HPV detection

HPV 检测
  • 文章类型: Journal Article
    越来越多的证据表明,高风险人乳头瘤病毒(HR-HPV)与口咽鳞状细胞癌(OPSCC)的病因有关。在这方面,国际癌症研究机构(IARC)建议直接进行分子HPV检测。到目前为止,对于在OPSCC福尔马林固定石蜡包埋(FFPE)材料上检测HPV的最合适方法尚无一致意见.在这项研究中,我们旨在评估与LiPA-25和p16ink4a免疫染色相比,高敏SureXHPV检测在OPSCCFFPE组织中的性能。2008年至2019年期间,由河南省肿瘤医院提供的一系列FFPE原发性OPSCC病例的回顾性诊断,中国。使用Cohen的Kappa(κ)统计量确定两个测定的一致性水平。检测到来自肿瘤切除(n=160)和诊断活检(n=70)的总共230个FFPEOPSCC样品。66份(28.7%)和70份(30.4%)样本被LiPA-25和SureX鉴定为HPV-DNA阳性,分别,其中HPV16主要是最常见的类型(95.5%vs94.3%)。我们发现LiPA-25和SureX在HPV-DNA状态(κ=0.906,95%CI:0.875-0.937)和HPV16(κ=0.925,95%CI:0.897-0.953)之间存在完美的一致性。此外,SureX和p16ink4a免疫染色具有完美的一致性(κ=0.917,95%CI:0.888-0.946)。此外,HPV驱动的部分,基于HPV-DNA和p16ink4a的双重阳性,SureX(230中的63,27.4%)和LiPA-25(230中的60,26.1%)相似。在来自切除和活检的样品中发现了类似的结果。SureX和LiPA-25相当。SureX可用于档案OPSCCFFPE组织的常规HPV-DNA检测和基因分型。
    Accumulating evidence has demonstrated that high-risk human papillomaviruses (HR-HPVs) are involved in the etiology of a subset of oropharyngeal squamous cell carcinoma (OPSCC). In this regard, the International Agency for Research on Cancer (IARC) has recommended direct molecular HPV testing. So far, there is no agreement on the most appropriate method for HPV detection on OPSCC formalin-fixed paraffin-embedded (FFPE) materials. In this study, we aimed to evaluate the performance of the high-sensitive SureX HPV assay in OPSCC FFPE tissues compared with LiPA-25 and p16ink4a immunostaining. A retrospective series of FFPE primary OPSCC cases were diagnosed between 2008 and 2019 and provided by the Henan Cancer Hospital, China. The level of agreement of two assays was determined using Cohen\'s Kappa (κ) statistics. A total of 230 FFPE OPSCC samples from tumor resections (n = 160) and diagnostic biopsies (n = 70) were detected. Sixty-six (28.7%) and 70 (30.4%) samples were identified as HPV-DNA-positive by LiPA-25 and SureX, respectively, of which HPV16 was largely the most common type (95.5% vs 94.3%). We found a perfect concordance between LiPA-25 and SureX for HPV-DNA status (κ = 0.906, 95% CI: 0.875-0.937) and for HPV16 (κ = 0.925, 95% CI: 0.897-0.953). In addition, SureX and p16ink4a immunostaining had a perfect concordance (κ = 0.917, 95% CI: 0.888-0.946). Moreover, the HPV-driven fraction, based on double positivity for HPV-DNA and p16ink4a, was similar between SureX (63 of 230, 27.4%) and LiPA-25 (60 of 230, 26.1%). Similar results were found in samples from resections and biopsies. SureX and LiPA-25 are comparable. SureX could be used for routine HPV-DNA detection and genotyping on archival OPSCC FFPE tissues.
