TY - JOUR

T1 - Human papillomavirus testing in metastatic squamous cell carcinoma of the neck with unknown primary using PCR on fine-needle aspiration smears

T2 - a prospective clinical study

AU - Channir, Hani Ibrahim

AU - Lomholt, Anne Fog

AU - Gerds, Thomas Alexander

AU - Charabi, Birgitte Wittenborg

AU - Kiss, Katalin

AU - von Buchwald, Christian

N1 - Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2022

Y1 - 2022

N2 - Purpose: Squamous cell carcinoma metastasis of the head and neck with unknown primary tumor (CUP) comprises a diagnostic challenge. Human papillomavirus (HPV) testing on cytologic specimens is gaining increasing focus as this may facilitate an early diagnosis of HPV-induced oropharyngeal carcinoma. This study aimed to prospectively assess PCR-based HPV-DNA testing on FNA smears in a clinical setting. Methods: Patients referred to a tertiary Head and Neck Cancer Center with suspected CUP were included from November 2016 to November 2018. Scraped cell material from FNA smears was analyzed for HPV-DNA with PCR using general primers (GP5 + /GP6 +) and correlated with the origin and histology of the primary tumor (oropharynx vs. outside oropharynx or benign tumor). The turn-around time reflecting the workflow for HPV-DNA testing by PCR was also calculated. Results: A total of 93 patients were enrolled in the study. The sensitivity and specificity were 86.7% [95% CI 75.4–94.1%] and 92.0% [95% CI 74.0–99.0%], and the positive and negative predictive values were 96.3% [95% CI 87.3–99.0%] and 74.2% [95% CI 59.9–84.7%], respectively. The turn-around time for HPV testing was a mean four calendar days. Conclusion: HPV-DNA testing on FNA smears can be performed within a reasonable timeframe and can guide for the detection of an HPV-positive oropharyngeal primary tumor in the clinical setting for patients presenting with CUP of the head and neck.

AB - Purpose: Squamous cell carcinoma metastasis of the head and neck with unknown primary tumor (CUP) comprises a diagnostic challenge. Human papillomavirus (HPV) testing on cytologic specimens is gaining increasing focus as this may facilitate an early diagnosis of HPV-induced oropharyngeal carcinoma. This study aimed to prospectively assess PCR-based HPV-DNA testing on FNA smears in a clinical setting. Methods: Patients referred to a tertiary Head and Neck Cancer Center with suspected CUP were included from November 2016 to November 2018. Scraped cell material from FNA smears was analyzed for HPV-DNA with PCR using general primers (GP5 + /GP6 +) and correlated with the origin and histology of the primary tumor (oropharynx vs. outside oropharynx or benign tumor). The turn-around time reflecting the workflow for HPV-DNA testing by PCR was also calculated. Results: A total of 93 patients were enrolled in the study. The sensitivity and specificity were 86.7% [95% CI 75.4–94.1%] and 92.0% [95% CI 74.0–99.0%], and the positive and negative predictive values were 96.3% [95% CI 87.3–99.0%] and 74.2% [95% CI 59.9–84.7%], respectively. The turn-around time for HPV testing was a mean four calendar days. Conclusion: HPV-DNA testing on FNA smears can be performed within a reasonable timeframe and can guide for the detection of an HPV-positive oropharyngeal primary tumor in the clinical setting for patients presenting with CUP of the head and neck.

KW - Fine-needle aspiration

KW - Human papillomavirus (HPV)

KW - Oropharyngeal cancer

KW - Polymerase chain reaction (PCR)

KW - Squamous cell carcinoma

U2 - 10.1007/s00405-021-07133-5

DO - 10.1007/s00405-021-07133-5

M3 - Journal article

C2 - 34689237

AN - SCOPUS:85117784468

VL - 279

SP - 3115

EP - 3121

JO - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

JF - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

SN - 0942-8992

ER -