Wuerdemann Nora, Jain Rishabh, Adams Anne, Speel Ernst-Jan M, Wagner Steffen, Joosse Simon A, Klussmann Jens P
Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne, Robert-Koch-Strasse 21, 50931 Cologne, Germany.
Cancers (Basel). 2020 Oct 15;12(10):2997. doi: 10.3390/cancers12102997.
Global incidences of oropharyngeal squamous cell carcinoma (OPSCC) are rising due to an association with high-risk human papillomavirus (HPV). Although there is an improved overall survival of HPV-related OPSCC; up to 25% of the patients develop recurrent or distant metastatic disease with a fatal outcomes. Biomarkers to monitor this disease are not established. This meta-analysis reviews the role of cell-free HPV DNA in liquid biopsy (LB) as a biomarker for HPV-related OPSCC. Pubmed, Livivo, and Cochrane Library databases were searched from inception to August, 2020. All studies were analyzed by Meta-DiSc 1.4 and Stata 16.0 statistical software. In total, 16 studies were considered for systematic review, whereas 11 studies met inclusion criteria for meta-analysis, respectively. Pooled sensitivity of cfHPV-DNA at first diagnosis and during follow-up was 0.81 (95% CI; 0.78-0.84) and 0.73 (95% CI; 0.57-0.86), while pooled specificity was 0.98 (95% CI; 0.96-0.99) and 1 (95% CI; 0.99-1). The diagnostic odds ratio (DOR) at first diagnosis was 200.60 (95% CI; 93.31-431.22) and 300.31 (95% CI; 60.94-1479.88) during follow-up. The area under the curve (AUC) of summary receiver operating characteristic (SROC) was 0.99 at first diagnosis and 1.00 during follow-up, respectively. In conclusion, cfHPV-DNA presents a potential biomarker with high specificity in patients with HPV-related OPSCC.
由于与高危型人乳头瘤病毒（HPV）相关，口咽鳞状细胞癌（OPSCC）的全球发病率正在上升。尽管HPV相关的OPSCC患者的总生存率有所提高，但仍有高达25%的患者会出现复发或远处转移性疾病，并导致致命后果。目前尚未建立用于监测这种疾病的生物标志物。这项荟萃分析回顾了游离HPV DNA在液体活检（LB）中作为HPV相关OPSCC生物标志物的作用。检索了从数据库建立至2020年8月的PubMed、Livivo和Cochrane图书馆数据库。所有研究均采用Meta-DiSc 1.4和Stata 16.0统计软件进行分析。总共纳入16项研究进行系统评价，其中11项研究符合荟萃分析的纳入标准。cfHPV-DNA在初次诊断时和随访期间的合并敏感度分别为0.81（95%CI：0.78-0.84）和0.73（95%CI：0.57-0.86），而合并特异度分别为0.98（95%CI：0.96-0.99）和1（95%CI：0.99-1）。初次诊断时的诊断比值比（DOR）为200.60（95%CI：93.31-431.22），随访期间为300.31（95%CI：60.94-1479.88）。汇总受试者工作特征曲线（SROC）在初次诊断时的曲线下面积（AUC）为0.99，随访期间为1.00。总之，cfHPV-DNA是HPV相关OPSCC患者中具有高特异性的潜在生物标志物。
