Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma characterized by spindled or pleomorphic cells which appear to be a true sarcoma but are actually epithelial. Some head and neck squamous cell carcinoma variants can be human papillomavirus (HPV)-related and have improved outcomes. We sought to determine if spindle cell carcinomas are associated with transcriptionally-active HPV. Cases of spindle cell carcinoma were retrieved from department files. Transcriptionally-active HPV was determined by mRNA in situ hybridization for high risk HPV E6 and E7 transcripts and by a surrogate marker, p16 immunohistochemistry, with a 50% staining cutoff. RT-PCR for high risk HPV mRNA was performed on the cases that were technical failures by in situ hybridization. Medical records and follow up information were retrieved for all patients. Of 31 cases, 5 were from the oropharynx, 12 from the oral cavity, and 14 from the larynx or hypopharynx. One purely spindled oral cavity spindle cell carcinoma was HPV positive. It was also diffusely positive for p16. Another laryngeal spindle cell carcinoma was HPV positive in both the squamous and spindle cell components, but was negative for p16. None of the five oropharyngeal spindle cell carcinomas were positive for p16 or HPV RNA. The HPV positive patients both presented at high stage (IV) and died with disease within 2 years of diagnosis. The majority of spindle cell carcinomas of the head and neck, including those arising in the oropharynx, are not related to transcriptionally active HPV. Although the number of cases is too small for any definitive conclusions, for the rare HPV positive spindle cell carcinoma cases, positive viral status does not appear to confer any prognostic benefit.

Wang et al.: Correlation between ER, PR, P53, Ki67 Expression and High-risk HPV Infection To investigate the correlation between high-risk human papillomavirus infection and the expression of ER, PR, P53 and Ki67 in patients with different grades of cervical intraepithelial neoplasia. A retrospective study was conducted in which from June 2016 to June 2018, 140 specimens of cervical intraepithelial neoplasia were collected from the pathology department of the Beijing Tongren Hospital that included 40 specimens of cervical intraepithelial neoplasia1, 50 specimens of cervical intraepithelial neoplasia2 and 50 specimens of cervical intraepithelial neoplasia1. The expression of ER, PR, p53 and Ki67 were determined by immunohistochemistry. High-risk human papillomavirus infections were detected by polymerase chain reaction fluorescence quantification and were given the correlation analysis. Results of the 140 specimens indicated the rates of human papillomavirus16 and human papillomavirus18 in cervical intraepithelial neoplasia1 specimens were 27.5 and 25.0 % respectively, in cervical intraepithelial neoplasia2 specimens were 64.0 and 60.0 %, respectively and in cervical intraepithelial neoplasia3 specimens were 90.0 and 92.0 % respectively, the difference were statistically significant (p<0.05). There was no significant correlation between human papillomavirus 16 and human papillomavirus 18 positive rate and patient age, tissue differentiation, and tumour size. With the increasing cervical intraepithelial neoplasia grade, the rate of ER, PR, p53 and Ki67 expression in specimens was also increased significantly (p<0.05). Pearson correlation analysis showed there were positive correlation between the rates of human papillomavirus 16 and human papillomavirus 18 and the rates of ER, PR, p53 and Ki67 expression (p<0.05). In conclusion with increasing cervical intraepithelial neoplasia level, rate of high-risk human papillomavirus infection increased along with increased rate of expression of ER, PR, p53 and Ki67.