Nuclear p16 Staining Is Positive in a Quarter of Squamous Cell Carcinomas of Lung Primary
Bibliographic record
Abstract
Squamous cell carcinoma (SCC) of the head and neck is commonly linked to infection by human papillomavirus (HPV) and immunohistochemically confirmed to be positive for p16 (a surrogate marker for HPV infection), analogous to what is seen in HPV-associated dysplasia and carcinoma of the uterine cervix. Thus, p16-positive metastatic SCC in the thoracic/neck lymph nodes is often considered to be of head and neck primary. However, two recent USCAP abstracts reported that p16 was expressed in a significant percent of primary lung SCC and small cell carcinoma, but HPV analyzed by molecular techniques was negative in all of these p16-positive tumors. The aim of the current study was to determine the incidence of p16-positive primary pulmonary SCC cases at our institution. 49 cases of primary pulmonary SCC were stained for p16 using a standard immunohistochemical staining method of formalin-fixed, paraffin-embedded tissue. Primary pulmonary SCC was defined as patients with SCC diagnosed on resection specimens with no radiographic or clinical evidence of SCC elsewhere. All cases were either of moderate or poor differentiation. The p16 nuclear staining was graded as 0 no staining, 1+ 10% staining, 2+ 50% expression, and 3+ more than 50% of nuclear staining in the SCC. 12 of the 49 cases (24.5%) showed positive nuclear staining for p16. In the positive cases, five cases were 3+, 6 cases were 2+, and one case was 1+. Our study found that approximately 1/4 of primary pulmonary SCC cases can exhibit p16 staining, indicating that p16 is not an entirely specific marker for metastatic SCC of head and neck origin in the thoracic/neck area.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".