title: Current and future techniques for human papilloma virus (HPV) testing in oropharyngeal squamous cell carcinoma.
abstract: Despite a reduction in smoking and alcohol consumption, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) is rising. This is attributed to human papilloma virus (HPV) infection and screening for HPV is now recommended in all cases of OPSCC. Despite a variety of clinically available tests and new non-invasive test strategies there is no consensus on which technique is best. This review reports on current techniques for HPV detection in OPSCC and the clinical applicability of emerging techniques. Literature searches of Medline, Embase and clinicaltrials.gov using the search terms 'head and neck neoplasms', 'squamous cell carcinoma' and 'HPV testing' were performed. 45 studies were identified and included. p16 immunohistochemistry (IHC), HPV DNA in situ hybridization (ISH) and HPV polymerase chain reaction (PCR) are the commonest tests to determine HPV status. p16 IHC and HPV DNA PCR are highly sensitive whilst HPV DNA ISH is more specific, these techniques conventionally utilize surgical biopsies. New tests using PCR to screen fine needle aspirates, saliva, brush cytology and serum for HPV are promising but have variable sensitivity and specificity. These non-invasive samples avoid the morbidity of surgical biopsies and need for tissue blocks; their clinical role in screening and surveillance remains largely untested. Further work is needed to validate these tests and define their role.
authors.affiliation: Department of Otolaryngology, Oxford University Hospitals NHS Trust, Oxford, England. aliqureishi@googlemail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Qureishi
authors.affiliation: Department of Otolaryngology, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mawby
authors.affiliation: Department of Otolaryngology, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Lisa
authors.initials: L
authors.lastname: Fraser
authors.affiliation: Department of Histopathology, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Ketan A
authors.initials: KA
authors.lastname: Shah
authors.affiliation: Cancer Epidemiology and Population Health, Kings College London, London, UK.
authors.forename: Henrik
authors.initials: H
authors.lastname: Møller
authors.affiliation: Department of Otolaryngology, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Stuart
authors.initials: S
authors.lastname: Winter
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D009959:Oropharyngeal Neoplasms / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000821:virology; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000821:virology; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral
keywords: HPV; Immunohistochemistry; In-situ hybridisation; Liquid-biopsy; Oropharyngeal SCC; PCR