Wasserman Jason K, Rourke Ryan, Purgina Bibianna, Caulley Lisa, Dimitroulakos Jim, Corsten Martin, Johnson-Obaseki Stephanie
Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
Department of Otolaryngology - Head and Neck Surgery, The University of Ottawa and The Ottawa Hospital, Ottawa Hospital-General Campus S3, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada.
J Otolaryngol Head Neck Surg. 2017 Jan 6;46(1):3. doi: 10.1186/s40463-016-0179-6.
Human papillomavirus (HPV) is an important cause of head and neck squamous cell carcinoma (HNSCC), especially in young people. These tumours overexpress p16 and respond well to treatment. The rapid detection of HPV in patients with HNSCC may expedite treatment when p16 status is not immediately available.
Saliva-based DNA collection kits and nested polymerase chain reaction (PCR) were used to determine the HPV status of 62 individuals with biopsy-proven HNSCC. Immunohistochemistry was used to determine tumour p16 status.
A total of 62 patients were included in the study. Twenty-nine samples (47%) were positive for HPV DNA, the majority of which were high risk (HR) subtypes (79%). Patients who tested positive for HR HPV were more likely to have a tumour arising in the oropharynx compared to a non-oropharyngeal site (74 vs 26%; p = 0.003). A positive HR HPV saliva assay was 100% specific (95% CI 59-100%) and had a 100% positive predictive value (95% CI 75-100%) for a p16 positive tumour arising in the oropharynx. In contrast, a negative HR HPV assay had a 96% negative predictive value (95% CI 80-100%) for tumours arising in a non-oropharyngeal site. Independent of site, the saliva assay had a sensitivity of 77% (95% CI 54-91%) and a specificity of 94% (95% CI 77-99%), respectively, for a p16 positive tumour.
We show that a saliva based assay is an effective method for detecting HPV in patients with HNSCC and that a positive HR HPV test is highly specific for p16 positive tumours arising in the oropharynx. This simple and rapid test could be used in cases where a biopsy of the primary tumour is not readily available.
人乳头瘤病毒（HPV）是头颈部鳞状细胞癌（HNSCC）的重要病因，尤其是在年轻人中。这些肿瘤过度表达p16，对治疗反应良好。当p16状态不能立即获得时，快速检测HNSCC患者中的HPV可能会加快治疗。
使用基于唾液的DNA采集试剂盒和巢式聚合酶链反应（PCR）来确定62例经活检证实为HNSCC的个体的HPV状态。免疫组织化学用于确定肿瘤的p16状态。
共有62例患者纳入研究。29个样本（47%）HPV DNA检测呈阳性，其中大多数为高危（HR）亚型（79%）。与非口咽部位相比，HR HPV检测呈阳性的患者更有可能在口咽部位发生肿瘤（74%对26%；p = 0.003）。HR HPV唾液检测对口咽部位发生的p16阳性肿瘤具有100%的特异性（95%可信区间59 - 100%）和100%的阳性预测值（95%可信区间75 - 100%）。相比之下，HR HPV检测阴性对非口咽部位发生的肿瘤具有96%的阴性预测值（95%可信区间80 - 100%）。不考虑部位，唾液检测对p16阳性肿瘤的敏感性分别为77%（95%可信区间54 - 91%）和特异性为94%（95%可信区间77 - 99%）。
我们表明，基于唾液的检测方法是检测HNSCC患者中HPV的有效方法，并且HR HPV检测阳性对口咽部位发生的p16阳性肿瘤具有高度特异性。这种简单快速的检测方法可用于无法轻易获得原发肿瘤活检的情况。
