Imai T, Sato I, Matsumoto K, Asada Y, Kato K, Sogai S, Watanabe K, Sadayasu R, Saijo S, Matsuura K
B-ENT. 2016;12(4):263-269.
Human papilloma virus detection in oropharyngeal cancer with gargle samples.
human papilloma virus (HPV) is a major risk factor for oropharyngeal squamous cell carcinoma (OPSCC) and knowledge of a patient's HPV status is clinically important in terms of treatment and prognosis. The practicality of using oral gargle samples to reliably detect HPV in patients with OPSCC remains unclear. Therefore, we evaluated the feasibility of HPV detection in gargle samples of OPSCC patients using an HPV-dedicated nucleic acid amplification test (cobas 4800 HPV Test; Roche Diagnostics K.K.).
15 patients with histologically proven OPSCC were evaluated from May 2014 to March 2015. Swab sam- ples served as positive controls and were tested using both the Hybrid Capture II HPV Test (HC-II; Digene Corporation) and the cobas 4800 HPV Test. Oral gargle samples were tested using the cobas 4800 HPV Test. Five of the 15 patients were confirmed to be HPV-positive by a combination of p16 immunohistochemistry, HPV-DNA in situ hybridization and nucleic acid amplification.
the sensitivity and specificity of the gargling method were 60% and 100%, respectively. No false-positives were obtained. Detection of HPV in two very small tumours rising from the base of the tongue was difficult and these cases were overlooked as HPV-negative.
use of the gargling method to determine HPV positivity in OPSCC patients appears feasible, except in patients with very small tumours. Real-time polymerase chain reaction using gargle samples may have greater clinical efficacy than the swabbing method.
通过漱口样本检测口咽癌中的人乳头瘤病毒。
人乳头瘤病毒（HPV）是口咽鳞状细胞癌（OPSCC）的主要危险因素，了解患者的HPV状态在治疗和预后方面具有重要临床意义。使用口腔漱口样本可靠检测OPSCC患者中HPV的实用性尚不清楚。因此，我们使用HPV专用核酸扩增检测（cobas 4800 HPV检测；罗氏诊断株式会社）评估了在OPSCC患者漱口样本中检测HPV的可行性。
2014年5月至2015年3月对15例经组织学证实的OPSCC患者进行评估。拭子样本用作阳性对照，并使用杂交捕获II HPV检测（HC-II；Digene公司）和cobas 4800 HPV检测进行检测。口腔漱口样本使用cobas 4800 HPV检测进行检测。15例患者中有5例通过p16免疫组织化学、HPV-DNA原位杂交和核酸扩增联合检测被确认为HPV阳性。
漱口法的敏感性和特异性分别为60%和100%。未获得假阳性结果。检测舌根处两个非常小的肿瘤中的HPV很困难，这些病例被漏诊为HPV阴性。
除了肿瘤非常小的患者外，使用漱口法确定OPSCC患者的HPV阳性似乎是可行的。使用漱口样本的实时聚合酶链反应可能比拭子法具有更高的临床疗效。
