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Updated: Jan 15, 2026
Chromogenic In Situ Hybridization as a Tool for HPV-Related Head and Neck Cancer Diagnosis
Published on: June 14, 2019
Diagnostic Accuracy of HPV Circulating Tumor DNA Following Non-Diagnostic FNA of a Cystic Lateral Neck Mass
Michael R Papazian1, Melanie D Hicks1, Kyle Mannion1
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background:
Cystic lateral neck masses in adults commonly represent nodal metastases from HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) or benign lesions. Because cystic lesions are relatively acellular, fine-needle aspiration (FNA) is often non-diagnostic. HPV circulating tumor DNA (ct-DNA) may aid diagnosis in these cases.
Methods:
We conducted a two-institution retrospective review of patients with cystic neck masses and non-diagnostic FNA who underwent pre-treatment HPV ct-DNA testing. Sensitivity, specificity, and predictive values were calculated based on final pathology.
Results:
Thirty-two patients were included. HPV ct-DNA was positive in 20/32 (62.5%) cases, all of which were HPV-associated OPSCC. Four patients with negative HPV ct-DNA were ultimately diagnosed with HPV-associated OPSCC (sensitivity: 83%, specificity: 100%, PPV: 100%, NPV: 67%).
Conclusion:
HPV ct-DNA demonstrated high specificity and may complement standard workup in adult cystic neck masses with non-diagnostic FNA. Positive HPV ct-DNA results should prompt further evaluation for HPV-associated OPSCC.
