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Human papillomavirus testing in metastatic squamous cell carcinoma of the neck with unknown primary using PCR on fine-needle aspiration smears: a prospective clinical study

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

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.

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Data availability

Data of this study are available from the corresponding author upon specific and reasonable request.

Code availability

Not applicable.

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Acknowledgements

We acknowledge the close collaboration with Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. The authors also acknowledge head and neck pathologists Tina Agander and Giedrius Lelkaitis for their contribution in the study.

Funding

The authors received no funding for the publication of this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 8, 2100, Copenhagen, Denmark

    Hani Ibrahim Channir, Anne Fog Lomholt, Birgitte Wittenborg Charabi & Christian von Buchwald

  2. Department of Biostatistics Copenhagen, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen, Denmark

    Thomas Alexander Gerds

  3. Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Katalin Kiss

Authors
  1. Hani Ibrahim Channir
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  2. Anne Fog Lomholt
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  3. Thomas Alexander Gerds
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  4. Birgitte Wittenborg Charabi
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  5. Katalin Kiss
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  6. Christian von Buchwald
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Contributions

Study design and concept: HIC, AFL, TAG, KK, and CvB; data acquisition, statistical analysis, and interpretation: HIC, AFL, TAG, and KK; drafting of manuscript including critical revision, review, and final approval: all authors.

Corresponding author

Correspondence to Hani Ibrahim Channir.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

This study was approved by the Regional Scientific Ethics Committee (H-16037827) and the Danish Data Protection Agency.

Consent to participate

All patients received both written and verbal information about the protocol. Informed consent form was signed by the patient, and by one of the primary or co-investigators prior to inclusion.

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Informed consent for publication was given by all patients.

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Channir, H.I., Lomholt, A.F., Gerds, T.A. et al. Human papillomavirus testing in metastatic squamous cell carcinoma of the neck with unknown primary using PCR on fine-needle aspiration smears: a prospective clinical study. Eur Arch Otorhinolaryngol 279, 3115–3121 (2022). https://doi.org/10.1007/s00405-021-07133-5

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  • DOI: https://doi.org/10.1007/s00405-021-07133-5

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