Tonsil

Histoire naturelle de l’infection à papillomavirus
humain dans les amygdales :
du tissu sain au cancer
Jean-Damien Combes1
pour Silvia Franceschi1, Christine Clavel2 et Jean Lacau Saint Guily3
International Agency for Research on Cancer, Lyon, France
INSERM UMR-S 903 / Université de Reims Champagne-Ardenne / CHU Reims, Laboratoire Pol-Bouin, Reims, France
3 Service d'ORL et chirurgie cervico-faciale, Hôpital Tenon AP-HP, Paris, France
1
2
Study of human Papillomavirus and
precancerous Lesions In the Tonsil
SPLIT study
Methods
http://split.iarc.fr/
-
Cross-sectional study
20 centres in France (2012-2016)
Tonsillectomy for non-cancer reasons
Gargling specimens before surgery
Detection of infectious agents
Cytological and histological precancerous lesions
1. HPV infection in non-cancerous tonsils
2. HPV-induced lesions in the oropharynx
HPV infection in non-cancerous tonsils
Sample tested
Tonsil brushing
Gargling
Age class
M/F
Total
193
314/378
692
89
121/147
268
0-14
15-24
25-34
35+
139
169
191
-
89
90
HPV-DNA detection test: Luminex® IARC E7-MPG (21 HPV types)
4
(T. Gheit, M. Tommasino)
HPV infection in non-cancerous tonsils
SPLIT study final results (submitted)
HPV DNA detection test: IARC E7-MPG platform
HPV infection in non-cancerous tonsils,
by age class and sex (gargle)
SPLIT study final results (submitted)
HPV DNA detection test: IARC E7-MPG platform
HPV infection in non-cancerous tonsils,
HPV types
SPLIT study final results (submitted)
HPV DNA detection test: IARC E7-MPG platform
HPV infection in non-cancerous tonsils,
concordance Gargle/Tonsil brushing
SPLIT study final results (submitted)
HPV DNA detection test: IARC E7-MPG platform
1. HPV infection in non-cancerous tonsils
2. HPV-induced lesions in the oropharynx
HPV-induced lesions in the tonsil (cytology)
HPV-induced lesions in the tonsil (cytology)
Uninterpretable cytology:
many clustered
lymphocytes hiding
epithelial cells
Uninterpretable cytology:
low cellularity
HPV-induced lesions in the tonsil (cytology)
PMID: 26111735
HPV-induced lesions in the tonsil (histology)
Conclusions
• Prevalence of tonsillar HPV infection is
overestimated using gargling
• Poor concordance between HPV detection by
gargle and tonsil brushing
• Limited prospect for early detection of
precancerous lesion in the tonsils
• HPV-induced tonsillar precancerous lesions?
Acknowledgement
Coordination méthodologie : Jean-Damien Combes (CIRC) et Véronique Dalstein (Reims)
Coordination anatomo-pathologie : Philippe Birembaut (Reims) et Marine Lefèvre (Tenon)
Coordination biologie moléculaire : Alain Jung (Paul Strauss Strasbourg) et Christine Clavel (Reims)
Coordination épidémiologie et statistiques : Gary Clifford (CIRC) et Silvia Franceschi (CIRC)
Coordination chirurgie : Jean Lacau Saint Guily (Tenon)
Chirurgie ORL : Olivier Mauvais et Jean-Michel Badet (Besançon), Emmanuel Babin (Caen), Christian Righini (Grenoble),
Justine Lerat (Limoges), Philippe Céruse et Alain Cosmidis (Lyon), Renaud Garel (Montpellier), Olivier Malard (Nantes),
Benjamin Lallemant (Nîmes), Nicolas Leboulanger (Trousseau, Necker), Christine Bach (Foch), Sébastien Albert et Beatrix
Barry (Bichat), Vincent Couloigner (Necker), Natacha Teissier et Thierry Van Den Abeele (Debré), Bertrand Baujat, Olivier de
Crouy Chanel, Maria Lesnik et Sophie Périé (Tenon), Xavier Dufour (Poitiers), Jean-Claude Mérol (Reims), Philippe Schultz
(Strasbourg), Sébastien Vergez (Toulouse), Sylvain Morinière (Tours).
Anatomo-pathologie : Elisabeth Brambilla (Grenoble), Béma Coulibaly (Limoges), Françoise Berger (Lyon), Elisabeth
Cassagnau (Nantes), Heliette Chapuis (Nîmes), Dibor Niang et Aurore Coulomb (Trousseau), Isabelle Wagner (Foch), Louise
Galmiche-Rolland (Necker), Dominique Berrebi (Debré), Alexandra Traverse-Glehen (Lyon), Isabelle Brocheriou (Tenon),
Pierre Levillain et Eric Frouin (Poitiers), Marie-Danièle Diebold (Reims), Mihaela Onea (Strasbourg), Emmanuelle Uro-Coste
(Toulouse).
Anatomo-pathologie SPLIT Lésions précancéreuses : Yves Denoux (Foch), Muriel Hourseau (Bichat), Emmanuèle
Lechapt (Caen), Cécilia Rousselot-Denis (Tours), Valérie Costes (Montpellier), Séverine Degano-Valmary (Besançon).
Biologie : Tarik Gheit et Massimo Tommasino (CIRC), Christiane Mougin et Jean-Luc Prétet (Besançon), Roger Lacave et
Patrick Soussan (Tenon), Brigitte Autran et Ghislaine Carcelain (Pitié), Gérard Agius et Agnès Beby-Defaux (Poitiers), Joseph
Abecassis (Paul Strauss Strasbourg).
Financement PAIR-VADS 2011 – Fondation ARC / INCa / Ligue contre le cancer