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  • 文章类型: Journal Article
    简介世界卫生组织指出,几乎所有宫颈癌病例都与通过性接触传播的高风险人类乳头瘤病毒感染有关。实施有效的监视和预防措施将使大多数宫颈癌病例得以预防,尤其是感染艾滋病毒的妇女。每年,尼日利亚大约有12,000名妇女被诊断出,近8000人死亡。尼日利亚的HPV宫颈癌检测能力很低。在整个卫生设施中测试扩大规模和宣传工作,包括宫颈组织样本采集,需要减少宫颈癌的病例。这项研究旨在评估尼日利亚HIV感染妇女中临床相关高危HPV的基因型特异性患病率。方法A描述性,在尼日利亚四个州的医疗机构就诊的成年HIV感染女性中进行了横断面研究.2022年8月至10月,将宫颈组织收集到PCR细胞培养基中,运送到尼日利亚医学研究所,并使用Cobas6800系统(罗氏诊断)测定HPV的存在和基因型。用Stata2进行统计分析。结果共检测4423份宫颈拭子样本。女性年龄18~72岁(平均36.61±8.61)。在我们的研究中,我们发现16.3%的参与者HPV检测呈阳性.在检测到的高危HPV基因型中,HPV16在1.44%的参与者中存在,HPV18占1.29%,其他高危型HPV(OHR-HPV)占11.35%。此外,观察到共同感染,0.98%的参与者对HPV16和OHR-HPV均呈阳性,HPV18和OHR-HPV为1.12%,HPV16、HPV18和OHR-HPV的发生率为0.12%。然而,总结果的7.4%被认为无效。结论OHR-HPV在尼日利亚北部和西部地缘政治区的HIV感染妇女中普遍存在。正在积极寻求旨在减少宫颈癌发病率的政策和干预措施。
    Introduction The World Health Organization states that almost all cervical cancer cases are linked to infection with high-risk human papillomaviruses transmitted through sexual contact. Implementing effective surveillance and preventive measures would enable the prevention of most cervical cancer cases, especially in HIV-infected women. Every year, about 12,000 women in Nigeria are diagnosed, with almost 8,000 deaths. HPV cervical cancer testing capacity is low in Nigeria. Testing scale-up and sensitization efforts across health facilities, including cervical tissue sample collection, are needed to reduce the cases of cervical cancer. This study aimed to assess the genotype-specific prevalence of clinically relevant high-risk HPV among women living with HIV in Nigeria. Methods A descriptive, cross-sectional study was conducted among adult HIV-infected women attending health facilities in four Nigerian states. From August to October 2022, cervical tissue was collected into PCR cell media, transported to the Nigerian Institute of Medical Research, and assayed for HPV presence and genotype using the Cobas 6800 System (Roche Diagnostics). Statistical analysis was conducted with Stata 2. Results A total of 4423 cervical swab samples were tested. The ages of women ranged from 18 to 72 years (mean 36.61±8.61). In our study, we found that 16.3% of participants tested positive for HPV. Among the high-risk HPV genotypes detected, HPV16 was present in 1.44% of participants, HPV18 in 1.29%, and other high-risk HPV (OHR-HPV) in 11.35%. Additionally, co-infections were observed, with 0.98% of participants testing positive for both HPV16 and OHR-HPV, 1.12% for HPV18 and OHR-HPV, and 0.12% for HPV16, HPV18, and OHR-HPV concurrently. However, 7.4% of the total results were deemed invalid. Conclusion OHR-HPV is prevalent among HIV-infected women across the north and west geopolitical zones of Nigeria. Policies and interventions geared towards curtailing the incidence of cervical cancer are fervently solicited.
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  • 文章类型: Journal Article
    目的:该研究的目的是评估HBRT-H14的临床表现,这是一种基于实时PCR的检测方法,可将人乳头瘤病毒(HPV)16和HPV18与其他12种高危(HR)HPV类型分开。根据中国的指导方针。
    方法:9829名符合条件的21-64岁河南省妇女,山西和广东省在基线时进行HBRT-H14检测和液基细胞学(LBC)筛查,并随访三年。敏感性,特异性,阳性预测值(绝对风险),并计算了宫颈上皮内瘤变2级或更差(CIN2+)病变的LBC诊断和HPV检测的阴性预测值。
    结果:在基线时,80例(0.81%)参与者被诊断为N2+CI。具有反射性LBC的HR-HPV具有明显更高的敏感性(78/80,97.50%[95%CI:91.34-99.31%]与62/80,77.50%[67.21-85.27%],PMcNemar<0.001),和略低的特异性(8528/9749,87.48%[86.80-88.12%]vs.8900/9749,91.29%[90.72-91.83%],PCMcNemar<0.001)比具有反射性HR-HPV的LBC为N2+。7832名(79.6%)参与者完成了3年随访,172名(2.20%)参与者累计诊断为CIN2+。与具有反射性HR-HPV的LBC相比,具有反射性LBC的HR-HPV的敏感性显着增加(161/172,93.60%[88.91-96.39%]vs.87/172,50.58%[43.18-57.96%],PMcNemar<0.001),但特异性略有下降(6776/7660,88.46%[87.72-89.16%]与6933/7660,90.51%[89.83-91.15],PCMcNemar<0.001)。此外,HPV16/18阳性个体的三年CIN2+绝对风险高达33%(80/238),而HPV阴性人群的风险仅为0.16%(11/6787),远低于上皮内病变或恶性肿瘤(NILM)阴性人群(1.21%,85/7018)。此外,在≥30岁的女性中也发现了类似的结果。
    结论:研究表明HBRT-14在宫颈筛查中具有可靠的临床应用性能。验证的HPV检测将提高人群筛查的质量。
    OBJECTIVE: The aim of the study was to evaluate the clinical performance of HBRT-H14, a real-time PCR-based assay that separates human papillomavirus (HPV) 16 and HPV18 from 12 other high-risk (HR) HPV types, in population according to Chinese guideline.
