Clinical efficacy of an antibody-based detection system for human papilloma virus infection in oral squamous cell carcin
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ORIGINAL ARTICLE
Clinical efficacy of an antibody-based detection system for human papilloma virus infection in oral squamous cell carcinoma Sebastian Blatt 1
&
Andreas Pabst 2 & Stefanie Zimmer 3 & Christian Walter 4 & Bilal Al-Nawas 1 & Maximilian Krüger 1
Received: 18 March 2020 / Accepted: 17 September 2020 # The Author(s) 2020
Abstract Objectives There is an increasing number of oral squamous cell carcinoma (OSCC) associated with HPV-16. However, p16 expression by immunohistochemistry as the current gold standard for a surrogate marker for virus infection reveals unsatisfying diagnostic accuracy. The aim of this study was to investigate a new rapid test for L1 antibody detection (Prevocheck®) and to validate its diagnostic performance. Materials and methods In a prospective study, the HPV 16 association of all consecutive patients with an OSCC treated between 2015 and 2019 were analyzed by L1 seropositivity (via PrevoCheck®), p16 immunostaining, and partly multiplex PCR for subtype analysis. Results Overall (n = 107), p16 expression was positive in 17 cases (15.9%), and L1 antibody seropositivity in 7 cases (6.5%). In PCR analysis, two cases of HPV35 and 50 were found. Total HPV prevalence was 8.4% overall and 6.5% for HPV-16. An inferior diagnostic accuracy for HPV-16-associated OSCC in comparison to PrevoCheck® was revealed. Conclusion The rapid test for L1 antibodies showed an optimal sensitivity and specificity, positive and negative predictive value, and an overall diagnostic accuracy of 100%. However, HPV prevalence seems low in OSCC. Clinical relevance L1 rapid test may represent an additional diagnostic staging method to detect HPV-16 association rather than p16 immunohistochemistry. Keywords Oral cancer . Head and neck cancer . Human papilloma virus . HPV . p16 expression . Biomarker
Introduction In head and neck oncology, oral squamous cell carcinoma (OSCC) is still an urgent health threat with a growing morbidity in various countries [1, 2]. While the incidence of OSCC related to the main risk factors tobacco and alcohol consumption is decreasing, there is an increasing number of OSCC
* Sebastian Blatt [email protected] 1
Department of Oral- and Maxillofacial Surgery - Plastic Surgery, University Medical Centre, Augustusplatz 2, 55131 Mainz, Germany
2
Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
3
Department of Pathology, University Medical Centre, Langenbeckstraße 1, 55131 Mainz, Germany
4
Oral- and Maxillofacial Surgery - Facial Plastic Surgery, Mediplus Clinic, Haifa-Allee 20, 55128 Mainz, Germany
associated with human papilloma virus (HPV), more precisely to the high risk type HPV 16 [3]. While many older studies reported a higher prevalence of HPV infection in OSCC (up to 82%) without differentiation between oropharyngeal squamous cell carcinoma (OPSCC) and OSCC, more recent studies revealed a lower overall prevalence of HPV infection in SCC located in the oral cavity of about 7% [4–7
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