title: Cytology and human papillomavirus testing on cytobrushing samples from patients with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The increasing incidence of human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) highlights the need for simple and effective tools to evaluate head and neck lesions and their HPV status. The main objective of the current study was to investigate the association between abnormal cytology and HPV infection, assessed on cytobrushing samples, and histologically confirmed HNSCC. Second, the authors attempted to investigate whether HPV status on cytobrushing samples reflected that of the tumoral tissue.
  
  
  METHODS
  A total of 164 samples from HNSCC, nonmalignant lesions, or healthy mucosae of the oral cavity and oropharynx were collected by cytobrushing in PreservCyt solution and evaluated by liquid-based cytology and Linear Array HPV genotyping test. All the findings from the cytologic samples were compared with those from the corresponding histologic samples.
  
  
  RESULTS
  Patients with abnormal cytology had a significantly higher risk of having an HNSCC (odds ratio [OR], 9.18; 95% confidence inteval [95% CI], 3.27-26.49). The association was stronger for oral cancer (OR, 10.86; 95% CI, 2.51-51.06) than oropharyngeal cancer (OR, 8.45; 95% CI, 1.62-49.82). HPV positivity in the oropharyngeal cytobrushing was associated with a nearly 5-fold higher risk of having abnormal cytology (OR, 4.57; 95% CI, 1.57-13.57) as well as histologically proven oropharyngeal cancer (OR, 5.09; 95% CI, 1.09-31.61). Comparing the HPV status on cytologic and corresponding histologic samples from patients with HNSCC, we found that 90.4% of the cases were concordant (kappa, 0.796).
  
  
  CONCLUSIONS
  Abnormal brushing cytology is strongly associated with a diagnosis of HNSCC, whereas HPV positivity on cytobrushing samples is only associated with oropharyngeal cancer. HPV testing on cytobrushing samples represents a valid option for the assessment of HPV infection in patients with oropharyngeal cancer.
authors.affiliation: STI Unit, San Gallicano Dermatological Institute, Rome, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Donà
authors.forename: Massimo
authors.initials: M
authors.lastname: Giuliani
authors.forename: Amina
authors.initials: A
authors.lastname: Vocaturo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spriano
authors.forename: Barbara
authors.initials: B
authors.lastname: Pichi
authors.forename: Francesca
authors.initials: F
authors.lastname: Rollo
authors.forename: Livia
authors.initials: L
authors.lastname: Ronchetti
authors.forename: Renato
authors.initials: R
authors.lastname: Covello
authors.forename: Edoardo
authors.initials: E
authors.lastname: Pescarmona
authors.forename: Maria
authors.initials: M
authors.lastname: Benevolo
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000821:virology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: cytology; head and neck; human papillomavirus; squamous cell carcinoma