    METHODS: A total of 9829 eligible women aged 21-64 years from Henan, Shanxi, and Guangdong provinces were performed by HBRT-H14 testing and liquid-based cytology (LBC) screening at baseline and followed up for 3-year. The sensitivity, specificity, positive predictive value (absolute risk), and negative predictive value of LBC diagnosis and HPV testing were calculated for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) Lesions.
    RESULTS: At baseline, 80 (0.81%) participants were diagnosed with CIN2+. HR-HPV with reflex LBC had a significantly higher sensitivity (78/80, 97.50% [95% CI, 91.34-99.31%] vs. 62/80, 77.50% [67.21-85.27%], McNemar\'s test p < 0.001), and a slightly lower specificity (8528/9749, 87.48% [86.80-88.12%] vs. 8900/9749, 91.29% [90.72-91.83%], McNemar\'s test p < 0.001) than LBC with reflex HR-HPV for CIN2+. 7832 (79.6%) participants completed 3-year follow-up and 172 (2.20%) participants were cumulatively diagnosed with CIN2+. Compared with LBC with reflex HR-HPV, HR-HPV with reflex LBC significantly increased the sensitivity (161/172, 93.60% [88.91-96.39%] vs. 87/172, 50.58% [43.18-57.96%], McNemar\'s test p < 0.001), but marginally decreased the specificity (6776/7660, 88.46% [87.72-89.16%] vs. 6933/7660, 90.51% [89.83-91.15], McNemar\'s test p < 0.001). In addition, the absolute 3-year risk of CIN2+ in HPV16/18-positive individuals was as high as 33% (80/238), whereas the risk in the HPV-negative population was only 0.16% (11/6787), much lower than those in the negative for intraepithelial lesion or malignancy population (1.21%, 85/7018). Moreover, similar results were found in women ≥30 years old.
    CONCLUSIONS: The study has indicated that HBRT-14 has a reliable clinical performance for use in cervical screening. The validated HPV test would improve the quality of population screening.
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  • 文章类型: Journal Article
    核酸适体由于其独特的分子识别能力而在诊断和治疗应用中具有巨大的潜力。然而,具有高亲和力和特异性的令人满意的适体仍然短缺。在这里,我们已经开发了新的选择方法,允许靶标和溶液中潜在的适体之间的自由相互作用。在我们的选拔系统中,首先将蛋白质靶标(随机或位点特异性生物素化)与随机DNA文库一起孵育,然后用链霉亲和素磁珠或生物层干涉(BLI)传感器进行下拉。通过比较两种生物素化策略(随机或位点特异性)和靶标的两种状态(游离或固定),我们发现位点特异性生物素化和无靶点策略的组合是最成功的.基于这些高效的选择策略,获得HPVL1适体。通过设计RCA和CRISPR/Cas12a辅助的三明治aptasensor,我们在临床样本中诊断出各种HPV亚型,例如容易收集的尿液样本。总之,我们的新策略可以有效选择具有高亲和力和特异性的适体,用于临床应用。
    Nucleic acid aptamers are of great potentials in diagnostic and therapeutic applications because of their unique molecular recognition capabilities. However, satisfactory aptamers with high affinity and specificity are still in short supply. Herein, we have developed new selection methods allowing the free interactions between the targets and potential aptamers in solution. In our selection system, the protein targets (biotinylated randomly or site-specifically) were first incubated with the random DNA library, followed by the pull-down with the streptavidin magnetic beads or biolayer-interferometry (BLI) sensors. By comparing the two biotinylation strategies (random or site-specific) and two states of the targets (free or immobilized), we have found that the combination of the site-specific biotinylation and free-target strategies was most successful. Based on these highly-efficient selection strategies, HPV L1 aptamers were obtained. By designing the sandwich aptasensor assisted with RCA and CRISPR/Cas12a, we have diagnosed various HPV subtypes in clinical samples, such as easily-collected urine samples. In summary, our new strategy can allow efficient selection of aptamers with high affinity and specificity for clinical applications.
