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August 22, 2026Cancer Cytopathology

Diagnostic utility of high‐risk HPV polymerase chain reaction–based testing in head and neck FNA specimens with indeterminate cytomorphology

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Authors

VTVanda F. TorousWFWilliam C. Faquin

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Overview

Retrospective study demonstrates 100% positive predictive value of high-risk HPV PCR in indeterminate head and neck FNA specimens, suggesting molecular testing can prevent repeat biopsies.

Key Points

  • To assess the diagnostic utility and positive predictive value of high-risk human papillomavirus (HR-HPV) PCR testing in head and neck fine-needle aspiration (FNA) specimens with indeterminate cytomorphology.
  • Retrospectively analyzed 279 head and neck FNA specimens with paired HR-HPV PCR testing on residual liquid cytology material over a 5-year period.
  • Calculated the positive predictive value (PPV) for histopathologically confirmed squamous cell carcinoma on surgical follow-up across cytologic diagnostic categories, accompanied by blinded slide reviews.
  • HR-HPV PCR results were positive in 50.2%, negative in 40.9%, and indeterminate in 9.0% of specimens, with positivity rates of 0% in negative, 19.0% in atypical, 41.2% in suspicious, 50.0% in nondiagnostic, and 57.3% in malignant cytology categories.
  • Among cytologically indeterminate specimens with positive HR-HPV PCR results (n = 14), the positive predictive value for squamous cell carcinoma was 100% (95% CI, 78.5%–100.0%), and all 15 cases definitively diagnosed via HR-HPV positivity during blinded review were confirmed malignant.

Cite This Study

Torous et al. (2026) studied this question.

synapsesocial.com/papers/6a895fc4ca7ade938187ea8ahttps://doi.org/10.1002/cncy.70144
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