Human papillomavirus

Stains
HPV (Human papillomavirus)

Author: Nat Pernick, M.D.

Topic Completed: 1 October 2012

Revised: 13 January 2020

Copyright: 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: HPV [title] stain

Page views in 2019: 1,968

Page views in 2020 to date: 141

Table of Contents

Cite this page: Pernick N. Human papillomavirus. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainshpv.html. Accessed January 23rd, 2020.

See also

Cervix-cytology chapter:

Definition / general

Nuclear antigen
- Detection methods include PCR, in-situ hybridization, immunohistochemistry
Can also detect via E6/E7 protein, p16 or ProExc (see below)
Note: must understand what HPV subtypes / components the particular detection method targets

Pathophysiology

HPV E6 protein induces p53 degradation by a ubiquitin-dependent pathway
- Also activates host cell telomerase
HPV E7 protein binds retinoblastoma protein, leading to release of E2F transcription factor, then cell cycle progression
E7 also interferes with p21 inhibition of cdk2, causing stimulation of S phase genes cyclin A and E

Uses by pathologists

At any site, detection of HPV in lesions without typical histologic findings or in equivocal cases (Am J Dermatopathol 2013;35:327)
Triage specimens with ASCUS into high risk (HPV+) or low risk (HPV-)
Differentiate endocervical adenocarcinoma (usually HPV+) from endometrial adenocarcinoma (usually HPV-, Am J Surg Pathol 2002;26:998, Am J Surg Pathol 2010;34:915)
Distinguish lung metastases from oropharyngeal squamous cell carcinoma (HPV+) from lung primary squamous cell carcinoma (HPV-, Am J Surg Pathol 2012;36:142)
Determine aggressiveness of basaloid squamous cell carcinomas of head and neck (aggressive: HPV-, less aggressive: HPV+, Am J Surg Pathol 2008;32:1044)
Testing for HPV E6/E7 transcripts by RNA ISH confirms presence of integrated and transcriptionally active virus (Am J Surg Pathol 2012;36:1874)
p16 immunohistochemistry (Am J Surg Pathol 2012;36:945, Am J Clin Pathol 2010;134:12) and ProExC immunocytochemistry (Am J Surg Pathol 2008;32:899, Cancer Epidemiol Biomarkers Prev 2011;20:628) are also useful to detect HPV

Microscopic (histologic) images

Images hosted on other servers:

Anal squamous neoplasia, HPV L1 capsid

Cervix, normal

Cervical condyloma

Cervix, low grade SIL

Cervix, high grade SIL

Cervix, squamous cell carcinoma

Cervix, large cell neuroendo carcinoma

Eye, conjunctival tumors

Oropharyngeal squamous cell carcinoma, HPV ISH and p16

Positive staining - normal

None

Positive staining - disease

HPV related lesions (condyloma, squamous papilloma; many dysplastic, in situ or invasive carcinomas of anus, cervix, penis and vulva; also other sites)
Bowen disease of skin
HPV L1 nuclear capsid: 38% of anal squamous cell carcinoma in situ, usually L1 negative in associated invasive carcinomas, Am J Clin Pathol 2011;135:436)
Langerhans cells in oropharyngeal squamous cell carcinoma (J Appl Oral Sci 2011;19:378)

Negative staining

Normal cervix (may have nonspecific background staining)
Endocervical glandular atypia / dysplasia (usually)
Sebaceous carcinoma
Verruciform xanthoma
Verrucous carcinoma