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  • 文章类型: Journal Article
    在前几年,一些皮肤疾病与人乳头瘤病毒(HPV)有关;然而,HPV的确切作用在很大程度上仍然未知.分析前阶段缺乏优化和标准化是一个主要障碍。这项研究的目的是开发一种准确/对患者友好的皮肤病采样方法,以皮肤疣为例。
    各种样品处理技术,评估了预处理方案和DNA提取方法.检查了几种抽样方法,也就是说,皮肤刮屑,拭子和基于胶带的方法。通过β-珠蛋白实时聚合酶链反应(qPCR)实现DNA产量的定量,疣相关HPV基因分型qPCR用于确定HPV患病率。
    所有样品的β-珠蛋白检测呈阳性。皮肤刮片的产量明显高于基于拭子和胶带的方法(p<0.01),后两者无显著差异(p>0.05)。棉花和植绒拭子的DNA产量没有显着差异(p>0.05)。所有拭子均为HPV阳性,尽管两种拭子之间的HPV患病率存在一些差异,发现总体上具有良好的一致性[κ=0.77,95%CI(0.71-0.83)]。
    尽管皮肤刮片产生的DNA产量最高,患者不适是该方法的一个重要限制。考虑到结合我们优化的DNA提取程序,所有样本均给出了有效的结果,首选侵入性较小的拭子方法。分析前阶段的标准化是建立HPV与特定皮肤疾病之间联系的第一步,可能具有重要的下游诊断和治疗意义。
    UNASSIGNED: In previous years, several cutaneous disorders have been associated with human papillomavirus (HPV); however, the exact role of HPV remains largely unknown. The lack of optimization and standardization of the pre-analytical phase forms a major obstacle. The aim of this study was to develop an accurate/patient-friendly sampling method for skin disorders, with cutaneous warts as a case study.
    UNASSIGNED: Various sample processing techniques, pre-treatment protocols and DNA extraction methods were evaluated. Several sampling methods were examined, that is, skin scrapings, swabs and a tape-based method. Quantification of DNA yield was achieved by beta-globin real-time polymerase chain reaction (qPCR), and a wart-associated HPV genotyping qPCR was used to determine the HPV prevalence.
    UNASSIGNED: All samples tested positive for beta-globin. Skin scrapings had significantly higher yield than both swab and tape-based methods (p < 0.01), the latter two did not significantly differ from each other (p > 0.05). No significant difference in DNA yield was found between cotton and flocked swabs (p > 0.05). All swabs were HPV positive, and although there were some discrepancies in HPV prevalence between both swabs, an overall good strength of agreement was found [κ = 0.77, 95% CI (0.71-0.83)].
    UNASSIGNED: Although skin scrapings produced the highest DNA yield, patient discomfort was an important limitation of this method. Considering that in combination with our optimized DNA extraction procedure, all samples gave valid results with the less invasive swab methods preferred. Standardization of the pre-analytical phase is the first step in establishing a link between HPV and specific skin disorders and may have significant downstream diagnostic as well as therapeutic implications.
