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

Yang, Xin; Hu, Chunfang; Zhao, Huan; Zhang, Zhihui; Zhao, Ling; Ni, Xiaoguang; H, Guo

doi:10.1159/000527951

Cited by 4 publications

(6 citation statements)

References 41 publications

(51 reference statements)

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“…It has the potential to be used for HPV status detection in HNSCC patients since it is a fully automated, affordable and reliable HPV detection platform. However, since this method only works with cytological specimens, in our preliminary study, endoscopic brush cytology was performed at the primary site, and FNA was performed at the metastatic site to obtain feasible specimens for APTIMA HPV detection [29]. In our study, APTIMA HPV testing showed a similarly high sensitivity to p16 IHC in detecting HPV status; however, the speci city analysis yielded a signi cant difference (p = 0.018) favoring APTIMA over p16 IHC.…”

Section: Discussionmentioning

confidence: 60%

How cytology and cytology-based HPV testing could assist clinicians in the diagnosis of head and neck squamous cell carcinoma

Yang,

Cui,

Zhao

et al. 2024

Preprint

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Introduction: Given the limitations of biopsy in the diagnosis of head and neck squamous cell carcinoma (HNSCC), we explored the diagnostic efficiency of cytology at the primary tumor site of HNSCC. In addition, p16 immunohistochemistry (IHC) can yield a false positive result in the detection of HPV status in HNSCC, so we sought to perform APTIMA HPV testing to improve the diagnostic accuracy for HPV status in HNSCC patients. Methods We categorized 151 enrolled HNSCC patients into two groups. The first cohort comprised 78 patients who underwent cytology examination at the primary tumor sites of HNSCC. The other cohort consisted of 132 patients whose HPV status was evaluated and whose cytology specimens underwent HPV APTIMA testing while their histologic biopsy specimens underwent p16 IHC. Patients with discordant Aptima HPV and p16 IHC results were reexamined with RNAscope assays. Results Among the 78 patients whose samples from the primary site of HNSCC underwent cytological examination, 71 underwent simultaneous pathological biopsy; due to sampling difficulties, the biopsy failed for the remaining 7 patients. There were 13 cases of HNSCC that could not be definitively diagnosed as SCC with preoperative biopsy. Of these 13 histologically underdiagnosed cases, SCC was ultimately diagnosed cytologically in six cases. Of the 7 patients whose preoperative biopsy failed, five were cytologically diagnosed with SCC. For all 132 HNSCC patients whose cytology specimens underwent HPV APTIMA testing, compared to p16 IHC, the APTIMA HPV test had greater specificity and positive predictive values (98.8% and 98.0% vs. 89.2% and 84.5%, p2 = 0.018, p3 = 0.020) and similar sensitivity and negative predictive values (98.0% and 98.8% vs. 100% and 100%, p1 = 1.000, p4 = 1.000). Conclusion Cytological examination can complement preoperative pathological biopsy in the diagnosis of HNSCC at the primary tumor site. Furthermore, cytology specimens could be utilized for HPV testing using the APTIMA HPV test to uncover potential errors in p16 IHC results on biopsy samples, allowing a more precise diagnosis and treatment of HNSCC.

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Section: Discussionmentioning

confidence: 60%

How cytology and cytology-based HPV testing could assist clinicians in the diagnosis of head and neck squamous cell carcinoma

Yang,

Cui,

Zhao

et al. 2024

Preprint

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“…In such instances, FNAC may constitute the sole available specimen for the initial diagnosis and molecular characterization. Various methodologies validated on cervicovaginal cytological specimens have undergone assessment on HN FNAC, forming an integral part of routine practice for confirming OPSCC or the diagnosis of HN‐CUP 6,10,19–22 …”

Section: Discussionmentioning

confidence: 99%

“…In this clinical context, the significance of HPV status on FNAC samples can guide the diagnostic workup and therapeutic management, indicating an oropharyngeal origin. Furthermore, reliable HPV testing techniques on cytological samples become imperative 10–12 …”

Section: Introductionmentioning

confidence: 99%

Parotid squamous cell carcinoma metastases: Application of human papillomavirus‐DNA test on liquid‐based cytology to recognize oropharyngeal origin of the neoplasm

Montella,

Ruggiero,

Savarese

et al. 2024

Diagnostic Cytopathology

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Malignancies of the parotid gland are relatively uncommon and in most cases are primary neoplasms; intraparotid metastases are rare. Oral and oropharyngeal squamous cell carcinoma (O‐ and OP‐SCC) can potentially metastasize to the parotid gland or intraparotid lymph nodes. Fine‐needle aspiration cytology (FNAC) serves as the initial diagnostic approach for this purpose. HPV status in FNAC specimens is relevant and can guide the diagnostic workup, indicating a potential oropharyngeal origin of the primary tumor. A small series of occult SCC metastases is presented below, in which HPV‐DNA testing of FNAC specimens helped identify primary neoplasms located in the oropharynx. US‐guided FNAC of parotid nodules was conducted by an experienced interventional cytopathologist in three cases. Each patient underwent assessment of direct smears, cell blocks, and liquid‐based samples for HPV testing. The morphological and immunocytochemical features of SCC were documented, and real‐time PCR was employed for the detection and genotyping of HPV. The role of HPV testing on FNAC specimens in pinpointing the primary neoplasms in the oropharynx is highlighted. Consequently, FNAC samples emerge as valuable diagnostic and prognostic tools in this context, providing essential insights for patient management.

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“…From a practical standpoint, mRNA testing is not done in practice because the results from p16 immunohistochemistry and in situ hybridization for HPV are generally considered reliable enough for clinical decision-making. It must be recognized, however, that concordance rates between tests can still be variable (17)(18)(19)(20)(21).…”

Section: Clinical Datamentioning

confidence: 99%

De-escalated radiation for human papillomavirus virus-related oropharyngeal cancer: evolving paradigms and future strategies

Chen¹

2023

Front. Oncol.

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The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma has increased dramatically in recent years reaching epidemic-like proportions. Data has emerged not only showing that these cancers are a unique entity with distinct molecular characteristics but that they also have a significantly improved prognosis as a result of their exquisite radiosensitivity compared to their HPV-negative counterparts. This, it has been increasingly suggested that these tumors can be targeted with de-escalated approaches using reduced doses of radiation. The overriding goal of de-escalation is to maintain the high cure and survival rates associated with traditional approaches while reducing the incidence of both short- and long-term toxicity. Although the exact reason for the improved radiosensitivity of HPV-positive oropharyngeal carcinoma is unclear, prospective studies have now been published demonstrating that de-escalated radiation can successfully maintain the high rates of cure and preserve quality of life for appropriately selected patients with this disease. However, these studies have been complicated by such factors as the relatively limited sample sizes, as well as the variability in treatment, inclusion criteria, and follow-up. As the data continues to mature on de-escalation, it is unquestionable that treatment paradigms for this disease will evolve. The ongoing quest to define a standard regimen comprises the subject of this review.

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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

Cited by 4 publications

References 41 publications

How cytology and cytology-based HPV testing could assist clinicians in the diagnosis of head and neck squamous cell carcinoma

How cytology and cytology-based HPV testing could assist clinicians in the diagnosis of head and neck squamous cell carcinoma

Parotid squamous cell carcinoma metastases: Application of human papillomavirus‐DNA test on liquid‐based cytology to recognize oropharyngeal origin of the neoplasm

De-escalated radiation for human papillomavirus virus-related oropharyngeal cancer: evolving paradigms and future strategies

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