ear, nose, and throat disorders
Oropharyngeal Squamous Cell Carcinoma
Diagnosis of Oropharyngeal Squamous Cell Carcinoma
Laryngoscopy Operative endoscopy and biopsy Imaging tests for staging All patients should undergo a direct laryngoscopy and biopsy before starting treatment to evaluate the primary lesion and to look for second primary lesions. Patients with confirmed carcinoma typically have neck CT with contrast, and most clinicians also do PET of the neck and chest. HPV DNA positivity, determined by polymerase chain reaction, is diagnostic of HPV. Immunohistochemical staining for p16 (an intracellular protein present in most HPV-positive cancers but also in few HPV-negative cancers) is a commonly used surrogate to determine HPV association. The staging criteria of HPV-associated oropharyngeal cancer correspond to the frequent lymph node involvement and better prognosis of these tumors versus HPV-negative tumors. (See tablesand.) 