HPV testing was performed by RNA in situ hybridization via the RNAscope method (Advanced Cell Diagnostics, Hayward, CA), as previously detailed.(12 (link)) Five micron sections from formalin-fixed and paraffin-embedded tissue blocks were evaluated for the presence of HPV RNA using the RNAscope HPV-HR18 Probe (Advanced Cell Diagnostics, Hayward, CA) which recognizes 18 high-risk HPV genotypes (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, and 82). In addition, all cases were tested with an HPV type 33-specific probe, and a subset were tested with an HPV type 16-specific probe. HPV positive controls included an HPV33-positive head and neck squamous cell carcinoma, while an HPV-negative head and neck squamous cell carcinoma served as a negative control.