A comparison of clinically utilized human papillomavirus detection methods in head and neck cancer (original) (raw)
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1994
Cancer-free tissues from various anatomical subsites in the head and neck were examined by the polymerase chain reaction (PCR) for the incidence of human papillomavirus (HPV) types 16 and 18. We detected HPV-16 DNA in 9 of 103 samples (8.7%), including specimens from the paranasal sinuses, tonsil, hypopharynx and larynx. However, no HPV-16/18 DNA was detected by Southern hybridization in these 9 samples. The significance of the presence of HPV-16 DNA in non-cancer tissues is still unknown, but PCR detection only of high-risk HPV DNA in head and neck cancer should be evaluated cautiously because of its ubiquity in this region.
Acta dermatovenerologica Alpina, Pannonica, et Adriatica, 2012
The Abbott RealTime is a novel real-time PCR assay designed for concurrent individual genotyping of HPV16 and HPV18 and pooled detection of 12 HPV genotypes: HPV31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 in cervical swab specimens. In this study, the performance of RealTime for detecting HPV in formalin-fixed, paraffin-embedded tissue specimens of head and neck cancers was compared to the Innogenetics INNO-LiPA assay, which allows identification of 28 HPVs, including all 14 covered by RealTime. A total of 60 FFPE tissue specimens obtained from the same number of patients with histologically confirmed cancer of the oral cavity or oropharynx were included in the study. Following DNA extraction using a Qiagen DNA Mini Kit, RealTime and INNO-LiPA were performed on all samples, as instructed by the manufacturers. A 136-bp fragment of human beta-globin serving as an internal control in RealTime was successfully amplified from all 60 tissue samples included in the study. RealTime a...
Applied Immunohistochemistry & Molecular Morphology, 2015
High risk human papillomavirus (HPV) infection is a common cause of oropharyngeal squamous cell carcinoma, especially in young male nonsmokers. Accurately diagnosing HPV-associated oral cancers is important, because they have a better prognosis and may be treated differently than smoking-related oral carcinomas. Various methods have been validated to test for high risk HPV in cervical tissue samples and they are in routine clinical use to detect dysplasia before it progresses to invasive disease. Similarly, future screening for HPV-mediated oropharyngeal dysplasia may identify patients before it progresses. Our objective was to compare four of these methods in a retrospective series of 87 oral and oropharyngeal squamous cell carcinomas that had archived fresh-frozen and paraffin-embedded tissue for evaluation. Patient age, gender, smoking history, and tumor location were also recorded. DNA prepared from fresh-frozen tissue was tested for HPV genotypes by multiplex PCR analysis (Diatherix), and high risk HPV screening was done with Hybrid Capture 2 (Qiagen hc2) and Cervista (Hologic). Histologic sections were immunostained for p16 (mtm/Roche). HPV positive outcome was defined as agreement between at least two of the three genetic tests and used for X 2 analysis and calculations of diagnostic predictive value. As expected, high risk HPV-positive oral cancers were most common in the tonsil and base of tongue (oropharynx) of younger male (55 years vs 65 years) (p=0.0002) nonsmokers (p=0.01). Most positive cases were HPV16 (33/36, 92%). Hybrid Capture 2 and Cervista were as sensitive as PCR and had fewer false positives than p16 immunohistochemistry.
International Journal of Radiation Oncology*Biology*Physics, 2014
In a subset of 50 consecutive primary oropharyngeal squamous cell carcinoma patients, enrolled and primarily treated by radiation therapy at the same institution, human papillomavirus (HPV) DNA detection proved to be a more reliable Purpose: Human papillomavirus (HPV) 16 infection is associated with oropharyngeal carcinogenesis and is likely the cause of the reported increase in disease incidence. We evaluated the prevalence of HPV infection and the reliability of different diagnostic tools using primary tumor samples from a cohort of 50 patients. Methods and Materials: Formalin-fixed paraffin-embedded (FFPE) tumor samples were collected from all 50 consecutive primary oropharyngeal SCC patients who were enrolled in the study; fresh tumor samples were available in 22 cases. NucliSENS EasyQ HPVv1 was used for RNA, and Digene Hybrid Capture-2(HC2) was used for DNA detection. p16 Expression was evaluated by immunohistochemistry in FPPE specimens. Results: Based on the DNA detection assay on FFPE samples, the frequency of high-risk Reprint requests to: diagnostic assay for the diagnosis of high-risk HPV infection than p16 immunohistochemistry. Furthermore, the detection of HPV DNA exhibits n better correlation with survival, appearing to be more reliable for routine use in daily clinical practice.
