HN 06-02What is the ideal HPV screening method in the oropharyngeal region? SHIO Study

27. HPV and oropharynx / Head and neck cancer
E. Szabó 1, K. Dános 2, E. Birtalan 2, B. Dudás 3, M. Kara 2, A. Horváth 2, B. Csillag 4, R. Koiss 5, E. Ujhelyi 1, P. Rásonyi-Kovács 4, I. Vályi-Nagy 6, L. Tamás 2.
1Molecular Biology Laboratory, Saint István and Saint László Hospital (Hungary), 2Dept. of Oto-Rhino-Laryngology, Head and Neck Surgery, Semmelweis University (Hungary), 3Budapest University of Technology and Economics (Hungary), 4Dept. of Oto-Rhino-Laryngology, Saint István and Saint László Hospital (Hungary), 5Gynacology, Saint István and Saint László Hospital (Hungary), 6Saint István and Saint László Hospital (Hungary)

Background / Objectives

Over the past decade, there has been an increase in the number of instances of head and neck squamous cell carcinoma (HNSCC) cases reported in parallel with HPV (human papillomavirus) infection. The strongest ratio of HPV to HNSCC has been found in oropharyngeal SCC (OPCC), especially in the tonsils. Hypothetically if the HPV virus is caught early in the background, then potentially SCC could be prevented. The big question is how it can be prevented and screened?  The purpose of SHIO (Screening of HPV infection in oropharyngeal region) study is to determine an effective HPV screening method that can be easily and quickly applied, and can therefore become the benchmark or gold standard for HPV testing worldwide. The study will also assess with a view to estimating the HPV incidence of the HN region in Hungarian adults.


Methods

All patients undergoing routine tonsillectomy for benign indications in the Hospital were invited to participate in our study. Using a questionnaire, all individuals were interviewed about their sexual behavior, socioeconomic factors, drug use and other known or suspected HPV infection risk factors. During this study three different samples were taken for HPV examination before tonsillectomy (1. rinse of mouth and tonsil area, 2. cytobrush sample from surface of tonsils, 3. sampling from tonsils with cytobrush after exerting pressure), and following tonsillectomy a fourth sample was then taken from tonsils for HPV testing (Anyplex™ II HPV28 Detection, Seegene Inc., Seoul, Korea) and a histological examination of the tonsils followed. Before the main project, we performed a pilot trial involving the inclusion of 100 patients, but in order to get statistically powered results, a sample-size of approximately 900 patients is required for the full trial to be meaningful. To achieve this number of patients we plan to cooperate with other hospitals.


Results

Conclusion

Based on our experiments the Anyplex™ II HPV28 Detection test can be used successfully in the examinations of HN samples. In terms of sexual habits, the samples proved to be representative.During the pilot we have set up a well-established sampling and screening system designed between the hospitals, the clinic and the laboratory. Now we are ready for the complete study. With more complete studies we will be able to build an accurate epidemiology of HPV infection within Hungarian adults using a non invasive screening method in the HN region.


References