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. 2022 Mar;26(3):2587-2595.
doi: 10.1007/s00784-021-04228-5. Epub 2021 Nov 27.

Accuracy of liquid-based brush cytology and HPV detection for the diagnosis and management of patients with oropharyngeal and oral cancer

Paola Castillo  1   2   3 , Jorge de la Oliva  1   2 , Silvia Alos  1 , Francisco Perez  1 , Naiara Vega  1 , Isabel Vilaseca  2   3   4   5 , Carles Marti  6 , Ada Ferrer  6 , Llucia Alos  7   8   9
Affiliations

Accuracy of liquid-based brush cytology and HPV detection for the diagnosis and management of patients with oropharyngeal and oral cancer

Paola Castillo et al. Clin Oral Investig. 2022 Mar.

Abstract

Objectives: This study aims to evaluate the usefulness of liquid-based brush cytology for malignancy diagnosis and HPV detection in patients with suspected oropharyngeal and oral carcinomas, as well as for the diagnosis of tumoral persistence after treatment.

Material and methods: Seventy-five patients with suspicion of squamous cell carcinoma of the oropharynx or oral cavity were included. Two different study groups were analyzed according to the date of the sample collection: (1) during the first endoscopy exploration and (2) in the first control endoscopy after treatment for squamous cell carcinoma. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for malignancy diagnosis as well as for HPV-DNA detection on brush cytologies were assessed.

Results: Before treatment, the brush cytology showed a sensitivity of 88%, specificity of 100%, and accuracy of 88%. After treatment, it showed a sensitivity of 71%, specificity of 77%, and accuracy of 75%. HPV-DNA detection in cytology samples showed a sensitivity of 85%, specificity of 100%, and accuracy of 91% before treatment and an accuracy of 100% after treatment.

Conclusions: Liquid-based brush cytology showed good accuracy for diagnosis of oropharyngeal and oral squamous cell carcinoma before treatment, but its value decreases after treatment. Nevertheless, it is useful for HPV-DNA detection, as well as to monitor the patients after treatment.

Clinical relevance: Brush cytology samples are reliable for the detection of HPV-DNA before and after treatment and may be a useful method to incorporate in the HPV testing guidelines.

Keywords: Cytology cytobrush; High-risk human papillomavirus; Oral carcinoma; Oropharyngeal carcinoma; Squamous cell carcinoma; p16.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Number of cytobrush samples included in each study groups for cytology diagnosis and HPV-DNA testing
Fig. 2
Fig. 2
Examples of cytologic specimens from oropharyngeal and oral cavity squamous cell carcinomas: a atypical cells from an oropharyngeal HPV-related squamous cell carcinoma, before treatment; b atypical cells from an oral cavity squamous cell carcinoma, before treatment; c atypical cells from the oropharynx in a patient without tumoral persistence, attributed to reactive changes secondary to received treatment. Note the similarities within the three samples, all showing high nucleus/cytoplasm ratio, visible and irregularly dispersed nucleoli, and atypical chromatin with nuclear clearing. Elongated, spindle-shaped cells are observed in samples B and C
See this image and copyright information in PMC

References

    1. Gillison ML (2000) Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92(9):709–720 - PubMed
    1. Leemans CR, Snijders PJF, Brakenhoff RH. The molecular landscape of head and neck cancer. Nat Rev Cancer. 2018;18(5):269–282. doi: 10.1038/nrc.2018.11. - DOI - PubMed
    1. Tumban E. A current update on human papillomavirus-associated head and neck cancers. Viruses. 2019;11(10):922. doi: 10.3390/v11100922. - DOI - PMC - PubMed
    1. Ndiaye C, Mena M, Alemany L, Arbyn M, Castellsagué X, Laporte L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15(12):1319–1331. doi: 10.1016/S1470-2045(14)70471-1. - DOI - PubMed
    1. Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24–35. doi: 10.1056/NEJMoa0912217. - DOI - PMC - PubMed

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