Pathology Department, Regina Elena National Cancer Institute IRCCS, Rome, Italy.
Sexually Transmitted Infection/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy.
Cancer Cytopathol. 2020 Sep;128(9):648-655. doi: 10.1002/cncy.22295. Epub 2020 Jun 2.
No screening is available for human papillomavirus (HPV)-associated oropharyngeal cancers. The authors investigated whether cytology may be used as a screening tool and whether oral HPV infection is associated with cytologic abnormalities detected in oropharyngeal brushings and in oral rinse-and-gargle specimens from asymptomatic individuals at increased risk for oral HPV infection.
Specimens were collected from men who have sex with men at 6-month intervals. Oropharyngeal samples and oral rinse-and-gargle specimens were collected using a cytobrush and mouthwash, respectively. Exfoliated cells were dispersed in PreservCyt. Liquid-based slides were stained with Papanicolaou. An HPV genotyping test using a linear array was used for HPV detection. Associations with abnormal cytology were investigated using logistic regression.
Overall, 631 brushings and 802 rinses collected from 310 individuals were evaluated; of these specimens, 2 brushings (0.3%) and 10 rinses (1.2%) were inadequate for morphologic evaluation. Of the adequate samples, 35 of 629 brushings (5.5%) and 19 of 792 rinses (2.4%) were abnormal. No associations of high-risk HPVs or HPV-16 infection with cytologic abnormalities were observed for oropharyngeal brushings (high-risk HPVs: odds ratio [OR], 1.19; 95% CI, 0.41-3.50; P = .75; HPV-16: OR, 0.76; 95% CI, 0.10-5.84; P = .79) or for oral rinses (high-risk HPVs: OR, 1.13; 95% CI, 0.26-4.98; P = .87; HPV-16: OR, 0.62; 95% CI, 0.04-10.60; P = .74). Concurrent moderate/heavy drinking and smoking significantly increased the risk of cytologic abnormalities in the brushings (hazard ratio, 4.84; 95% CI, 1.15-20.43; P = .03).
Oral HPV infection by high-risk HPVs and HPV-16 does not confer an increased risk of cytologic abnormalities in oropharyngeal brushings and oral rinses. Abnormal cytology seems to be associated with smoking and drinking habits.
目前尚无针对人乳头瘤病毒（HPV）相关口咽癌的筛查方法。作者研究了细胞学检查是否可作为一种筛查工具，以及口腔 HPV 感染是否与无症状、高风险感染 HPV 人群的口咽刷检和口腔冲洗液细胞学异常有关。
每 6 个月对男男性行为者进行一次检查，采集口咽样本和口腔冲洗液样本。使用细胞刷采集口咽样本，用漱口液采集口腔冲洗液样本。将脱落细胞分散在 PreservCyt 液中，用巴氏染色液对液基薄片进行染色，采用线性探针法 HPV 基因分型检测进行 HPV 检测。采用 logistic 回归分析与异常细胞学的相关性。
共评估了 310 名患者的 631 个刷检样本和 802 个冲洗样本，其中 2 个刷检样本（0.3%）和 10 个冲洗样本（1.2%）因形态学评估不充分而不合格。在足够的样本中，629 个刷检样本中有 35 个（5.5%）和 792 个冲洗样本中有 19 个（2.4%）细胞学异常。口咽刷检未发现高危型 HPV 或 HPV-16 感染与细胞学异常相关（高危型 HPV：比值比 [OR]，1.19；95%置信区间 [CI]，0.41-3.50；P=0.75；HPV-16：OR，0.76；95%CI，0.10-5.84；P=0.79），口腔冲洗也未发现高危型 HPV 或 HPV-16 感染与细胞学异常相关（高危型 HPV：OR，1.13；95%CI，0.26-4.98；P=0.87；HPV-16：OR，0.62；95%CI，0.04-10.60；P=0.74）。同时有中度/重度饮酒和吸烟的患者刷检样本中细胞学异常的风险显著增加（风险比 [HR]，4.84；95%CI，1.15-20.43；P=0.03）。
高危型 HPV 和 HPV-16 的口腔 HPV 感染并不会增加口咽刷检和口腔冲洗液的细胞学异常风险。异常细胞学似乎与吸烟和饮酒习惯有关。
