人乳头瘤病毒（HPV）是口咽癌（OPC）的重要预后因素。 p16 是诊断 HPV OPC 的替代标记，但它并不是 HPV 存在的直接证据。我们研究的目的是评估 HPV DNA 检测 - Cobas HPV 检测 - 通过颈部淋巴结抽吸诊断 HPV OPC。研究人员对 2018 年 1 月至 2022 年 12 月期间在台大医院接受细针抽吸（FNA）或芯针活检（CNB）的颈部肿块进行了回顾。除常规细胞学和病理学研究外，还收集针冲洗液进行 Cobas HPV 检测，以检测高危 HPV。我们分析了 137 例疑似淋巴结患者，其中 32 例（23.4%）为 HPV OPC 患者，105 例（76.6%）为 HPV OPC 患者。其中患有非 HPV 相关疾病。根据淋巴结的大小和坏死状态，对31名患者进行了FNA，对106名患者进行了CNB。 CNB联合p16免疫组化染色诊断HPV OPC的敏感性为93.3%，特异性为97.8%，阳性预测值（PPV）为87.5%，阴性预测值（NPV）为98.9%，准确度为97.2%。另一方面，对于针冲洗罗氏Cobas HPV检测，测试显示敏感性为96.9％，特异性为100％，PPV为100％，NPV为99.1％，准确性为99.3％。与 p16 IHC 染色相比，Cobas HPV 检测显示出更好的 PPV，具有统计学意义 (p = 0.04)。Cobas HPV 检测是美国 FDA 批准的、高度自动化且易于使用的技术，可直接检测高危 HPV 的存在。我们建议在颈部淋巴结病的检查中结合使用 Cobas HPV 检测和常规细胞学或组织病理学检查。© 2024。外科肿瘤学会。

Human papillomavirus (HPV) is a crucial prognostic factor in oropharyngeal cancer (OPC). p16 is a surrogate marker for diagnosing HPV+ OPC, however it is not direct evidence of HPV existence.The purpose of our study was to evaluate an HPV DNA test-Cobas HPV assay-in diagnosing HPV+ OPC through neck lymph node aspiration.Patients with suspected neck mass who received fine needle aspiration (FNA) or core needle biopsy (CNB) at the National Taiwan University Hospital between January 2018 and December 2022 were reviewed. Besides routine cytology and pathology study, needle rinse fluid was collected for the Cobas HPV assay to detect high-risk HPV.We analyzed 137 patients with suspected lymph nodes, 32 (23.4%) of whom were HPV+ OPC patients and 105 (76.6%) of whom had non-HPV-related disease. FNA was performed in 31 patients and CNB was performed in 106 patients, according to the size and necrosis status of the lymph nodes. For diagnosing HPV+ OPC, CNB combined with p16 immunohistochemistry staining showed sensitivity of 93.3%, specificity of 97.8%, positive predictive value (PPV) of 87.5%, negative predictive value (NPV) of 98.9%, and accuracy of 97.2%. On the other hand, for the needle rinse Roche Cobas HPV assay, the test showed sensitivity of 96.9%, specificity of 100%, PPV of 100%, NPV of 99.1%, and accuracy of 99.3%. Compared with p16 IHC staining, the Cobas HPV test showed better PPV with statistical significance (p = 0.04).The Cobas HPV assay is a US FDA-approved, highly automated, and readily used technique to directly detect the presence of high-risk HPV. We recommend utilizing the Cobas HPV assay in combination with routine cytology or histopathology examination in the work-up of neck lymphadenopathy.© 2024. Society of Surgical Oncology.