Aptima HR-HPV Testing of Cytology Specimens Is an Effective Supplement for p16 Staining to Improve Diagnostic Accuracy for HPV-Related Oropharyngeal Squamous Cell Carcinoma.

IF 1.6 4区医学 Q3 PATHOLOGY

Acta Cytologica Pub Date : 2023-01-01 Epub Date: 2022-12-13 DOI:10.1159/000527951

Xin Yang, Chunfang Hu, Huan Zhao, Zhihui Zhang, Linlin Zhao, Jing Yu, Xiaoguang Ni, Huiqin Guo

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引用次数: 0

Abstract

Introduction: Regarding a small proportion of oropharyngeal squamous cell carcinoma (OPSCC) patients who tested p16-positive but human papillomavirus (HPV)-negative, we attempted to perform HPV testing to improve the accuracy of HPV detection in OPSCC patients.

Methods: We simultaneously performed Aptima HPV testing of cytological specimens and p16 immunohistochemistry (IHC) staining of histologic biopsies from the same cohort of patients with head and neck SCC (HNSCC). The cytological specimens included fine-needle aspiration specimens from patients with enlarged nodes and endoscopic brushing specimens from the primary lesions of patients without enlarged nodes. Cases with discordant results for p16 IHC staining and Aptima HPV testing were reexamined by a third method, RNAscope testing.

Results: Sixty patients with HNSCC (39 OPSCC and 21 non-OPSCC) were recruited for examination of HPV status. Among these patients, 28 were p16+/HPV+, 29 were p16-/HPV-, 2 were p16+/HPV-, and 1 was p16-/HPV+. The overall concordance rate between Aptima HPV testing and p16 IHC was 95.0%. Three cases with discordant results for these two methods were reexamined by RNAscope testing, and all were confirmed to be HPV negative. The prevalence of HPV in OPSCC and non-OPSCC patients was 61.5% (24/39) and 19.0% (4/21), respectively. The sensitivity and negative predictive values of Aptima HPV testing and p16 IHC were consistent at 100%, while the specificity and positive predictive values were 96.9% and 96.6% versus 93.8% and 93.3%, respectively. Additionally, 30 OPSCCs were simultaneously examined and diagnosed by both brush cytology and biopsy pathology; six of these SCCs were underdiagnosed by histopathology but accurately diagnosed by supplemental brush cytology.

Conclusion: Aptima HPV testing of cytology specimens can be used as an adjuvant examination to identify false-positive OPSCC patients after p16 IHC of biopsies, while brush cytology may be a supplemental method for the histologic diagnosis of malignant oropharyngeal tumors.

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细胞学标本的 Aptima HR-HPV 检测是 p16 染色的有效补充，可提高与 HPV 相关的口咽鳞状细胞癌的诊断准确性。

导言：有一小部分口咽鳞状细胞癌（OPSCC）患者的p16检测呈阳性，但人乳头状瘤病毒（HPV）检测呈阴性，针对这一情况，我们尝试进行HPV检测，以提高口咽鳞状细胞癌患者HPV检测的准确性：我们同时对细胞学标本进行了 Aptima HPV 检测，并对来自同一批头颈部 SCC（HNSCC）患者的组织学活检样本进行了 p16 免疫组织化学（IHC）染色。细胞学标本包括结节增大患者的细针穿刺标本和无结节增大患者原发病灶的内窥镜刷片标本。对于 p16 IHC 染色和 Aptima HPV 检测结果不一致的病例，则采用第三种方法（RNAscope 检测）进行复查：共招募了 60 例 HNSCC 患者（39 例 OPSCC 和 21 例非 OPSCC）进行 HPV 状态检查。在这些患者中，28 人 p16+/HPV+ ，29 人 p16-/HPV- ，2 人 p16+/HPV- ，1 人 p16-/HPV+ 。Aptima HPV 检测与 p16 IHC 检测的总体吻合率为 95.0%。三种方法结果不一致的三个病例通过 RNAscope 检测进行了复查，结果均证实为 HPV 阴性。OPSCC和非OPSCC患者的HPV感染率分别为61.5%（24/39）和19.0%（4/21）。Aptima HPV 检测和 p16 IHC 的灵敏度和阴性预测值均为 100%，特异性和阳性预测值分别为 96.9% 和 96.6% 与 93.8% 和 93.3%。此外，刷状细胞学和活检病理学同时检查和诊断了30个OPSCC；其中6个SCC组织病理学诊断不足，但补充刷状细胞学诊断准确：结论：细胞学标本的Aptima HPV检测可用作辅助检查，以鉴别活检p16 IHC后假阳性的OPSCC患者，而毛刷细胞学检查可作为恶性口咽肿瘤组织学诊断的补充方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Cytologica 生物-病理学

CiteScore

3.70

自引率

11.10%

发文量

审稿时长

4-8 weeks

期刊介绍： With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.