Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press110610.17650/2222-1468-2025-15-3-75-82DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИThe role of human papillomavirus marker p16 in identifying the primary focus in patients with metastases of squamous cell carcinoma from an undiagnosed primary focusРоль маркера p16 вируса папилломы человека в выявлении первичного очага у пациентов с метастазами плоскоклеточного рака из невыявленного первичного очагаhttps://orcid.org/0000-0002-9015-7030ZolotarevK. A.ЗолотаревК. А.
Russian Federation

Konstantin Aleksandrovich Zolotarev

24 Kashirskoe Shosse, Moscow 115522

Bld.2, 11 Rossolimo St., Moscow 119021

18A Zagorodnoye Shosse, Moscow 117152

Константин Александрович Золотарев 

115522 Москва, Каширское шоссе, 24

119021 Москва, ул. Россолимо, 11, стр. 2

117152 Москва, Загородное шоссе, 18А

zolotarev31@mail.ruhttps://orcid.org/0000-0002-0918-3857MudunovA. M.МудуновА. М.
Russian Federation

Bld.2, 11 Rossolimo St., Moscow 119021

111 1st Uspenskoe Shosse, Lapino,  Moscow Region 143081

119021 Москва, ул. Россолимо, 11, стр. 2

143081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111

https://orcid.org/0000-0002-6851-9867AlymovYu. V.АлымовЮ. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0002-2283-1812SaprinaO. A.СапринаО. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 24

https://orcid.org/0000-0003-1611-4603PeshkoD. A.ПешкоД. А.
Russian Federation

24 Kashirskoe Shosse, Moscow 115522

Bld.2, 11 Rossolimo St., Moscow 119021

28 Orekhovy Boul’var, Moscow 115682

115522 Москва, Каширское шоссе, 24

119021 Москва, ул. Россолимо, 11, стр. 2

115682 Москва, Ореховый бульвар, 28

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава РоссииN.V. Sklifosovsky Institute of Clinical Medicine, Sechenov University, Ministry of Health of RussiaИнститут клинической медицины им. Н. В. Склифосовского, ФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова Минздрава России (Сеченовский Университет)Oncological Center No. 1 – a branch of the S. S. Yudin City Clinical Hospital, Moscow Healthcare DepartmentОнкологический центр № 1 – филиал ГБУЗ г. Москвы «Городская клиническая больница им. С. С. Юдина Департамента здравоохранения г. Москвы»Clinical Hospital “Lapino” of the “Mother and Child” Group of companiesКлинический госпиталь «Лапино» группы компаний «Мать и дитя»Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of RussiaФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства России»0311202515375820311202503112025Copyright ©; 2025, Zolotarev K.A., Mudunov A.M., Alymov Y.V., Saprina O.A., Peshko D.A.Copyright ©; 2025, Золотарев К.А., Мудунов А.М., Алымов Ю.В., Саприна О.А., Пешко Д.А.2025Zolotarev K.A., Mudunov A.M., Alymov Y.V., Saprina O.A., Peshko D.A.Золотарев К.А., Мудунов А.М., Алымов Ю.В., Саприна О.А., Пешко Д.А.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/1106

Introduction. Squamous cell carcinoma of the oropharynx associated with Human papilloma virus (Hpv) has been identified as a distinct nosological unit among squamous cell carcinoma of the head and neck. This is due to the peculiarities of the disease and localization (the tumor mainly occurs in the palatine or lingual tonsils). primary squamous cell carcinoma of the oropharynx often debuts in the form of cancer metastases from an undiagnosed primary focus.

Aim. To show relationship between presence of the Hpv marker p16 in patients with metastases from an undiagnosed primary focus with primary squamous cell carcinoma of the oropharynx.

Materials and methods. The retrospective study included 151 patients with cervical lymph node metastases from an undiagnosed primary focus, treated from 2014 to 2024 in the Oncology Department of Surgical methods of Treatment No. 10 of the N. N. Blokhin National medical Center of Oncology, 83 of whom were found to have p16 – a surrogate marker of Hpv.

Results. The findings suggest a strong relationship between the presence of Hpv in the metastatic focus and oropharyngeal squamous cell carcinoma. The difficulty of identifying the primary focus is most likely due to the small size of this focus and its submucosal location, as well as with early metastasis to the lymph nodes.

Conclusion. In order not to miss clinically latent squamous cell carcinoma of the oropharynx, interdisciplinary collaboration and conduct of thorough immunohistological study, especially a surrogate marker test for Hpv p16, are needed.

Введение. Плоскоклеточный рак ротоглотки, ассоциированный с вирусом папилломы человека (Впч), идентифицирован как отдельная нозологическая единица в рамках плоскоклеточного рака головы и шеи. Это связано с особенностями заболевания и локализации (опухоль преимущественно возникает в нёбных или язычной миндалинах). Первичный плоскоклеточный рак ротоглотки зачастую дебютирует в виде метастазов рака из невыявленного первичного очага.

Цель исследования – показать взаимосвязь наличия маркера Впч р16 у пациентов с метастазами из невыявленного первичного очага с первичным плоскоклеточным раком ротоглотки.

Материалы и методы. В ретроспективное исследование включен 151 пациент с метастазами в шейных лимфатических узлах из невыявленного первичного очага, с 2014 по 2024 г. получавший лечение в онкологическом отделении хирургических методов лечения № 10 Национального медицинского центра онкологии им. Н. Н. блохина, у 83 из которых обнаружен p16 – суррогатный маркер Впч.

Результаты. Полученные данные свидетельствуют о тесной взаимосвязи наличия Впч в метастатическом очаге и плоскоклеточного рака ротоглотки. сложность выявления первичного очага, скорее всего, обусловлена небольшим размером этого очага и его подслизистым расположением, а также ранним метастазированием в лимфатические узлы.

Заключение. Чтобы не пропустить клинически скрытый плоскоклеточный рак ротоглотки, необходимы междисциплинарное сотрудничество и проведение тщательного иммуногистологического исследования, особенно тест на суррогатный маркер Впч p16.

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