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  • 文章类型: Journal Article
    尽管基于尿液的HPV检测在宫颈癌筛查中很有前途,它还没有得到很好的发展。30-65岁的妇女被邀请参加当前的研究,以提供一次尿液,和两个配对的阴道样本.尿液采用基于PCR的HPV检测(基于尿液的HPV检测)。通过careHPV和GenPlex®HPV基因分型检测检测两个阴道样本,分别。阴道HPV阳性的女性被召回进行阴道镜检查,如果有临床指征,则进行活检。基于尿液的HPV检测之间的一致性为79.0%(κ=0.563)和80%(κ=0.605),careHPV测试,和GenPlex®HPV基因分型测定。AgainstCIN2+检测,careHPV检测显示77.4%的敏感性,和71.0%的特异性,而GenPlex®HPV基因分型检测的灵敏度为100%,特异性为58.7%.对于基于尿液的HPV测试,相应的比率分别为96.8%和58.7%。此外,尿液HPV检测和careHPV检测(p=0.3395)和GenPlex®HPV基因分型检测(p=0.338)之间没有观察到显著差异.新开发的基于尿液的HPV测试显示了可接受的一致性和与阴道样品的参考HPV测试相当的临床表现。因此,对于宫颈癌筛查有困难的女性,基于尿液的HPV检测可能是一种有用的替代方法.本文受版权保护。保留所有权利。
    Although urine-based human papillomavirus (HPV) detection is promising in cervical cancer screening, it has not yet been well-developed. Women aged 30-65 were invited to participate in the current study to provide one urine and two paired vaginal samples. Urine was detected by polymerase chain reaction (PCR)-based HPV test (urine-based HPV test). Two vaginal samples were tested by careHPV and GenPlex® HPV genotyping assay, respectively. Women with vaginal HPV positive were called back for colposcopy and biopsied if clinically indicated. The consistency was 79.0% (κ = 0.563) and 80.5% (κ = 0.605) between the urine-based HPV test, careHPV test, and GenPlex® HPV genotyping assay. Against CIN2 detection, the careHPV test showed 77.4% sensitivity, and 71.0% specificity, while the GenPlex® HPV genotyping assay had a sensitivity of 100% and a specificity of 58.7%. For urine-based HPV test, the corresponding rates were 96.8% and 58.7%. Moreover, no significant differences were observed between the urine-based HPV test and careHPV test (p = 0.3395) and GenPlex® HPV genotyping assay (p = 0.338). The newly developed urine-based HPV test demonstrated acceptable consistency and comparable clinical performance with referenced HPV tests for vaginal samples. Therefore, urine-based HPV detection could be a useful alternative for women with difficulties to access cervical cancer screening.
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  • 文章类型: Journal Article
    The etiology of bladder cancer is known to be associated with behavioral and environmental factors. Moreover, several studies suggested a potential role of HPV infection in the pathogenesis with controversial results. A systematic review was conducted to assess the role of HPV. A total of 46 articles that reported the prevalence of HPV infection in squamous (SCC), urothelial (UC), and transitional cell carcinomas (TCC) were selected. A pooled prevalence of 19% was found, with a significant difference in SCC that was mainly driven by HPV-16. Moreover, infection prevalence in case-control studies showed a higher risk of bladder cancer in HPV-positive cases (OR: 7.84; p-value < 0.00001). The results may suggest an etiologic role of HPV in bladder cancer. HPV vaccine administration in both sexes could be key to prevent the infection caused by high-risk genotypes.
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  • 文章类型: Journal Article
    (1)背景:患者对常规宫颈癌筛查方法的依从性较低,因此需要考虑其他方法。而阴道HPV自我取样就是其中之一。我们的目的是评估,使用在线调查,罗马尼亚妇女对阴道HPV自我取样的可接受性。(2)方法:在三个Facebook群组上进行13个问题的在线调查,并对结果进行了总结。(3)结果:尽管有良好的教育背景,10.8%(n=60)的受访者不知道巴氏涂片是什么,33%(n=183)未被告知免费的国家宫颈癌筛查计划。多变量分析显示,不了解巴氏试验的受访者接受阴道自我取样的可能性增加(OR:7.80;95CI:1.062−57.431;p=0.021),国家宫颈癌筛查计划(OR:1.96;95CI:1.010−3.806;p=0.02),HPV感染(OR:7.35;95CI:3.099-17.449;p<0.001)或HPV检测(OR:1.67;95CI:0.950-2.948;p=0.03)。此外,以前没有接受过宫颈癌筛查的女性更有可能接受新的筛查方法(OR:1.62;95CI:0.878-3.015;p=0.04).(4)结论:我们的结果表明,参与者对阴道HPV自我采样的可接受率很高。
    (1) Background: Low patient’s adherence to conventional cervical cancer screening methods determined the need to take into consideration alternative approaches, and vaginal HPV self-sampling is one of them. We aimed to evaluate, using an online survey, the Romanian women’s acceptability of vaginal HPV self-sampling. (2) Methods: A 13-questions online survey was distributed on three Facebook groups, and the results were summarized. (3) Results: Despite of good educational background, 10.8% (n = 60) of the respondents did not know what a Pap smear is, and 33% (n = 183) were not informed about the free national cervical cancer screening program. Multivariate analysis revealed an increased likelihood of vaginal self-sampling acceptance among respondents who did not know about Pap test (OR: 7.80; 95%CI: 1.062−57.431; p = 0.021), national cervical cancer screening program (OR: 1.96; 95%CI: 1.010−3.806; p = 0.02), HPV infection (OR: 7.35; 95%CI: 3.099−17.449; p< 0.001) or HPV test (OR: 1.67; 95%CI: 0.950−2.948; p = 0.03). Moreover, women who did not previously undergo a cervical cancer screening program were more likely to accept the new screening method (OR: 1.62; 95%CI: 0.878−3.015; p = 0.04). (4) Conclusions: Our results showed high acceptability rates of vaginal HPV self-sampling among participants.
