Clinical and morphogenetic classification of squamous cell carcinoma of the oral cavity and oropharynx

Squamous cell carcinoma of the head and neck (SCCHN) is a biologically heterogeneous disease in which the anatomical location and stage of the disease do not always correlate with the actual prognostic and clinical behavior of the tumor. The results of translational studies, including TCGA and high-throughput transcriptome analysis, demonstrate differences between the mechanisms of carcinogenesis associated with HPV infection and TP53 gene mutations. In the present study, a clinically applicable surrogate classification of HPV-related squamous cell carcinoma was developed based on immunohistochemical expression of p16, p53, and PD-L1 proteins, with eight molecular subtypes identified that reflect key genetic events and features of the immune microenvironment. Each subtype is characterized by unique clinical and morphological features, as well as significantly distinct overall and recurrence-free survival rates. The proposed classification allows patients to be stratified into prognostic risk groups and serves as a basis for personalized therapy selection, including chemoradiotherapy, immunotherapy, modification of adjuvant treatment strategies, and minimally invasive surgical approaches. Thus, immunohistochemical identification of surrogate subtypes of SCCHN is an accessible and clinically significant tool for optimizing cancer care and predicting disease outcomes.
Keywords: squamous cell carcinoma, oropharyngeal carcinoma, surrogate classification, p16, p53, PD-L1, pathological tumor regression grade
Conflict of interest. The authors declare that the study was conducted without any commercial or financial relationships that could be considered a potential conflict of interest.
Funding. The study received no funding.