title: Sensitivity of tumor surface brushings to detect human papilloma virus DNA in head and neck cancer.
abstract: Human papilloma virus (HPV) induced head and neck squamous cell carcinoma (HNSCC) represents a distinct tumor subset. We questioned how accurately a brushing from the tumor surface detects HPV in patients with HNSCC.
  
  
  
  Brushings from the tumor surface were compared with HPV DNA isolation from formalin-fixed and paraffin-embedded (FFPE) tumor biopsies, which served as the reference standard. In both matrices, HPV DNA was detected using a commercially available test kit. In addition, p16 was assessed in tumor biopsies by immunohistochemistry (IHC). The tumors were considered p16 positive if 70% or more of cancer cells expressed p16.
  
  
  
  93 patients with HNSCC were included. Sensitivity and specificity of the brush test were 83% (95%CI: 67-92%) and 85% (95%CI: 72-93%). Results of p16 IHC were concordant with FFPE samples DNA determinations in 73/93 patients. In 53 patients (57%) the tumor was located in the oropharynx and in 40 patients (43%) the tumor was located in the non-oropharynx region. Sensitivity and specificity of the brush test in patients with oropharyngeal cancer was higher with 86% (95%CI: 70-95%) and 89% (95%CI: 65-99%).
  
  
  
  Superficial brushes from the tumor surface may be used to identify HPV positive HNSCC.
authors.affiliation: Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address: ba.kofler@tirol-kliniken.at.
authors.forename: Barbara
authors.initials: B
authors.lastname: Kofler
authors.affiliation: Division of Virology, Department of Hygiene, Microbiology, Social Medicine, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, 6020 Innsbruck, Austria.
authors.forename: Wegene
authors.initials: W
authors.lastname: Borena
authors.affiliation: Department of Pathology, Medical University of Innsbruck, Müllerstrasse 44, 6020 Innsbruck, Austria.
authors.forename: Claudia
authors.initials: C
authors.lastname: Manzl
authors.affiliation: Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Dudas
authors.affiliation: Department of Pathology, Medical University of Innsbruck, Müllerstrasse 44, 6020 Innsbruck, Austria.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Wegscheider
authors.affiliation: Institute for Biomedical Ageing Research, Medical University of Innsbruck, Rennweg 10, 6020 Innsbruck, Austria.
authors.forename: Pidder
authors.initials: P
authors.lastname: Jansen-Dürr
authors.affiliation: Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Volker
authors.initials: V
authors.lastname: Schartinger
authors.affiliation: Department of Otorhinolaryngology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Riechelmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000821:virology*; D006801:Humans; D057230:Limit of Detection; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D004279:DNA, Viral
keywords: Brush test; Head and neck cancer; Human papillomavirus; p16