Combes Jean-Damien, Dalstein Véronique, Gheit Tarik, Clifford Gary M, Tommasino Massimo, Clavel Christine, Lacau St Guily Jean, Franceschi Silvia
International Agency for Research on Cancer, 69372 Lyon Cedex 08, France.
CHU Reims, Hôpital Maison Blanche, Laboratoire Biopathologie, Reims 51092, France; INSERM, UMR-S 903, Reims 51092, France; Université de Reims Champagne-Ardenne, Faculté de Médecine, Reims 51095, France.
Oral Oncol. 2017 Mar;66:52-57. doi: 10.1016/j.oraloncology.2017.01.001. Epub 2017 Jan 18.
To evaluate human papillomavirus (HPV) prevalence in the tonsil using extensive ex vivo brushing and gargling in a large age-stratified sample of cancer-free patients.
From 2012 to 2016, consecutive patients undergoing tonsillectomy for benign indications in 19 French University Hospitals were invited to participate in the SPLIT study. Immediately after resection, half-tonsils were extensively brushed at the pathology laboratories on the surface epithelium and in tonsil crypts to collect exfoliated cells. In 11 centers, patients aged 15 and over (adults) were also asked to provide gargle samples before surgery. HPV-DNA detection used a very sensitive Luminex technology to evaluate 21 HPV types.
Tonsil brushings from 692 patients aged 1-70 years and gargles from 268 adults were tested for HPV. Among adults, overall HPV prevalence was 3.6% in tonsil brushings and 13.1% in gargles and HPV16 prevalence was 2.2% and 4.1%, respectively. Among 139 children, tonsil brushings were positive in two girls (1.4%). Percent agreement in HPV detection in paired tonsil brushings and gargles in adults was 85.8% and positive agreement 9.5%. HPV prevalence in gargles significantly varied by sex (prevalence ratio in men vs women=2.1; 95% confidence interval; 1.1-4.1) and tonsillectomy indication (non-infectious vs. infectious=4.9; 1.4-17.0).
HPV infection is infrequent in tonsil brushings of cancer-free children and adults. In contrast, HPV infection in gargles in adults is rather common. Low agreement in paired tonsil brushings and gargles suggests that gargle is not representative of HPV prevalence in the tonsil.
在大量按年龄分层的无癌患者样本中，通过广泛的离体刷牙和漱口来评估扁桃体中人乳头瘤病毒（HPV）的流行情况。
2012年至2016年，邀请法国19家大学医院中因良性指征接受扁桃体切除术的连续患者参与SPLIT研究。切除后立即在病理实验室对半扁桃体的表面上皮和扁桃体隐窝进行广泛刷牙以收集脱落细胞。在11个中心，还要求15岁及以上的患者（成年人）在手术前提供漱口样本。HPV-DNA检测采用非常灵敏的Luminex技术来评估21种HPV类型。
对692名年龄在1至70岁患者的扁桃体刷牙样本以及268名成年人的漱口样本进行了HPV检测。在成年人中，扁桃体刷牙样本中HPV总体流行率为3.6%，漱口样本中为13.1%，HPV16流行率分别为2.2%和4.1%。在139名儿童中，两名女孩的扁桃体刷牙样本呈阳性（1.4%）。成年人配对的扁桃体刷牙样本和漱口样本中HPV检测的百分比一致性为85.8%，阳性一致性为9.5%。漱口样本中的HPV流行率因性别（男性与女性的流行率之比=2.1；95%置信区间；1.1 - 4.1）和扁桃体切除指征（非感染性与感染性=4.9；1.4 - 17.0）而有显著差异。
在无癌儿童和成年人的扁桃体刷牙样本中，HPV感染并不常见。相比之下，成年人漱口样本中的HPV感染相当普遍。配对的扁桃体刷牙样本和漱口样本一致性较低，表明漱口样本不能代表扁桃体中HPV的流行情况。
