Advances in testing for human papillomavirus -mediated head and neck cancer.

IF 2.8 4区医学 Q2 ONCOLOGY

Current Opinion in Oncology Pub Date : 2024-05-01 Epub Date: 2024-03-19 DOI:10.1097/CCO.0000000000001029

Hisham Mehanna, Laia Alemany, Christian von Buchwald

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引用次数: 0

Abstract

Purpose of review: New evidence has recently emerged regarding the utility and benefits of dual p16 INKa (p16) and Human papillomavirus (HPV) status testing when determining the diagnosis and prognosis of patients with oropharyngeal cancer.

Recent findings: HPV RNA polymerase chain reaction (PCR) is the most accurate diagnostic test. The other assays (HPV DNA PCR, HPV DNA/RNA in-situ hybridization (ISH) and p16) applied to formalin fixed tumour tissue have varying but high sensitivities and specificities. Dual p16 and HPV testing identifies discordant (p16+/HPV- or p16-/HPV+) results in 9.2% of cases, who have significantly poorer prognoses than p16+/HPV+, particularly in smokers. The proportion of discordant cases varies by region, and appears to be highest in regions with lowest attributable (p16+/HPV+) fractions. Dual testing improves prognostication for oropharyngeal cancer cases by identifying discordant cases and improving the prognostic power of the Tumour Node Metastasis (TNM) classification, especially in regions with high discordant rates.

Summary: Dual testing is essential when considering patients for clinical trials of treatment de-escalation, and may be important when counselling patients on prognosis, especially in regions with high discordant rates and in smokers.

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人类乳头瘤病毒介导的头颈癌检测进展。

综述目的：最近有新证据表明，在确定口咽癌患者的诊断和预后时，p16INKa（p16）和人乳头瘤病毒（HPV）状态双重检测具有实用性和益处：最新发现：HPV RNA 聚合酶链反应（PCR）是最准确的诊断测试。应用于福尔马林固定肿瘤组织的其他检测方法（HPV DNA PCR、HPV DNA/RNA 原位杂交（ISH）和 p16）的敏感性和特异性各不相同，但都很高。在 9.2% 的病例中，p16 和 HPV 双重检测会发现不一致（p16+/HPV- 或 p16-/HPV+）的结果，这些病例的预后明显差于 p16+/HPV+ 病例。不一致病例的比例因地区而异，在可归因病例（p16+/HPV+）比例最低的地区，不一致病例的比例似乎最高。双重检测可识别不一致病例并提高肿瘤结节转移（TNM）分类的预后能力，从而改善口咽癌病例的预后，尤其是在不一致率较高的地区。摘要：在考虑将患者纳入降级治疗临床试验时，双重检测至关重要；在向患者提供预后咨询时，双重检测可能也很重要，尤其是在不一致率较高的地区和吸烟者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Oncology 医学-肿瘤学

CiteScore

6.10

自引率

2.90%

发文量

130

审稿时长

4-8 weeks

期刊介绍： With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.