{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:41:34Z","timestamp":1776336094725,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T00:00:00Z","timestamp":1562544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>In the larynx, differentiating squamous papillomas from de\u2010novo papillary squamous dysplasias or squamous cell carcinomas (SCC) has significant consequences for management. Overlapping clinical presentations and cytologic changes across the spectrum of papillary lesions presents diagnostic challenges for otolaryngologists and pathologists. In this study, we evaluate whether ribonucleic acid (RNA) in\u2010situ hybridization (ISH) for low\u2010risk and high\u2010risk human papillomavirus (HPV) can help distinguish these lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We constructed tissue microarrays from 97 papillary laryngeal lesions, including 61 squamous papillomas, two papillomas with dysplasia, two SCCs\u2010ex papilloma, 14 papillary squamous dysplasias, and 18 papillary SCCs identified at the Johns Hopkins Hospital between 2000 and 2017. We performed RNA ISH using probes for low\u2010risk and high\u2010risk HPV types.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Low\u2010risk HPV RNA was identified in 55 benign papillomas (90%), two papillomas with dysplasia (100%), and two SCCs\u2010ex papilloma (100%) but was absent in de\u2010novo papillary dysplasias and SCCs (0%). High\u2010risk HPV RNA ISH was positive only in four papillary SCC (22%). Overall, low\u2010risk HPV RNA ISH was 90% sensitive and 89% specific for benign papillomas with a positive predictive value of 93% and negative predictive value of 84%. In contrast, high\u2010risk HPV was 20% sensitive for SCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low\u2010risk HPV RNA ISH is a useful diagnostic adjunct for distinguishing laryngeal squamous papillomas from papillary squamous dysplasia and SCC. However, it is not entirely specific for benign processes as it is also retained in papillomas with dysplasia and SCCs\u2010ex papilloma. Because high\u2010risk HPV is rare in papillary laryngeal lesions, high\u2010risk HPV RNA ISH has limited utility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level 4<\/jats:p><jats:p><jats:italic>Laryngoscope<\/jats:italic>, 130:955\u2013960, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28159","type":"journal-article","created":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T14:21:42Z","timestamp":1562595702000},"page":"955-960","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["HPV RNA in\u2010situ hybridization as a diagnostic aid in papillary laryngeal lesions"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3336-0294","authenticated-orcid":false,"given":"Jordan A.","family":"Garcia","sequence":"first","affiliation":[{"name":"Department of Otolaryngology The Johns Hopkins Hospital  Baltimore, Maryland U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8699-033X","authenticated-orcid":false,"given":"Simon R.","family":"Best","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology The Johns Hopkins Hospital  Baltimore, Maryland U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Rooper","sequence":"additional","affiliation":[{"name":"Department of Pathology The Johns Hopkins Hospital  Baltimore, Maryland U.S.A."},{"name":"Department of Oncology The Johns Hopkins Hospital  Baltimore, Maryland 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