Aptima HR-HPV细胞学检测是p16染色的有效补充,可提高hpv相关口咽鳞状细胞癌的诊断准确性。

IF 1.6 4区 医学 Q3 PATHOLOGY
Acta Cytologica Pub Date : 2023-01-01 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: 1

摘要

引言:针对一小部分p16阳性但人乳头瘤病毒(HPV)阴性的口咽鳞状细胞癌(OPSCC)患者,我们试图进行HPV检测以提高OPSCC患者HPV检测的准确性。方法:我们同时对同一队列头颈部鳞状细胞癌(HNSCC)患者的细胞学标本进行Aptima HPV检测,并对组织活检进行p16免疫组化(IHC)染色。细胞学标本包括淋巴结肿大患者的细针穿刺标本和非淋巴结肿大患者原发病变的内镜下涂刷标本。p16免疫组化染色和Aptima HPV检测结果不一致的病例用第三种方法RNAscope检测重新检查。结果:60例HNSCC患者(39例OPSCC和21例非OPSCC)被招募进行HPV状态检查。其中p16+/HPV+ 28例,p16-/HPV- 29例,p16+/HPV- 2例,p16-/HPV+ 1例。Aptima HPV检测与p16 IHC的总体符合率为95.0%。两种方法检测结果不一致的3例复查RNAscope,均为HPV阴性。HPV在OPSCC和非OPSCC患者中的患病率分别为61.5%(24/39)和19.0%(4/21)。Aptima HPV检测和p16 IHC检测的敏感性和阴性预测值一致,均为100%,特异性和阳性预测值分别为96.9%和96.6%,而特异性和阳性预测值分别为93.8%和93.3%。此外,30例OPSCCs同时接受刷细胞学和活检病理检查和诊断;其中6例SCCs未被组织病理学诊断,但通过补充刷细胞学准确诊断。结论:细胞学标本Aptima HPV检测可作为活检p16免疫组化后鉴别假阳性OPSCC患者的辅助检查,而刷细胞学可作为口咽恶性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。
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.

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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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
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.
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