Pathology Department, Regina Elena National Cancer Institute, Scientific Institute for Research and Healthcare, Rome, Italy.
Otolaryngology-Head and Neck Surgery Department, Regina Elena National Cancer Institute, Scientific Institute for Research and Healthcare, Rome, Italy.
Cancer. 2019 Aug 1;125(15):2587-2593. doi: 10.1002/cncr.32152. Epub 2019 Apr 29.
Testing for oral high-risk human papillomavirus (HPV) DNA may be useful for identifying individuals at increased risk for HPV-driven oropharyngeal cancer (OPC). However, positivity for HPV DNA provides no information on the transforming potential of the infection. In contrast, the detection of high-risk HPV E6/E7 messenger RNA (mRNA) may help to identify clinically significant infections because of the indispensable role of E6/E7 viral oncoproteins in the carcinogenic process.
Oral rinses were collected with a mouthwash from cancer-free individuals at increased risk for oral HPV infection. High-risk HPV DNA and mRNA were evaluated via the testing of the oral rinses with the Linear Array HPV genotyping test and the Aptima HPV assay, respectively.
Overall, 310 subjects with no clinical evidence of lesions of the oral cavity and oropharynx were included in the study. Thirty-three (10.6%) harbored high-risk HPV DNA in their oral rinse. These cases, together with 10 random samples negative for high-risk HPV DNA, were tested with the Aptima assay. A valid result was obtained for 41 of the 43 specimens (95.3%). Among the 31 cases that were positive for high-risk HPV DNA and had a valid Aptima result, 4 (12.9%) were positive for HPV mRNA. HPV mRNA was not detected in any of the samples negative for high-risk HPV DNA.
HPV mRNA is detectable in oral rinses of cancer-free subjects. Oral HPV mRNA testing may be useful in the screening and/or early detection of HPV-driven OPC by possibly identifying active and transforming oral infections. The testing of individuals at increased risk for HPV-related OPC via simply and noninvasively collected oral specimens is an attractive option for future screening strategies.
检测口腔高危型人乳头瘤病毒（HPV）DNA 可能有助于识别 HPV 驱动型口咽癌（OPC）风险增加的个体。然而，HPV DNA 阳性并不能提供感染转化潜能的信息。相比之下，检测高危型 HPV E6/E7 信使 RNA（mRNA）可能有助于识别具有临床意义的感染，因为 E6/E7 病毒癌蛋白在致癌过程中起着不可或缺的作用。
从 HPV 感染风险增加的无口腔癌和口咽癌临床证据的个体中采集漱口液。通过线性阵列 HPV 基因分型检测和 Aptima HPV 检测分别评估口腔冲洗液中的高危型 HPV DNA 和 mRNA。
共有 310 名无口腔和口咽腔病变临床证据的受试者纳入研究。33 名（10.6%）在口腔冲洗液中携带高危型 HPV DNA。这些病例与 10 个随机的高危型 HPV DNA 阴性样本一起用 Aptima 检测进行检测。43 个标本中有 41 个（95.3%）获得了有效结果。在 31 例高危型 HPV DNA 阳性且 Aptima 结果有效的病例中，4 例（12.9%）HPV mRNA 阳性。任何高危型 HPV DNA 阴性的样本中均未检测到 HPV mRNA。
HPV mRNA 可在无癌症的受试者的口腔冲洗液中检测到。口腔 HPV mRNA 检测可能有助于通过可能识别活跃和转化的口腔感染，筛选和/或早期检测 HPV 驱动的 OPC。通过简单和非侵入性采集的口腔标本对 HPV 相关 OPC 风险增加的个体进行检测，是未来筛查策略的一个有吸引力的选择。
