gms | German Medical Science

Background: High-risk human papillomavirus (HPV) infection could be identified as a relevant risk for the development of head and neck squamous cell carcinomas (HNSCC) and the incidence of HPV positiv cancers is still on the rise. As HPV status has also gained a role as prognostic and predictive biomarker for this entity, there is a growing demand for valid HPV testing in HNSCC patients. However, currently used tests can still not distinguish between a latent HPV infection with the potential of selflimitation and a HPV infection leading to cancerous transformation.

Methods: Liquid-based cytological suspensions from 45 HNSCC patients (swab from tumor surface), 15 HNSCC control patients (swab from tumor-free oral mucosa) and 5 control patients (swab from healthy mucosa) were used for the detection of high-risk HPV-DNA by PCR and a simultaneous immunocytochemical detection of p16 and Ki67 applying the CINtecPLUS kit (Roche mtm laboratories, Heidelberg, Germany) that is routinely used in gynecology.

Results: Tumor cells were detected in the swab material from 44/45 (98%) HNSCC patients. In 13/65 (20%) cases, high-risk HPV-DNA could be detected in the cytological suspension. From these HPV-DNA-positive cases, tumor cells showed a simultaneous expression of Ki67 and p16 in 9 samples (69%) representing a staining pattern that is strongly associated with a carcinogenic high-risk HPV infection.

Conclusions: A simultaneous immunocytochemical detection of p16 and Ki67 can reliably be performed on liquid-based cytological smears of HNSCC using the CINtecPLUS kit and the same cytological material can be used for the detection of HPV-DNA by PCR. Results enable a discrimination between latent and carcinogenic HPV infections and thus can provide information on the prognosis of HNSCC patients and facilitate therapeutic decisions.