillomavirus (HPV) in head and neck cancer. An association of HPV16 with squamous cell carcinoma of Waldeyer's tonsillar ring. Cancer 1997; 79: 595-604. (Pubitemid 27051787)
5. Marur S, D'Souza G, Westra WH, Forastiere AA: HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 2010; 11: 781-789.
6. Hammarstedt L, Lindquist D, Dahlstrand H, Romanitan M, Dahlgren LO, Joneberg J, Creson N, Lindholm J, Ye W, Dalianis T, Munck-Wikland E: Human papillomavirus as a risk factor for the increase in incidence of tonsillar cancer. Int J Cancer 2006; 119: 2620-2623. (Pubitemid 44691317)
7. Cohan DM, Popat S, Kaplan SE, Rigual N, Loree T, Hicks WL Jr: Oropharyngeal cancer: current understanding and management. Curr Opin Otolaryngol Head Neck Surg 2009; 17: 88-94.
8. Gillison ML, D'Souza G, Westra W, Sugar E, Xiao W, Begum S, Viscidi R: Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 2008; 100: 407-420. (Pubitemid 351480511)
9. Vidal L, Gillison ML: Human papillomavirus in HNSCC: recognition of a distinct disease type. Hematol Oncol Clin North Am 2008; 22: 1125-1142, vii.
10. Kreimer AR, Alberg AJ, Daniel R, Gravitt PE, Viscidi R, Garrett ES, Shah KV, and Gillison ML: Oral human papillomavirus infection in adults is associated with sexual behavior and HIV serostatus. J Infect Dis 2004; 189: 686-698. (Pubitemid 38270923)
11. Gillison ML, Broutian T, Pickard RK, Tong ZY, Xiao W, Kahle L, Graubard BI, Chaturvedi AK: Prevalence of oral HPV infection in the United States, 2009-2010. JAMA 2012; 307: 693-703.
12. Hernandez BY, Wilkens LR, Zhu X, Thompson P, McDuffie K, Shvetsov YB, Kamemoto LE, Killeen J, Ning L, Goodman MT: Transmission of human papillomavirus in heterosexual couples. Emerg Infect Dis 2008; 14: 888-894. (Pubitemid 351838596)
13. Castellsagué X, Muñoz N: Cofactors in human papillomavirus carcinogenesis: role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 2003; 31: 20-28.
14. Markowitz LE, Sternberg M, Dunne EF, Mc-Quillan G, Unger ER: Seroprevalence of human papillomavirus types 6, 11, 16, and 18 in the United States: National Health and Nutrition Examination Survey 2003-2004. J Infect Dis 2009; 200: 1059-1067.
15. Safaeian M, Porras C, Schiffman M, Rodriguez AC, Wacholder S, Gonzalez P, Quint W, van Doorn LJ, Sherman ME, Xhenseval V, Herrero R, Hildesheim A, Costa Rican Vaccine Trial Group: Epidemiological study of anti-HPV16/18 seropositivity and subsequent risk of HPV16 and-18 infections. J Natl Cancer Inst 2010; 102: 1653-1662.
16. Wiest T, Schwarz E, Enders C, Flechtenmacher C, Bosch FX: Involvement of intact HPV16 E6/E7 gene expression in head and neck cancers with unaltered p53 status and perturbed pRb cell cycle control. Oncogene 2002; 21: 1510-1517. (Pubitemid 34226138)
17. Andl T, Kahn T, Pfuhl A, Nicola T, Erber R, Conradt C, Klein W, Helbig M, Dietz A, Weidauer H, Bosch FX: Etiological involvement of oncogenic human papillomavirus in tonsillar squamous cell carcinomas lacking retinoblastoma cell cycle control. Cancer Res 1998; 58: 5-13. (Pubitemid 28027707)
18. Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML: Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010; 363: 24-35.
19. D'Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, Westra WH, Gillison ML: Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007; 356: 1944-1956. (Pubitemid 46740304)
20. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML: Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008; 100: 261-269. (Pubitemid 351480538)
21. Kies MS, Holsinger FC, Lee JJ, William WN Jr, Glisson BS, Lin HY, Lewin JS, Ginsberg LE, Gillaspy KA, Massarelli E, Byers L, Lippman SM, Hong WK, El-Naggar AK, Garden AS, Papadimitrakopoulou V: Induction chemotherapy and cetuximab for locally advanced squamous cell carcinoma of the head and neck: results from a phase II prospective trial. J Clin Oncol 2010; 28: 8-14.
