循环肿瘤 HPV DNA 在 HPV 口咽癌治疗中的应用及其与 MRI 的相关性。
Circulating tumor HPV DNA in the management of HPV+ oropharyngeal cancer and its correlation with MRI.
发表日期：2024 Jul 09
作者：
Flaminia Campo, Francesca Paolini, Valentina Manciocco, Silvia Moretto, Barbara Pichi, Claudio Moretti, Giovanni Blandino, Valentina De Pascale, Maria Benevolo, Fulvia Pimpinelli, Antonello Vidiri, Simona Marzi, Sergio Ruggiero, Irene Terrenato, Oreste Iocca, Aldo Venuti, Raul Pellini
来源：
Epigenetics & Chromatin
摘要：
第一个目标是将 ctHPVDNA 的 ddPCR 检测与 p16 IHC 和定性 HPV PCR 进行比较。第二个目标是进行纵向血液采样，以测试 ctHPVDNA 与组织学证实的复发之间的关系。第三个目标是进行多维评估，包括：（1）临床特征； (2)ctHPVDNA； (3)基于MRI的原发肿瘤(PT)和颈部淋巴结转移(CLNM)的肿瘤大小测量。治疗前和随访期间收集血浆样本，并进行包含HPV16、HPV 33和HPV 35的E6的ddPCR检测。本研究对 117 名患者进行诊断，结果显示 ctHPVDNA 敏感性为 100% (95% CI 95.5-100)，特异性为 94.4 (95% CI 81.3-99.3)，阳性预测值 (PPV) 为 94.4 ( 95% CI 81.3-99.3)，阴性预测值 (NPP) 为 100% (95% CI 89.7-100)。随访期间，ctHPVDNA 的敏感性为 100% (95% CI 72.1-100)%，特异性为 98.4% (95% CI 91.7-100)%，PPV% 为 90.9% (95% CI 62.3-98.4)，NPV检测复发能力的 100% (95% CI 94.3-100)。观察到CLNM体积与PT和CLNM体积之和之间的相关性。ctHPVDNA在诊断时对HPV-OPSCC的识别优于p16。在诊断环境之外引入 ctHPVDNA，是改善 OPSCC 患者随访方案的绝佳机会。© 2024 作者。头
First aim was to compare ddPCR assays of ctHPVDNA with p16 IHC and qualitative HPV PCR. Second aim was to carry out longitudinal blood sampling to test for association of ctHPVDNA with histological confirmed recurrence. Third aim was to perform a multidimensional assessment which included: (1) clinical features; (2) ctHPVDNA; (3) MRI-based tumor size measurements of primary tumor (PT) and cervical lymph node metastases (CLNM).Plasma samples were collected before treatment and during follow-up, and ddPCR assay comprising E6 of HPV16 and HPV 33 and HPV 35 was used.Present study was conducted at diagnosis in 117 patients and revealed a ctHPVDNA sensitivity of 100% (95% CI 95.5-100) and a specificity of 94.4 (95% CI 81.3-99.3), positive predictive value (PPV) of 94.4 (95% CI 81.3-99.3), and negative predictive value (NPP) of 100% (95% CI 89.7-100). During follow-up ctHPVDNA had a sensitivity of 100% (95% CI 72.1-100)% and specificity of 98.4% (95% CI 91.7-100)%, PPV% of 90.9% (95% CI 62.3-98.4) and NPV% of 100% (95% CI 94.3-100) for ability to detect recurrence. Correlation between both the CLNM volume and the sum of PT and CLNM volume was observed.ctHPVDNA was superior to p16 in identification of HPV-OPSCC at diagnosis. Introduction of ctHPVDNA, beyond diagnostic setting, represents a great opportunity to improve follow-up protocol of OPSCC patients.© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.