Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Clin Exp Dent Res. 2022 Feb;8(1):169-175. doi: 10.1002/cre2.522. Epub 2021 Dec 29.
Oral human papilloma virus (HPV) infection is associated with nearly three-quarters of all oropharyngeal cancers in the United States. Research also suggests its association with periodontal disease. There are limited studies evaluating differences in HPV detection methods; however, oral rinse is considered the most sensitive detection method. We compared HPV detection by self-collected oral rinse versus self-collected cytobrush and assessed whether the strength of association between periodontitis and HPV is modified by the collection method.
Data from a cross-sectional study of Hispanic adults in Puerto Rico (n = 346) who provided oral rinse and cytobrush samples for oral HPV detection and were clinically evaluated for periodontitis. The agreement between the oral mouthwash and cytobrush methods was assessed using the Kappa (κ) statistic. Logistic regression models were used to determine if the association between HPV infection and other risk factors varied by oral sample collection method.
HPV prevalence was slightly higher using cytobrush than oral rinse (5.8% vs. 4.3%). The sensitivity of cytobrush to detect oral HPV was 64.7%, and the specificity was 97.4%. We observed a κ of 0.61 (95% confidence interval [CI]: 0.45-0.78), indicative of fair to good agreement between the two collection methods. The association between oral HPV infection and periodontitis severity was stronger when using the oral rinse collection method (odds ratio [OR] = 3.23, 95% CI: 1.06-9.84); the association was not statistically significant for cytobrush (OR = 1.96, 95% CI: 0.68-5.65).
These findings support the significance of choosing the most suitable collection method in oral HPV-related studies. Selecting the most appropriate collection method is an essential criterion in oral HPV-related studies.
口腔人乳头瘤病毒(HPV)感染与美国近四分之三的口咽癌有关。研究还表明其与牙周病有关。目前评估 HPV 检测方法差异的研究有限;然而,漱口液被认为是最敏感的检测方法。我们比较了自我采集的口腔冲洗液与自我采集的口腔刷之间 HPV 的检测,并评估了牙周炎与 HPV 之间的关联强度是否因采集方法而改变。
本研究为波多黎各西班牙裔成年人的横断面研究,共 346 例参与者提供了口腔冲洗液和口腔刷样本用于口腔 HPV 检测,并进行了牙周炎的临床评估。采用 Kappa(κ)统计评估口腔漱口水和口腔刷方法之间的一致性。使用逻辑回归模型确定 HPV 感染与其他危险因素之间的关联是否因口腔样本采集方法而异。
使用口腔刷检测 HPV 的阳性率略高于口腔冲洗(5.8%比 4.3%)。口腔刷检测口腔 HPV 的敏感性为 64.7%,特异性为 97.4%。我们观察到κ值为 0.61(95%置信区间[CI]:0.45-0.78),表明两种采集方法之间存在良好到中等的一致性。当使用口腔冲洗采集方法时,口腔 HPV 感染与牙周炎严重程度之间的关联更强(比值比[OR] = 3.23,95%CI:1.06-9.84);而使用口腔刷采集方法时,该关联不具有统计学意义(OR = 1.96,95%CI:0.68-5.65)。
这些发现支持在与口腔 HPV 相关的研究中选择最合适的采集方法的重要性。选择最合适的采集方法是与口腔 HPV 相关的研究中的一个重要标准。