22. Lassen P, Eriksen JG, Hamilton-Dutoit S, Tramm T, Alsner J, Overgaard J: Effect of HPV-associated p16INK4A expression on response to radiotherapy and survival in squamous cell carcinoma of the head and neck. J Clin Oncol 2009; 27: 1992-1998.
23. Lassen P, Eriksen JG, Hamilton-Dutoit S, Tramm T, Alsner J, Overgaard J, Danish Head and Neck Cancer Group (DAHANCA): HPV-associated p16 expression and response to hypoxic modification of radiotherapy in head and neck cancer. Radiother Oncol 2010; 94: 30-35.
24. Lassen P, Eriksen JG, Krogdahl A, Therkildsen MH, Ulhøi BP, Overgaard M, Specht L, Andersen E, Johansen J, Andersen LJ, Grau C, Overgaard J, Danish Head and Neck Cancer Group (DAHANCA): The influence of HPVassociated p16 expression on accelerated fractionated radiotherapy in head and neck cancer: evaluation of the randomised DAHANCA 6&7 trial. Radiother Oncol 2011; 100: 49-55.
25. Posner MR, Lorch JH, Goloubeva O, Tan M, Schumaker LM, Sarlis NJ, Haddad RI, Cullen KJ: Survival and human papillomavirus in oropharynx cancer in TAX 324: a subset analysis from an international phase III trial. Ann Oncol 2011; 22: 1071-1077.
26. Rischin D, Young RJ, Fisher R, Fox SB, Le QT, Peters LJ, Solomon B, Choi J, O'Sullivan B, Kenny LM, McArthur GA: Prognostic significance of p16INK4A and human papillomavirus in patients with oropharyngeal cancer treated on TROG 02.02 phase III trial. J Clin Oncol 2010; 28: 4142-4148.
27. Worden FP, Kumar B, Lee JS, Wolf GT, Cordell KG, Taylor JM, Urba SG, Eisbruch A, Teknos TN, Chepeha DB, Prince ME, Tsien CI, D'Silva NJ, Yang K, Kurnit DM, Mason HL, Miller TH, Wallace NE, Bradford CR, Carey TE: Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: response and survival positively associated with HPV16 copy number. J Clin Oncol 2008; 26: 3138-3146.
28. Chung CH, Schwartz DL: Impact of HPV-related head and neck cancer in clinical trials: opportunity to translate scientific insight into personalized care. Otolaryngol Clin North Am 2012; 45: 795-806.
29. El Mofty SK, Lu DW: Prevalence of human papillomavirus type 16 DNA in squamous cell carcinoma of the palatine tonsil, and not the oral cavity, in young patients: a distinct clinicopathologic and molecular disease entity. Am J Surg Pathol 2003; 27: 1463-1470. (Pubitemid 37315200)
30. Barnes L, Eveson JW, Reichart P, Sidransky D (eds): Pathology and Genetics of Head and Neck Tumours. Lyon, IARC Press, 2007.
31. Begum S, Westra WH: Basaloid squamous cell carcinoma of the head and neck is a mixed variant that can be further resolved by HPV status. Am J Surg Pathol 2008; 32: 1044-1050.
32. Chernock RD, Lewis JS Jr, Zhang Q, El-Mofty SK: Human papillomavirus-positive basaloid squamous cell carcinomas of the upper aerodigestive tract: a distinct clinicopathologic and molecular subtype of basaloid squamous cell carcinoma. Hum Pathol 2010; 41: 1016-1023.
33. Jo VY, Mills SE, Stoler MH, Stelow EB: Papillary squamous cell carcinoma of the head and neck: frequent association with human papillomavirus infection and invasive carcinoma. Am J Surg Pathol 2009; 33: 1720-1724.
34. Carpenter DH, El-Mofty SK, Lewis JS Jr: Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis. Mod Pathol 2011; 24: 1306-1312.
35. Singhi AD, Stelow EB, Mills SE, Westra WH. Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. Am J Surg Pathol 2010; 34: 800-805.
