口咽鳞状细胞癌中人乳头瘤病毒的唾液检测：一项诊断准确性研究。
Saliva testing for human papilloma virus in oropharyngeal squamous cell carcinoma: A diagnostic accuracy study.
作者信息
Qureishi A, Ali M, Fraser L, Shah K A, Møller H, Winter S
机构信息
Specialist Registrar, Department of Otolaryngology, Oxford University Hospitals NHS Trust, Oxford, UK.
Department of Molecular Diagnostics, Oxford University Hospitals NHS Trust, Oxford, UK.
出版信息
Clin Otolaryngol. 2018 Feb;43(1):151-157. doi: 10.1111/coa.12917. Epub 2017 Jul 10.
BACKGROUND
New cases of oropharyngeal squamous cell carcinoma (OPSCC) are routinely tested for HPV. HPV in saliva can be detected with PCR, but its clinical applicability in the context of OPSCC remains unknown.
METHODS
Forty-six consecutive patients diagnosed with OPSCC had pre-treatment saliva specimens collected. PCR for HPV on saliva was compared to p16 IHC and HPV DNA in situ hybridisation (ISH) on surgical biopsies.
RESULTS
The sensitivity and specificity of saliva testing when compared to the reference test of p16 IHC and HPV DNA ISH were 72.2% and 90%, and positive and negative predictive values were 96.3% and 47.4%. There were no adverse events. Time from last meal, smoking, alcohol drinking and physical exercise did not impact on results.
CONCLUSIONS
Saliva testing is a promising test to detect HPV in patients with OPSCC. A positive result could avoid the need for surgical biopsies, thereby reducing costs, patient morbidity and expedite treatment.
背景
口咽鳞状细胞癌（OPSCC）的新发病例通常会进行人乳头瘤病毒（HPV）检测。唾液中的HPV可通过聚合酶链反应（PCR）检测，但在OPSCC背景下其临床适用性仍不明确。
方法
连续收集46例诊断为OPSCC的患者治疗前的唾液标本。将唾液HPV的PCR检测结果与手术活检组织的p16免疫组化（IHC）和HPV DNA原位杂交（ISH）结果进行比较。
结果
与p16 IHC和HPV DNA ISH的参考检测相比，唾液检测的敏感性和特异性分别为72.2%和90%，阳性预测值和阴性预测值分别为96.3%和47.4%。未发生不良事件。距上次进食的时间、吸烟、饮酒和体育锻炼均未对结果产生影响。
结论
唾液检测是检测OPSCC患者HPV的一种有前景的检测方法。阳性结果可避免手术活检的需要，从而降低成本、减少患者发病率并加快治疗。
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