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  • 文章类型: Journal Article
    High-throughput HPV typing assays with increased automation, faster turnaround and type-specific digital readout would facilitate studies monitoring the impact of HPV vaccination. We evaluated the NanoString nCounter® platform for detection and digital readout of 48 HPV types in a single reaction. NanoString (NS) used proprietary software to design CodeSets: type-specific probe pairs targeting 48 HPV types and the globin gene. We tested residual DNA extracts from epidemiologic specimens and defined samples (HPV plasmids at 10 to 104 copies/reaction) directly (No-PCR) as well as after L1 consensus PCR of 45 (PCR-45) or 15 cycles (PCR-15). Assay and interpretation followed NS recommendations. We evaluated analytic performance by comparing NanoString results for types included in prior assays: Roche Linear Array (LA) or HPV TypeSeq assay. No-PCR results on 40 samples showed good type-specific agreement with LA (k = 0.621) but sensitivity was 65% with lower limit of detection (LOD) at 104 plasmid copies. PCR-45 results showed almost perfect type-specific agreement with LA (k = 0.862), 82% sensitivity and LOD at 10 copies. PCR-15 results on 75 samples showed substantial type-specific agreement with LA (k = 0.796, 92% sensitivity) and TypeSeq (k = 0.777, 87% sensitivity), and LOD at 10 copies of plasmids. This proof-of-principle study demonstrates the efficacy of the NS platform with HPV CodeSet for type-specific detection using a low number of PCR cycles (PCR-15). Studies are in progress to evaluate assay reproducibility and analytic validation with a larger number of samples.
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  • 文章类型: Journal Article
    目前的指南推荐p16免疫组织化学(IHC)用于检测口咽腺癌(OPSCC)中的人乳头瘤病毒(HPV)。我们评估了将DNA原位杂交(ISH)添加到p16IHC的价值。
    分析了50例OPSCC患者。用Gwet的一致系数测定HPV-DNAISH与p16IHC的一致性。
    p16IHC在35/48(72.9%)中呈阳性,8/48(16.7%)患者阴性。广谱DNA-ISH在9/23(39%)患者中呈阳性,在14/23(60.9%)患者中呈阴性。高危16/18(HR)HPVDNA-ISH在11/23(47.8%)中呈阳性,在12(52.2%)中呈阴性。HPVDNA-ISH与p16IHC之间的一致性是公平的(Gwet'sAC1=0.318)。
    p16IHC和HPV-DNAISH之间的一致性是公平的。然而,ISH敏感度较低。我们的发现增加了目前的数据,即p16IHC检测是可靠的,可能足以作为OPSCC中HPV检测的独立检测。
    UNASSIGNED: Current guidelines recommend p16 immunohistochemistry (IHC) for testing human papillomavirus (HPV) in oropharyngeal carcinoma (OPSCC). We evaluated the value of adding DNA in situ hybridization (ISH) to p16 IHC.
    UNASSIGNED: Fifty patients with OPSCC were analyzed. Concordance between HPV-DNA ISH and p16 IHC was measured by Gwet\'s agreement coefficient.
    UNASSIGNED: p16 IHC was positive in 35/48 (72.9%), negative in 8/48 (16.7%) patients. Wide spectrum DNA-ISH was positive in 9/23 (39%) and negative in 14/23 (60.9%) patients. High-risk 16/18 (HR) HPV DNA-ISH was positive in 11/23 (47.8%) and negative in 12 (52.2%) patients. The agreement between HPV DNA-ISH and p16 IHC is fair (Gwet\'s AC1 = 0.318).
    UNASSIGNED: The agreement between p16 IHC and HPV-DNA ISH was fair. However, ISH sensitivity was low. Our findings add to the current data that p16 IHC testing is reliable and may be enough as a stand-alone test for HPV detection in OPSCC.
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