Paolini Francesca, Campo Flaminia, Iocca Oreste, Manciocco Valentina, De Virgilio Armando, De Pascale Valentina, Moretto Silvia, Dalfino Gianluca, Vidiri Antonello, Blandino Giovanni, Pimpinelli Fulvia, Venuti Aldo, Pellini Raul
HPV-Unit, UOSD Tumor Immunology and Immunotherapy IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy.
Department of Biochemical Sciences A. Rossi Fanelli, Sapienza University of Rome, Rome, Italy.
Head Neck. 2023 Nov;45(11):2945-2954. doi: 10.1002/hed.27515. Epub 2023 Sep 16.
The possibility of detecting circulating tumor HPV DNA (ctHPVDNA) in plasma in patients with oropharyngeal cancer has been demonstrated in several reports. However, these data are from small cohorts and available tests for detection of ctHPVDNA are not fully validated. The aim is to evaluate sensitivity, specificity, and accuracy of ctHPVDNA by ddPCR to define its efficacy in the clinical setting for the diagnosis of HPV + OPSCC. A comprehensive search of three different databases: MEDLINE, Embase, and Cochrane Library databases. A total of 998 patients were evaluated from the 13 studies. OPSSC p16+ were 729, while controls p16- were 269. The meta-analytic study estimated the diagnostic performance of ctHPVDNA as follows: pooled sensitivity and specificity of 0.90 (95% CI: 0.82-0.94) and 0.94 (95% CI: 0.85-0.98), respectively; positive and negative likelihood ratios of 12.6 (95% CI: 4.9-32.1) and 0.05 (95% CI: 0.02-0.13), respectively. ddPCR for ctHPVDNA has good accuracy, sensitivity, and specificity for diagnosis of HPV + OPSCC. ctHPVDNA kinetic represents a great reliable opportunity to improve diagnostic and therapeutic management of cancer patients and could open new perspectives for understanding tumor biology.
多项报告已证实，口咽癌患者血浆中存在循环肿瘤HPV DNA（ctHPVDNA）。然而，这些数据来自小样本队列，且用于检测ctHPVDNA的现有检测方法尚未得到充分验证。本研究旨在通过数字滴度聚合酶链反应（ddPCR）评估ctHPVDNA的敏感性、特异性和准确性，以确定其在临床环境中诊断HPV阳性口咽鳞状细胞癌（OPSCC）的效能。对三个不同数据库进行全面检索，分别为MEDLINE、Embase和Cochrane图书馆数据库。共从13项研究中评估了998例患者。其中OPSCC p16阳性患者729例，对照组p16阴性患者269例。荟萃分析研究估计ctHPVDNA的诊断性能如下：合并敏感性和特异性分别为0.90（95%置信区间：0.82 - 0.94）和0.94（95%置信区间：0.85 - 0.98）；阳性和阴性似然比分别为12.6（95%置信区间：4.9 - 32.1）和0.05（95%置信区间：0.02 - 0.13）。用于ctHPVDNA检测的ddPCR对HPV阳性OPSCC的诊断具有良好的准确性、敏感性和特异性。ctHPVDNA动力学为改善癌症患者的诊断和治疗管理提供了一个非常可靠的机会，并可能为理解肿瘤生物学开辟新的前景。
