Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy.
Otolaryngology Division, Sassari University Hospital, Italy.
Head Neck. 2019 Apr;41(4):1104-1111. doi: 10.1002/hed.25591. Epub 2019 Feb 12.
A consensus about the most appropriate diagnostic method(s) for head and neck human papillomavirus (HPV)-induced carcinogenesis is still lacking because most of the commercially available assays have been designed for the cervix.
This article summarizes current data and trends concerning HPV diagnostic strategies in oropharyngeal squamous cell carcinoma (OPSCC). Six main approaches are described.
The diagnostic gold standard for HPV-related OPSCC, focusing on E6/E7 mRNA detection, requires fresh samples. Because most frequently available samples are formalin-fixed paraffin-embedded (FFPE), the pros and cons of the different approaches were analyzed.
In the FFPE samples, the immunohistochemistry of p16, which is considered appropriate to assess HPV-driven carcinogenesis in OPSCC according to the 8th American Joint Committee on Cancer TNM classification, may not be specific enough to become the diagnostic standard in the perspective of treatment deintensification. p16 may play a safer role in combination with another highly sensible assay. Other promising approaches are based on DNA detection through real-time polymerase chain reaction and RNAscope.
由于大多数市售检测方法都是为宫颈而设计的，因此对于头颈部人乳头瘤病毒（HPV）诱导的癌变最适当的诊断方法仍缺乏共识。
本文总结了有关口咽鳞状细胞癌（OPSCC）中 HPV 诊断策略的最新数据和趋势。描述了六种主要方法。
针对 HPV 相关 OPSCC 的诊断金标准，主要集中在 E6/E7 mRNA 检测上，需要使用新鲜样本。由于最常使用的样本是福尔马林固定石蜡包埋（FFPE）的样本，因此分析了不同方法的优缺点。
在 FFPE 样本中，根据第 8 版美国癌症联合委员会 TNM 分类，p16 的免疫组织化学被认为可以适当评估 OPSCC 中 HPV 驱动的癌变，但在治疗减量化方面，p16 可能不够特异，无法成为诊断标准。p16 可能与另一种高灵敏度的检测方法结合使用更安全。其他有前途的方法基于通过实时聚合酶链反应和 RNAscope 进行 DNA 检测。
