Brush cytology for the detection of high-risk HPV infection in oropharyngeal squamous cell carcinoma.

刷片细胞学检测口咽鳞状细胞癌高危型HPV感染

Broglie MA,Jochum W,Förbs D,Schönegg R,Stoeckli SJ

阅读：1183 Cancer Cytopathology； December 2015 Volume 123, Issue 12:732-8

Abstract

High-risk human papillomavirus (HR-HPV) infection is associated with improved prognosis and a better response to treatment in patients with oropharyngeal squamous cell carcinoma (OPSCC). Brush cytology is a noninvasive method with which to collect cells from the surface of mucosal lesions. The objective of the current study was to assess the performance of OPSCC brush cytology for the detection of HR-HPV.
Liquid-based brush cytology specimens were prospectively collected during panendoscopy from 51 patients with OPSCC. Cell suspensions were analyzed with Papanicolaou staining, polymerase chain reaction-based HPV DNA testing, and p16 immunostaining. HPV testing and p16 staining were also performed on paired OPSCC biopsy or surgical resection specimens. The detection of HR-HPV DNA alone and the combined positivity for HR-HPV DNA and p16 protein in dysplastic squamous cells were used to calculate accuracy, sensitivity, specificity, and positive and negative predictive values for HR-HPV detection using brush cytology samples.
Approximately 96% of OPSCC brush cytology samples (49 of 51 samples) were classified as satisfactory for evaluation. Dysplastic squamous cells were found in 88% of samples (43 of 49 samples). HPV DNA testing was conclusive in 95% of samples (41 of 43 samples) and revealed HR-HPV DNA in approximately 54% of patients (22 of 41 patients) (HPV type 16 in 19 patients and HPV type 33 in 3 patients). Approximately 49% of brush cytology samples (20 of 41 samples) were positive for HR-HPV DNA and p16 expression. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of brush cytology to identify HR-HPV DNA-positive and p16-positive OPSCC samples were 88%, 83%, 94%, 95%, and 81%, respectively.
Brush cytology appears to be a valid approach with which to determine the HR-HPV status of patients with OPSCC. Cancer (Cancer Cytopathol) 2015;123:732-738. © 2015 American Cancer Society.

摘要

高危型人乳头瘤病毒（HR-HPV）感染与口咽鳞状细胞癌（OPSCC）患者预后好、疗效佳相关。刷片细胞学检查是一种无创方法，可以从病变粘膜的表面收集细胞。本研究的目的是评估OPSCC刷片细胞学检测高危型HPV感染可行性。

51例OPSCC患者全喉镜检查过程中前瞻性收集液基细胞学刷片标本。细胞悬浮液制片巴氏染色、行聚合酶链反应为主的HPV DNA检测，p16免疫染色并综合分析。对照组OPSCC活检或手术切除标本也进行了HPV检测和p16染色。不典型增生鳞状上皮细胞检测到单独HR-HPV DNA及HR-HPV DNA和 p16蛋白组合表达用于计算刷片细胞学标本检测HR-HPV准确性、灵敏度、特异性、阳性预测值和阴性预测值。

OPSCC刷片细胞学标本约96％（49 /51）评估为样本满意。其中88％（43/49）诊断为不典型鳞状上皮细胞。 95％（ 41/43 ）有HPV DNA检测结果，约54％（ 22/41）显示有HR-HPV DNA（19例为HPV16型、3例为HPV33型）。约49％（20/41）刷片细胞学标本为HR-HPV DNA阳性同时有p16表达。刷片细胞学检测OPSCC样本HR-HPV DNA阳性同时伴p16阳性的准确性、灵敏度、特异性、阳性预测值和阴性预测值分别为88％、83％、94％、95％和81％。