JNCI Journal of the National Cancer Institute
Background: High-risk human papillomaviruses (HPVs) are etiologic agents for anogenital tract cancers and have been detected in head and neck squamous cell carcinomas (HNSCCs). We investigated, retrospectively, an etiologic role for HPVs in a large series of patients with HNSCC. Methods: Tumor tissues from 253 patients with newly diagnosed or recurrent HNSCC were tested for the presence of HPV genome by use of polymerase chain reaction (PCR)-based assays, Southern blot hybridization, and in situ hybridization. The viral E6 coding region was sequenced to confirm the presence of tumor-specific viral isolates. Exons 5-9 of the TP53 gene were sequenced from 166 specimens. The hazard of death from HNSCC in patients with and without HPVpositive tumors was determined by proportional hazards regression analysis. Results: HPV was detected in 62 (25%) of 253 cases (95% confidence interval [CI] = 19%-30%). Highrisk, tumorigenic type HPV16 was identified in 90% of the HPV-positive tumors. HPV16 was localized specifically by in situ hybridization within the nuclei of cancer cells in preinvasive, invasive, and lymph node disease. Southern blot hybridization patterns were consistent with viral integration. Poor tumor grade (odds ratio [OR] = 2.4; 95% CI = 1.2-4.9) and oropharyngeal site (OR = 6.2; 95% CI = 3.1-12.1) independently increased the probability of HPV presence. As compared with HPV-negative oropharyngeal cancers, HPVpositive oropharyngeal cancers were less likely to occur among moderate to heavy drinkers (OR = 0.17; 95% CI = 0.05-0.61) and smokers (OR = 0.16; 95% CI = 0.02-1.4), had a characteristic basaloid morphology (OR = 18.7; 95% CI = 2.1-167), were less likely to have TP53 mutations (OR = 0.06; 95% CI = 0.01-0.36), and had improved disease-specific survival (hazard ratio [HR] = 0.26; 95% CI = 0.07-0.98). After adjustment for the presence of lymph node disease (HR = 2.3; 95% CI = 1.4-3.8), heavy alcohol consumption (HR = 2.6; 95% CI = 1.4-4.7), and age greater than 60 years old (HR = 1.4; 95% CI = 0.8-2.3), all patients with HPV-positive tumors had a 59% reduction in risk of death from cancer when compared with HPV-negative HNSCC patients (HR = 0.41; 95% CI = 0.20-0.88). Conclusions: These data extend recent molecular and epidemiologic studies and strongly suggest that HPV-positive oropharyngeal cancers comprise a distinct molecular, clinical, and pathologic disease entity that is likely causally associated with HPV infection and that has a markedly improved prognosis. [J Natl Cancer Inst 2000; 92:709-20] Head and neck squamous cell carcinoma (HNSCC) is a disease largely attributed to environmental exposures. Tobacco use and alcohol consumption are well-established risk factors . However, a small proportion (15%-20%) of HNSCCs occurs in Tumors positive for HPV16 by PCR, for which at least 2-5 g of tumor DNA were available, were examined for HPV16 sequences by Southern blot hybridization of unamplified tumor DNAs. Full-length HPV16 genomic DNA (7905 bp) in pGEM II (Promega Corp., Madison, WI) was gel purified and labeled to a high specific activity with [␣-32 P]deoxycytidine triphosphate by the random primer method (Random Primers DNA Labeling System; Life Technologies, Inc.
Acta cytologica, 2015
The importance of detecting human papillomavirus (HPV) in head and neck squamous cell carcinoma (HNSCC) has resulted in a growing expectation for HPV testing of clinical samples. Although testing protocols vary, most pertain to primary tumor biopsies/resections. Testing of fine-needle aspirates and core biopsies (FNACBs) is advantageous, but it is unclear whether technical and biological factors adversely affect the fidelity of HPV detection in these samples. Data was collected for 85 patients with regionally metastatic HNSCC that had undergone FNACB with HPV analysis as part of clinical care. HPV testing consisted of p16 immunostaining and HPV in situ hybridization (ISH). The FNACBs were compared with the subsequent biopsies/resections for HPV status. p16 staining was present in 60 cases (71%). p16 positivity was predictive of oropharyngeal origin (p < 0.001) and correlated with the presence of HPV by ISH (98% correlation). On comparison of the metastases and primary cancers, th...
World Journal of Oncology
Background: The rise in human papillomavirus (HPV) infection rates over the last few decades in the USA has contributed to a significant increase in the overall incidence of patients diagnosed with squamous cell carcinoma of the head and neck. These head and neck carcinomas develop in the oropharynx, with more than 90% of them caused by infection with high-risk HPV type 16. Patients diagnosed with HPVinduced oropharyngeal squamous cell carcinomas (OPSCCs) have a better prognosis and treatment response than those diagnosed with head and neck cancers caused by alcohol consumption and tobacco use. To identify patients with HPV-positive OPSCC, new guidelines recommend positive staining of oropharyngeal tissues for p16 INK4a (p16) by immunohistochemistry (IHC). Herein we discuss the testing algorithm that was adopted to address discrepant results between p16 IHC and a DNA in situ hybridization (ISH) test used routinely to diagnose HPV-positive OPSCC patients. Methods: A DNA polymerase chain reaction (PCR) test that amplifies HPV16 and HPV18 E7 was developed to aid in the diagnosis of HPV-positive OPSCC in a subset of patients. Specimens from these patients stained positive for p16 by an IHC test, but negative for highrisk HPV by a commercial DNA ISH test. Moreover, these results did not match the histopathological characteristics of the specimens, nor the clinical presentations of the patients. Results: Of 21 patients' specimens that were tested for p16 by IHC, 11 specimens showed concordant results with the high-risk HPV 16/18 DNA ISH test. Whereas, in eight p16 IHC positive specimens, HPV viral DNA was not detected by HPV16/18 DNA ISH, and two specimens were not tested by DNA ISH. When these eight p16 IHC positive specimens with discrepant p16 IHC and DNA ISH results were further tested by DNA PCR, six specimens showed concordance with p16 IHC with positive results for HPV16 E7, while two specimens were negative for HPV16 E7 by DNA PCR. All tested specimens were negative for HPV18 E7 by DNA PCR. Thus, the addition of the HPV16 and HPV18 E7 DNA PCR test identified a significant number of false negative test results by the HPV16/18 DNA ISH test and likely several false positive results by p16 IHC. Conclusions: Inclusion of an HPV16 E7 DNA PCR test improved the robustness of HPV-associated OPSCC diagnosis in patients with discrepant results from p16 IHC staining and a DNA ISH test, and identified patients for proper management with less misclassification.
