Aptima HR-HPV testing from Diff-Quick-stained fine-needle aspiration smears of oropharyngeal squamous cell carcinoma

Min Han; Cory T Bernadt; Benjamin Murray; Steven M Johnson; Jalal B Jalaly; Telly Garcia; Laura J Adhikari

doi:10.1016/j.jasc.2016.05.001

Aptima HR-HPV testing from Diff-Quick-stained fine-needle aspiration smears of oropharyngeal squamous cell carcinoma

J Am Soc Cytopathol. 2016 Jul-Aug;5(4):221-226. doi: 10.1016/j.jasc.2016.05.001. Epub 2016 May 26.

Authors

Min Han¹, Cory T Bernadt¹, Benjamin Murray¹, Steven M Johnson², Jalal B Jalaly¹, Telly Garcia¹, Laura J Adhikari³

Affiliations

¹ Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.
² Anatomic and Clinical Pathology, Christian Hospital, St. Louis, Missouri.
³ Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma. Electronic address: Laura-Adhikari@ouhsc.edu.

PMID: 31042512
DOI: 10.1016/j.jasc.2016.05.001

Abstract

Introduction: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) is a biologically unique form of carcinoma that is important to identify for prognosis and treatment. The objective of this study was to evaluate the performance of the Aptima HPV assay using Diff-Quick (DQ) stained smears from fine-needle aspiration (FNA) of HPV-related oropharyngeal SCC.

Materials and methods: Patients with a diagnosis of head and neck SCC who also had FNA sample demonstrating metastatic disease were identified. Using a mounting media-based cell transfer technique, approximately 200 tumor cells were selected and harvested from DQ-stained aspirate smeared slides. The selected cells were tested for high risk HPV using the Aptima HPV assay, an in vitro nucleic acid amplification test for the qualitative detection of E6/E7 viral messenger RNA from high-risk types of HPV. These results were compared with the p16 immunohistochemical staining of the corresponding surgical pathology specimens.

Results: Twenty-eight of 32 (87.5%) FNAs of p16-positive oropharyngeal SCC were positive for high-risk HPV by the Aptima assay and 18 of 18 (100%) FNAs of p16-negative SCC were negative for high-risk HPV by the Aptima assay.

Conclusions: DQ-stained FNA smears can be used by the Aptima HPV assay to accurately detect high-risk HPVs in oropharyngeal SCCs with a sensitivity of 87.5% and a specificity of 100%. This provides an alternative to p16 immunohistochemical staining of FNA cell block material, which may not be available on all specimens.

Keywords: Aptima; Diff-Quick smear; Fine needle aspiration; HPV; Oropharyngeal; Squamous cell carcinoma.