36. Bishop JA, Westra WH: Human papillomavirus-related small cell carcinoma of the oropharynx. Am J Surg Pathol 2011; 35: 1679-1684.
37. Kraft S, Faquin WC, Krane JF: HPV-associated neuroendocrine carcinoma of the oropharynx: a rare new entity with potentially aggressive clinical behavior. Am J Surg Pathol 2012; 36: 321-330.
38. Thompson LD, Heffner DK: The clinical importance of cystic squamous cell carcinomas in the neck: a study of 136 cases. Cancer 1998; 82: 944-956. (Pubitemid 28104176)
39. Goldenberg D, Begum S, Westra WH, Khan Z, Sciubba J, Pai SI, Califano JA, Tufano RP, Koch WM: Cystic lymph node metastasis in patients with head and neck cancer: an HPVassociated phenomenon. Head Neck 2008; 30: 898-903. (Pubitemid 352008950)
40. Fakhry C, Rosenthal BT, Clark DP, Gillison ML: Associations between oral HPV16 infection and cytopathology: evaluation of an oropharyngeal 'Pap-test equivalent' in high-risk populations. Cancer Prev Res 2011; 4: 1378-1384.
41. Jarboe EA, Willis M, Bentz B, Buchmann L, Hunt J, Ellis G, Layfield L: Detection of human papillomavirus using Hybrid Capture II in oral brushings from patients with oropharyngeal squamous cell carcinoma. Am J Clin Pathol 2011; 135: 766-769.
42. Lingen MW: Brush-based cytology screening in the tonsils and cervix: there is a difference! Cancer Prev Res 2011; 4: 1350-1352.
43. Begum S, Gillison ML, Ansari-Lari MA, Shah K, Westra WH: Detection of human papillomavirus in cervical lymph nodes: a highly effective strategy for localizing site of tumor origin. Clin Cancer Res 2003; 9: 6469-6475. (Pubitemid 38031835)
44. De Braud F, Sarraf M: Diagnosis and management of squamous cell carcinoma of unknown primary tumor site of the neck. Semin Oncol 1993; 20: 273-278. (Pubitemid 23171897)
45. Best SR, Niparko KJ, Pai SI: Biology of human papillomavirus infection and immune therapy for HPV-related head and neck cancers. Otolaryngol Clin North Am 2012; 45: 807-822.
46. Bishop JA, Ogawa T, Chang X, Illei PB, Gabrielson E, Pai SI, Westra WH: HPV analysis in distinguishing second primary tumors from lung metastases in patients with head and neck squamous cell carcinoma. Am J Surg Pathol 2012; 36: 142-148.
47. Banks ER, Frierson HF Jr, Covell JL: Fineneedle aspiration cytologic findings in metastatic basaloid squamous cell carcinoma of the head and neck. Acta Cytol 1992; 36: 126-131.
48. Gilcrease MZ, Guzman-Paz M: Fine-needle aspiration of basaloid squamous carcinoma: a case report with review of differential diagnostic considerations. Diagn Cytopathol 1998; 19: 210-215. (Pubitemid 28381652)
49. Marks RA, Cramer HM, Wu HH: Fine-needle aspiration cytology of basaloid squamous cell carcinoma and small cell carcinoma-a comparison study. Diagn Cytopathol 2013; 41: 81-84.
