Human papillomavirus (HPV) is an important risk factor in a subset of head and neck squamous cell carcinomas (HNSCC), but the association with oral cavity squamous cell carcinomas (OCSCC) remains controversial. This study aimed to identify the prevalence of HPV infection in OCSCC. A systematic search on PubMed and EMBASE was performed, including articles assessing the prevalence of HPV-positive (HPV+) OCSCC published from January 2017 to December 2022. OCSCC was considered HPV+ by the detection of HPV DNA, HPV RNA, and/or p16 overexpression in the tumor mass. A meta-analysis was made determining the overall HPV+ OCSCC prevalence. We included 31 studies comprising 5007 patients from 24 countries. The study size ranged from 17 to 940 patients. The HPV+ OCSCC proportion variated widely and ranged from 0% to 37%. Tumors in the tongue were the predominant sublocation for HPV in the oral cavity. The meta-analysis revealed that the overall HPV+ OCSCC prevalence is 6% (95% CI; 3–10%), and only one study found HPV and OCSCC significantly associated. Thus, HPV may not be a necessary or a strong risk factor in OCSCC oncogenesis, and the possibility of a site misclassification of a mobile tongue with the root of the tongue cannot be excluded.

Background: In risk assessment of recurrence, papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC) are often grouped together as differentiated thyroid cancer (DTC). However, while risk factors affecting recurrence of PTC are well established, risk factors for recurrence of FTC are not. This systematic review examines risk factors for recurrence of FTC and evaluates their significance. Methods: A systematic search on PubMed and Embase was performed in September 2020, including studies evaluating risk factors for recurrence of FTC. A quality assessment of the enrolled studies was performed. Results: Nine studies (n = 1544 patients) from eight countries were included. The average recurrence rate was 13.6%, and distant metastasis (DM) constituted 64.8% of the recurrent cases. The risk factors examined were sex, age at diagnosis, primary tumor size, degree of invasiveness, focality, positive resection margin, lymph node (LN) metastasis, and DM at diagnosis. Risk factors correlated with recurrence of FTC were age older than 45 years, primary tumor size above 40 mm, widespread invasion, multifocality, positive resection margin, LN metastasis, and DM at diagnosis. Sex was not a statistically significant risk factor. Conclusions: We identified seven risk factors associated with recurrence of FTC. Age and multifocality were found to be of greater impact regarding recurrence risk of FTC compared with PTC. Future research needs to address the impact of different risk factors for recurrence of FTC particularly including age, primary tumor size, angioinvasion, and mutational status.

BACKGROUND Mass testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been an important tool to limit the spread of infection in society during the coronavirus disease 19 (COVID-19) pandemic. Proper upper respiratory specimen collection is the most critical step in the diagnosis of the SARS-CoV-2 virus in public settings. An oropharyngeal swab (OPS) specimen is the preferred sample in many countries, either alone or combined with nasal swab. However, there is great variability in the diagnostic accuracy for OPS with a 95% confidence interval from 52-100% reported in systematic reviews. Many of the previous studies performing OPS also lack a detailed description of the OPS sampling technique, which makes it difficult to compare the different diagnostic accuracy results. Some studies perform an oropharyngeal sample by only collecting specimens from the posterior oropharyngeal wall while others also include a swab of the palatine tonsils for SARS-CoV-2 testing. However, studies suggest that the palatine tonsils could have a tissue tropism for SARS-CoV-2 which may improve the SARS-CoV-2 detection during sampling. This may explain the variation of sensitivity reported, but no clinical studies have explored the differences between the two sample techniques. OBJECTIVE The objective of this study is to examine the sensitivity of an OPS sample, including the palatine tonsils, compared to only swabbing the posterior oropharyngeal wall in molecular detection of SARS-CoV-2. METHODS We will conduct a randomized, controlled study to compare the molecular detection rate of SARS-CoV-2 by an OPS performed from the posterior oropharyngeal wall and the palatine tonsils (intervention group) or the posterior oropharyngeal wall only (control group). Participants will be randomized in a 1:1 ratio. All participants fill out a baseline questionnaire on the day of the test examining their reason for being tested, symptoms etc. and a follow up questionnaire three months later exploring the course of illness. RESULTS A total of 2361 participants we enrolled in this study between November 10th 2022 and December 31st 2022 and data from follow up questionnaires are expected to be collected until May 1st 2023. CONCLUSIONS This randomized clinical trial will provide us with information about whether oropharyngeal swabs including specimens from the palatine tonsils will improve the diagnostic sensitivity for SARS-CoV-2 molecular detection. These results can, therefore, be used to improve future testing recommendations as well as it will provide additional information about the tissue tropism for SARS-CoV-2. CLINICALTRIAL The protocol was registered with the ClinicalTrials.gov database (NCT05611203).

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