Ent updates, 2018
Özet: Normal ve tümöral orofaringeal dokuda in situ hibridizasyon ve p16 ekspresyonu ile human papilloma virüsü varl›¤›n›n de¤erlendirilmesi ve klinikopatolojik önemi Amaç: Human papilloma virüs (HPV) pozitif orofaringeal hücreli kanser olgular›nda son y›llarda görülen art›fl, bu virüsün tespitinin klinik önemini art›rmaktad›r. Bu çal›flmada amac›m›z orofaringeal kanser hastalar›m›z›n HPV pozitiflik oranlar›n› bulmak, farkl› HPV tespit yöntemleri olan p16 immünohistokimya (IHC) ve in situ hibridizasyonunun (ISH) etkinli¤ini karfl›laflt›rarak boyanma paternlerini göstermektir. Yöntem: Retrospektif dosya taramas› ile bulunan 23 hasta ve 10 kontrol çal›flmaya dahil edilerek hastalar›n patoloji arflivinden bulunan parafin bloklar›nda p16 IHC ve HPV ISH çal›fl›ld›. Bulgular: Yirmi üç olgunun 7'si p16 pozitif idi. Bunlar›n alt›s› yüksek p16 ekspresyonu gösterirken biri düflük p16 ekspresyonu göstermekteydi. 23 olgunun alt›s› ISH pozitif idi. Yüksek p16 ekspresyonu gösteren tüm olgular HPV ISH pozitif iken düflük ekspresyon gösteren bir olgu HPV ISH negatif idi. Tüm p16 pozitif olgular diffüz p16 ekspresyonu göstermekteydi, dolay›s›yla tümör heterojenitesi göstermemekteydi. Sonuç: Yüksek p16 ekspresyonu (>%70) HPV pozitifli¤inin güvenilir bir göstergesidir ve p16 IHC ile kombine etmek spesifitesini art›rmak-tad›r. Olgular tümör heterojenitesi göstermemekte, dolay›s›yla al›nan az miktarda biyopsi parças›nda bile p16 ekspresyonunun gözlenmesi bize tüm tümöral dokuda p16 ekspresyonu oldu¤unu göstermektedir.
Infectious Agents and Cancer, 2012
Background: Recent emerging evidences identify Human Papillomavirus (HPV) related Head and Neck squamous cell carcinomas (HN-SCCs) as a separate subgroup among Head and Neck Cancers with different epidemiology, histopathological characteristics, therapeutic response to chemo-radiation treatment and clinical outcome. However, there is not a worldwide consensus on the methods to be used in clinical practice. The endpoint of this study was to demonstrate the reliability of a triple method which combines evaluation of: 1. p16 protein expression by immunohistochemistry (p16-IHC); 2. HPV-DNA genotyping by consensus HPV-DNA PCR methods (Consensus PCR); and 3 viral integration into the host by in situ hybridization method (ISH). This triple method has been applied to HN-SCC originated from oral cavity (OSCC) and oropharynx (OPSCC), the two anatomical sites in which high risk (HR) HPVs have been clearly implicated as etiologic factors. Methylation-Specific PCR (MSP) was performed to study inactivation of p16-CDKN2a locus by epigenetic events. Reliability of multiple methods was measured by Kappa statistics. Results: All the HN-SCCs confirmed HPV positive by PCR and/or ISH were also p16 positive by IHC, with the latter showing a very high level of sensitivity as single test (100% in both OSCC and OPSCC) but lower specificity level (74% in OSCC and 93% in OPSCC). Concordance analysis between ISH and Consensus PCR showed a faint agreement in OPSCC ( = 0.38) and a moderate agreement in OSCC ( = 0.44). Furthermore, the addition of double positive score (ISHpositive and Consensus PCR positive) increased significantly the specificity of HR-HPV detection on formalin-fixed paraffin embedded (FFPE) samples (100% in OSCC and 78.5% in OPSCC), but reduced the sensitivity (33% in OSCC and 60% in OPSCC). The significant reduction of sensitivity by the double method was compensated by a very high sensitivity of p16-IHC detection in the triple approach.