50. Wain SL, Kier R, Vollmer RT, Bossen EH: Basaloid-squamous carcinoma of the tongue, hypopharynx, and larynx: report of 10 cases. Hum Pathol 1986; 17: 1158-1166. (Pubitemid 17182899)
51. Wu M, Wang B, Gil J, Sabo E, Miller L, Gan L, Burstein DE: p63 and TTF-1 immunostaining. A useful marker panel for distinguishing small cell carcinoma of lung from poorly differentiated squamous cell carcinoma of lung. Am J Clin Pathol 2003; 119: 696-702. (Pubitemid 37051496)
52. Zhang H, Liu J, Cagle PT, Allen TC, Laga AC, Zander DS: Distinction of pulmonary small cell carcinoma from poorly differentiated squamous cell carcinoma: an immunohistochemical approach. Mod Pathol 2005; 18: 111-118. (Pubitemid 40128103)
53. Yuan J, Knorr J, Altmannsberger M, Goeckenjan G, Ahr A, Scharl A, Strebhardt K: Expression of p16 and lack of pRB in primary small cell lung cancer. J Pathol 1999; 189: 358-362. (Pubitemid 29489220)
54. Madur BP, Jambhekar NA: Basaloid squamous carcinoma simulating adenoid cystic carcinoma: diagnostic dilemma. Oral Oncol 2006; 42: 227-230. (Pubitemid 43977821)
55. Chan MK, McGuire LJ, Lee JC: Fine-needle aspiration cytodiagnosis of nasopharyngeal carcinoma in cervical lymph nodes. A study of 40 cases. Acta Cytol 1989; 33: 344-350. (Pubitemid 19201914)
56. Grenko RT, Shabb NS: Metastatic nasopharyngeal carcinoma: cytologic features of 18 cases. Diagn Cytopathol 1991; 7: 562-566.
57. Jayaram G, Swain M, Khanijow V, Jalaludin MA: Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma. Diagn Cytopathol 1998; 19: 168-172. (Pubitemid 28381642)
58. Kollur SM, El Hag IA: Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: comparison with metastatic squamous cell carcinoma, and Hodgkin's and non-Hodgkin's lymphoma. Diagn Cytopathol 2003; 28: 18-22. (Pubitemid 36043478)
59. Mohanty SK, Dey P, Ghoshal S, Saikia UN: Cytologic features of metastatic nasopharyngeal carcinoma. Diagn Cytopathol 2002; 27: 340-342. (Pubitemid 35424167)
60. Viguer JM, Jiménez-Heffernan JA, López-Ferrer P, Banaclocha M, Vicandi B: Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma. Diagn Cytopathol 2005; 32: 233-237. (Pubitemid 40397335)
61. Jannapureddy S, Cohen C, Lau S, Beitler JJ, Siddiqui MT: Assessing for primary oropharyngeal or nasopharyngeal squamous cell carcinoma from fine-needle aspiration of cervical lymph node metastases. Diagn Cytopathol 2010; 38: 795-800.
62. Lee WY, Hsiao JR, Jin YT, Tsai ST: Epstein-Barr virus detection in neck metastases by insitu hybridization in fine-needle aspiration cytologic studies: an aid for differentiating the primary site. Head Neck 2000; 22: 336-340.
63. Ustün M, Risberg B, Davidson B, Berner A: Cystic change in metastatic lymph nodes: a common diagnostic pitfall in fine-needle aspiration cytology. Diagn Cytopathol 2002; 27: 387-392. (Pubitemid 35424177)
64. Troxel D: Diagnostic errors in surgical pathology uncovered by a review of malpractice claims. VI. Urinary bladder and branchial cleft cyst. Int J Surg Pathol 2001; 9: 227-229. (Pubitemid 32979976)
65. Troxel DB: Trends in pathology malpractice claims. Am J Surg Pathol 2012; 36:e1-e5.
66. Cao D, Begum S, Ali SZ, Westra WH: Expression of p16 in benign and malignant cystic squamous lesions of the neck. Hum Pathol 2010; 41: 535-539.
67. Pai RK, Erickson J, Pourmand N, Kong CS: p16(INK4A) immunohistochemical staining may be helpful in distinguishing branchial cleft cysts from cystic squamous cell carcinomas originating in the oropharynx. Cancer 2009; 117: 108-119.
68. Schache AG, Liloglou T, Risk JM, Filia A, Jones TM, Sheard J, Woolgar JA, Helliwell TR, Triantafyllou A, Robinson M, Sloan P, Harvey-Woodworth C, Sisson D, Shaw RJ: Evaluation of human papilloma virus diagnostic testing in oropharyngeal squamous cell carcinoma: sensitivity, specificity, and prognostic discrimination. Clin Cancer Res 2011; 17: 6262-6271.
69. Singhi AD, Westra WH. Comparison of human papillomavirus in situ hybridization and p16 immunohistochemistry in the detection of human papillomavirus-associated head and neck cancer based on a prospective clinical experience. Cancer 2010; 116: 2166-2173.
