Affiliation:
1. Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences University at Buffalo, the State University of New York Buffalo New York USA
2. University of Delaware Newmark Delaware USA
3. Department of Pathology University of Texas MD Anderson Cancer Center Houston Texas USA
Abstract
ABSTRACTDigital Papillary Adenocarcinoma (DPA) is a rare tumor that can cause metastasis and death. It can morphologically mimic benign sweat gland tumors. In 2022, the novel association of HPV‐42 and DPA was discovered by means of DNA sequencing. In this scoping review, we aimed to systematically evaluate alternatives to HPV‐42 molecular sequencing. Of 87 articles on DPA identified in a PUBMED meta‐search, eight met the inclusion criteria. We found that DNA sequencing for HPV‐42 is most sensitive (94%). Comparable tests included HPV‐42 in situ hybridization (ISH), which had 82% sensitivity, and p16 immunohistochemistry, which had 70%–75% sensitivity. We further evaluated the performance of HPV‐42 ISH and performed a stratified analysis of HPV‐42 ISH‐negative DPA cases. There was a statistically significant difference in HPV‐42 positivity in patients younger than and older than 60 years old (p = 0.02). We recommend HPV‐42 ISH for cases with equivocal morphology from patients aged over 60 years. Tumors with equivocal morphology from patients under the age of 60 years should be sequenced for HPV‐42. For cases with classic morphology, p16 can be used to support the diagnosis, but molecular testing for HPV‐42 is unnecessary.