Comparison of the endoscopical appearance of HPV-positive and HPV-negative oropharyngeal carcinomas

Introduction Oropharyngeal carcinomas are associated with the human papillomaviruses (HPV). Benign diseases, induced by HPVs, like the papillomatosis have a characteristic exophytic, multinodular appearance. HPV-positive oropharyngeal carcinomas have often a papillomatous, exophytic appearance. These lesions have mostly perpendicular and irregular vessels. On the other hand, HPV-negative tumors have an irregular, ulcerated, hyperkeratotic surface.

Materials and methods In a retrospective, endoscope-based study 57 patients with histologiscally confirmed carcinomas were analyzed. We compared the HPV-positive and HPV-negative carcinomas depending on the endoscopical appeaance. There was an avalaible HPV-status for all patients. There were 18 HPV-positive and 39 HPV-negative oropharyngeal carcinomas.

Results In 15 HPV-positive oropharyngeal carcinomas there was a distinctive papillary epithelial surface with irregular vertical vessels. The papillary pattern was not identified in three patients, either because of a low quality of the picture or because of the keratosis of the tumor. In the 39 HPV-negative carcinomas there were ulcerations with hyperkeratosis and the surface of the tumor had less looped vessels.

Conclusion Through the exact observation of oropharyngeal carcinomas and the vessels of the tumor, it is possible to recognise the HPV-positivity of the oropharyngeal carcinomas.

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Publication History

Article published online:
10 June 2020