title: HPV DNA in saliva from patients with SCC of the head and neck is specific for p16-positive oropharyngeal tumours.
abstract: Human papillomavirus (HPV) is an important cause of head and neck squamous cell carcinoma (HNSCC), especially in young people. These tumours overexpress p16 and respond well to treatment. The rapid detection of HPV in patients with HNSCC may expedite treatment when p16 status is not immediately available.
  
  
  
  Saliva-based DNA collection kits and nested polymerase chain reaction (PCR) were used to determine the HPV status of 62 individuals with biopsy-proven HNSCC. Immunohistochemistry was used to determine tumour p16 status.
  
  
  
  A total of 62 patients were included in the study. Twenty-nine samples (47%) were positive for HPV DNA, the majority of which were high risk (HR) subtypes (79%). Patients who tested positive for HR HPV were more likely to have a tumour arising in the oropharynx compared to a non-oropharyngeal site (74 vs 26%; p = 0.003). A positive HR HPV saliva assay was 100% specific (95% CI 59-100%) and had a 100% positive predictive value (95% CI 75-100%) for a p16 positive tumour arising in the oropharynx. In contrast, a negative HR HPV assay had a 96% negative predictive value (95% CI 80-100%) for tumours arising in a non-oropharyngeal site. Independent of site, the saliva assay had a sensitivity of 77% (95% CI 54-91%) and a specificity of 94% (95% CI 77-99%), respectively, for a p16 positive tumour.
  
  
  
  We show that a saliva based assay is an effective method for detecting HPV in patients with HNSCC and that a positive HR HPV test is highly specific for p16 positive tumours arising in the oropharynx. This simple and rapid test could be used in cases where a biopsy of the primary tumour is not readily available.
authors.affiliation: Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Jason K
authors.initials: JK
authors.lastname: Wasserman
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The University of Ottawa and The Ottawa Hospital, Ottawa Hospital-General Campus S3, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada.
authors.forename: Ryan
authors.initials: R
authors.lastname: Rourke
authors.affiliation: Department of Pathology and Laboratory Medicine, Division of Anatomical Pathology, The University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Bibianna
authors.initials: B
authors.lastname: Purgina
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The University of Ottawa and The Ottawa Hospital, Ottawa Hospital-General Campus S3, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Caulley
authors.affiliation: Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Jim
authors.initials: J
authors.lastname: Dimitroulakos
authors.affiliation: Aurora St. Luke's Hospital, Milwaukee, WI, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Corsten
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The University of Ottawa and The Ottawa Hospital, Ottawa Hospital-General Campus S3, 501 Smyth Rd, Ottawa, Ontario, K1H 8L6, Canada. sjohnsonobaseki@gmail.com.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnson-Obaseki
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000821:virology*; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D004279:DNA, Viral / Q000378:metabolism*; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000378:metabolism / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D012463:Saliva / Q000378:metabolism / Q000821:virology*; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral
keywords: Head and neck cancer; Human papillomavirus; Oropharyngeal cancer; Screening