ArticleThe American journal of surgical pathology2012
Tumor cell anaplasia and multinucleation are predictors of disease recurrence in oropharyngeal squamous cell carcinoma, including among just the human papillomavirus-related cancers.
Article in The American journal of surgical pathology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 49 citations in OpenAlex.
- Selection Criteria for De-Escalated Chemoradiotherapy for HPV-Related Oropharyngeal Cancer Based on Prognostic Biomarkers or Early Tumor Response to Therapy: A Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- Biological feature-based machine learning in histopathological images: a systematic review.Journal of pathology informatics · 2026Review
- Clinical, morphologic and molecular heterogeneity of HPV-associated oropharyngeal cancer.Oncogene · 2023Review
- Machine learning driven index of tumor multinucleation correlates with survival and suppressed anti-tumor immunity in head and neck squamous cell carcinoma patients.Oral oncology · 2023Article
- Article
- Oropharyngeal cancer outcomes correlate with p16 status, multinucleation and immune infiltration.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- Predicting lymph node metastasis and recurrence in patients with early stage colorectal cancer.Frontiers in medicine · 2022Article
- Oropharyngeal Squamous Cell Carcinoma Morphology and Subtypes by Human Papillomavirus Type and by 16 Lineages and Sublineages.Head and neck pathology · 2021Article
- Staging of human papilloma virus related cancers of the oropharynx.Journal of surgical oncology · 2021Review
- Computerized tumor multinucleation index (MuNI) is prognostic in p16+ oropharyngeal carcinoma.The Journal of clinical investigation · 2021Article
- Artificial intelligence for automating the measurement of histologic image biomarkers.The Journal of clinical investigation · 2021Article
- Reimagining T Staging Through Artificial Intelligence and Machine Learning Image Processing Approaches in Digital Pathology.JCO clinical cancer informatics · 2020Article
- Are Histomorphological Features Predictive of p16 Immunopositivity Different for Oral and Oropharyngeal Squamous Cell Carcinoma?Indian journal of surgical oncology · 2020Article
- Roles of cell fusion, hybridization and polyploid cell formation in cancer metastasis.World journal of clinical oncology · 2020Review
- HPV-related carcinomas of the head and neck: morphologic features, variants, and practical considerations for the surgical pathologist.Virchows Archiv : an international journal of pathology · 2017Review
- Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: Catch Me If You Can!Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2017Review
- Histopathologic risk factors in oral and oropharyngeal squamous cell carcinoma variants: an update with special reference to HPV-related carcinomas.Medicina oral, patologia oral y cirugia bucal · 2014Review
- Human papillomavirus and Epstein Barr virus in head and neck carcinomas: suggestions for the new WHO classification.Head and neck pathology · 2014Article
- A quantitative histomorphometric classifier (QuHbIC) identifies aggressive versus indolent p16-positive oropharyngeal squamous cell carcinoma.The American journal of surgical pathology · 2014Article
- Cyclin D1-a prognostic marker in oropharyngeal squamous cell carcinoma that is tightly associated with high-risk human papillomavirus status.Human pathology · 2013Article
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4 authors at 3 institutions in 2 countries.
Funding
Abstract
Oropharyngeal squamous cell carcinoma (SCC) is frequently related to high risk human papillomavirus. This tumor expresses p16, frequently has a nonkeratinizing morphology, and has improved outcomes. Despite having a good prognosis, tumors can have focal or diffuse nuclear anaplasia or multinucleation, the significance of which is unknown. From a database of 270 oropharyngeal SCCs with known histologic typing (using our established system) and p16 immunohistochemistry, all surgically resected cases (149) were reviewed. Anaplasia was defined as any × 40 field with ≥ 3 tumor nuclei with diameters ≥ 5 lymphocyte nuclei (~25 μm), and multinucleation was defined as any × 40 field with ≥ 3 tumor cells with multiple nuclei. p16 was positive in 128 cases (85.9%), 64 cases (43.0%) showed anaplasia, and 71 (47.7%) showed multinucleation. Anaplasia and multinucleation were highly related (P<0.001), and both also correlated with histologic type (P<0.001 and P=0.01, respectively), p16 status (P=0.09 and 0.03, respectively), and partially with nodal extracapsular extension. There was no correlation with any of the other variables. In univariate analysis, cases showing anaplasia or multinucleation had worse overall, disease-specific, and disease-free survival (P<0.006 for all). Higher T-stage, keratinizing histologic type, extracapsular extension, and smoking also all correlated with worse survival. In multivariate analysis, anaplasia and multinucleation both predicted worse disease-specific survival (hazard ratio 9.9, P=0.04; and hazard ratio 11.9, P=0.02, respectively) independent of the other variables. In summary, among surgically resectable oropharyngeal SCC (including among just the p16-positive cohort), tumor cell anaplasia and multinucleation independently correlated with disease recurrence and poorer survival.
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