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

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.

Estimated projection of oral cavity and oropharyngeal cancer deaths in Spain to 2044

“…However, in females > 65 years, this increase is projected to continue until the end of the period studied. Since HPV infection is a well-established risk factor for a high proportion of oropharyngeal squamous cell carcinomas [12], it seems reasonable to assume that this increase in mortality could correspond to an increase in the incidence of HPV infection. Although information on HPV status was not available in our INE data, a causal association has been reported in the literature, as up to > 80% of OPC patients are infected with HPV [13].…”

Oral and periodontal manifestation related during human papilloma virus infections: Update on early prognostic factors

“…2 ). In most cases the horizontal transmission is sexually, but the virus can spread non sexually through skin-to-skin, skin-to mucosa, or mucosa to mucosa paths [ 33 , 34 ]. The transmission from mother to child can occur not only by the birth canal but also through the placenta or amniotic fluid [ [35] , [36] , [37] , [38] ].…”

“…It was revealed the inapplicability of this method for early detection of HPV driven lesions of the tonsils in vivo since the results were unsatisfactory. However, cytobrushing has been assessed as valid option of detecting HPV infection in oral lesions, especially when it comes to malignant lesions and it's the most valid method of screening for uterine cervical cancer [ 34 , [93] , [94] , [95] , [96] ].…”

Exploring the role of HPV: from Sexually transmitted infection to Oropharyngeal Cancers

“…In a study by Broglie et al, brush cytology was able to detect HPV positivity in 66% patients, but was able to identify dysplastic cells in 88% patients [156]. Castillo et al performed liquid -based brush cytology for detection of HPV in patient suspicious of OPC, with 88% sensitivity of the cytology assessment pre-treatment, 71% post-treatment, while 91% accuracy of HPV-DNA assessment, across 75 patients [157]. In the OHMAR study by Benevolo et al, testing of oropharyngeal cytobrush samples and oral rinse and gargle specimens were testing by cytological evaluation and HPV genotyping, respectively, in a group of men who have sex with men at 6-months intervals.…”