Hybrid Capture 2 is as Effective as PCR Testing for High Risk Human Papillomavirus in Head and Neck Cancers

摘要

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 X² 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) non-smokers (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.