70. Smeets SJ, Hesselink AT, Speel EJ, Haesevoets A, Snijders PJ, Pawlita M, Meijer CJ, Braakhuis BJ, Leemans CR, Brakenhoff RH: A novel algorithm for reliable detection of human papillomavirus in paraffin-embedded head and neck cancer specimen. Int J Cancer 2007; 121: 2465-2472. (Pubitemid 350022416)
71. Wadsworth B, Bumpous JM, Martin AW, Nowacki MR, Jenson AB, Farghaly H: Expression of p16 in sinonasal undifferentiated carcinoma without associated human papillomavirus. Head Neck Pathol 2011; 5: 349-354.
72. Begum S, Cao D, Gillison M, Zahurak M, Westra WH: Tissue distribution of human papillomavirus 16 DNA integration in patients with tonsillar carcinoma. Clin Cancer Res 2005; 11: 5694-5699. (Pubitemid 41170292)
73. Lewis JS Jr, Thorstad WL, Chernock RD, Haughey BH, Yip JH, Zhang Q, El-Mofty SK: p16-positive oropharyngeal squamous cell carcinoma: an entity with a favorable prognosis regardless of tumor HPV status. Am J Surg Pathol 2010; 34: 1088-1096.
74. Perrone F, Gloghini A, Cortelazzi B, Bossi P, Licitra L, Pilotti S: Isolating p16-positive/HPV-negative oropharyngeal cancer: an effort worth making. Am J Surg Pathol 2011; 35: 774-777.
75. Bishop JA, Ma XJ, Wang H, Luo Y, Illei PB, Begum S, Taube JM, Koch WM, Westra WH: Detection of transcriptionally active high-risk HPV in patients with head and neck squamous cell carcinoma as visualized by a novel E6/E7 mRNA in situ hybridization method. Am J Surg Pathol 2012; 36: 1874-1882.
76. Grimes R, Garcia-Buitrago MT, Jorda M, Ganjei-Azar P, Ferrell A, Gomez-Fernandez C: p16INKa immunocytochemistry in fineneedle aspiration cytology smears of metastatic head and neck squamous cell carcinoma. Acta Cytol 2013; 57: 33-37.
77. Jakscha J, Zlobec I, Storck C, Obermann EC, Tornillo L, Terracciano LM, Fischer CA: The clinical impact of p16 status in fine-needle aspirates of cervical lymph node metastasis of head and neck squamous cell carcinomas. Eur Arch Otorhinolaryngol 2012, E-pub ahead of print.
78. Begum S, Gillison ML, Nicol TL, Westra WH: Detection of human papillomavirus-16 in fine-needle aspirates to determine tumor origin in patients with metastatic squamous cell carcinoma of the head and neck. Clin Cancer Res. 2007; 13: 1186-1191. (Pubitemid 46424059)
79. Umudum H, Rezanko T, Dag F, Dogruluk T: Human papillomavirus genome detection by in situ hybridization in fine-needle aspirates of metastatic lesions from head and neck squamous cell carcinomas. Cancer 2005; 105: 171-177. (Pubitemid 40868897)
80. Zhang MQ, El-Mofty SK, Dávila RM: Detection of human papillomavirus-related squamous cell carcinoma cytologically and by in situ hybridization in fine-needle aspiration biopsies of cervical metastasis: a tool for identifying the site of an occult head and neck primary. Cancer 2008; 114: 118-123. (Pubitemid 351640791)
81. Barwad A, Sood S, Gupta N, Rajwanshi A, Panda N, Srinivasan R: Human papilloma virus-associated head and neck cancer: a PCRbased study. Diagn Cytopathol 2012; 40: 893-897.
82. Bishop JA, Maleki Z, Valsamakis A, Ogawa T, Chang X, Pai SI, Westra WH: Application of the Hybrid Capture II assay to squamous cell carcinomas of the head and neck: a convenient liquid-phase approach for the reliable determination of human papillomavirus status. Cancer Cytopathol 2012; 120: 18-25.
83. Solomides CC, Bibbo M, Wang ZX: Assessment of fine-needle aspiration specimen adequacy for high-risk HPV detection and genotyping in oropharyngeal squamous cell carcinoma. Acta Cytol 2012; 56: 196-198.