Broglie Martina A, Jochum Wolfram, Förbs Diana, Schönegg René, Stoeckli Sandro J
Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Institute of Pathology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Cancer Cytopathol. 2015 Dec;123(12):732-8. doi: 10.1002/cncy.21606. Epub 2015 Sep 8.
High-risk human papillomavirus (HR-HPV) infection is associated with improved prognosis and a better response to treatment in patients with oropharyngeal squamous cell carcinoma (OPSCC). Brush cytology is a noninvasive method with which to collect cells from the surface of mucosal lesions. The objective of the current study was to assess the performance of OPSCC brush cytology for the detection of HR-HPV.
Liquid-based brush cytology specimens were prospectively collected during panendoscopy from 51 patients with OPSCC. Cell suspensions were analyzed with Papanicolaou staining, polymerase chain reaction-based HPV DNA testing, and p16 immunostaining. HPV testing and p16 staining were also performed on paired OPSCC biopsy or surgical resection specimens. The detection of HR-HPV DNA alone and the combined positivity for HR-HPV DNA and p16 protein in dysplastic squamous cells were used to calculate accuracy, sensitivity, specificity, and positive and negative predictive values for HR-HPV detection using brush cytology samples.
Approximately 96% of OPSCC brush cytology samples (49 of 51 samples) were classified as satisfactory for evaluation. Dysplastic squamous cells were found in 88% of samples (43 of 49 samples). HPV DNA testing was conclusive in 95% of samples (41 of 43 samples) and revealed HR-HPV DNA in approximately 54% of patients (22 of 41 patients) (HPV type 16 in 19 patients and HPV type 33 in 3 patients). Approximately 49% of brush cytology samples (20 of 41 samples) were positive for HR-HPV DNA and p16 expression. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of brush cytology to identify HR-HPV DNA-positive and p16-positive OPSCC samples were 88%, 83%, 94%, 95%, and 81%, respectively.
Brush cytology appears to be a valid approach with which to determine the HR-HPV status of patients with OPSCC.
高危型人乳头瘤病毒（HR-HPV）感染与口咽鳞状细胞癌（OPSCC）患者预后改善及对治疗反应较好相关。刷检细胞学是一种从黏膜病变表面采集细胞的非侵入性方法。本研究的目的是评估OPSCC刷检细胞学检测HR-HPV的性能。
在51例OPSCC患者的全内镜检查过程中前瞻性收集液基刷检细胞学标本。细胞悬液采用巴氏染色、基于聚合酶链反应的HPV DNA检测和p16免疫染色进行分析。还对配对的OPSCC活检或手术切除标本进行HPV检测和p16染色。单独检测HR-HPV DNA以及发育异常鳞状细胞中HR-HPV DNA和p16蛋白的联合阳性用于计算使用刷检细胞学样本检测HR-HPV的准确性、敏感性、特异性以及阳性和阴性预测值。
约96%的OPSCC刷检细胞学样本（51个样本中的49个）被分类为评估合格。88%的样本（49个样本中的43个）发现发育异常鳞状细胞。95%的样本（43个样本中的41个）HPV DNA检测结果明确，约54%的患者（41例患者中的22例）检测到HR-HPV DNA（19例患者为HPV 16型，3例患者为HPV 33型）。约49%的刷检细胞学样本（41个样本中的20个）HR-HPV DNA和p16表达呈阳性。刷检细胞学识别HR-HPV DNA阳性和p16阳性OPSCC样本的准确性、敏感性、特异性、阳性预测值和阴性预测值分别为88%、83%、94%、95%和81%。
刷检细胞学似乎是确定OPSCC患者HR-HPV状态的有效方法。
