Evaluating Efficacy of Cervical HPV-HR DNA Testing as Alternative to PET/CT Imaging for Post-Treatment Cancer Surveillance: Retrospective Proof of Concept Study.
Cameron Huddleston, Chinnadurai Mani, Naresh Sah, Emerald Courtney, Kimberly Reese, Stephanie Stroever, Komaraiah Palle, Mark B Reedy
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引用次数: 0
Abstract
Background: High-risk-human papillomaviruses (HPV-HR) are implicated in over 99% of cervical/vaginal malignancies. Despite this strong association, current guidelines recommend Positron Emission Tomography/Computed Tomography (PET/CT) imaging over HPV-HR DNA testing as the standard prognostic tool following definitive therapy. This retrospective, single-institution, proof-of-concept study evaluated HPV-HR DNA testing as a potential alternative to PET/CT imaging for post-treatment surveillance in cervical and vaginal cancers.
Methods: Female patients with cervical or vaginal cancer treated between 2010 and 2023 at our institution were retrospectively analyzed. Eligible patients had complete documentation of pre- and post-treatment PET/CT imaging and HPV-HR DNA testing. Of over 100 patients identified, only 53 met the inclusion criteria and both radical hysterectomy and chemoradiation patients were included. Statistical analyses, including sensitivity, specificity, and predictive values, were conducted using STATA, with significance set at 0.05.
Results: Post-treatment HPV-HR DNA testing demonstrated a superior sensitivity (92.31%) and negative predictive value (97.44% NPV) compared to PET/CT imaging (76.92% sensitivity, 92.31% NPV). While PET/CT imaging maintained higher specificity over HPV-HR DNA testing (100% vs. 95%) and positive predictive value (100% vs. 85.71%), HPV-HR DNA testing offers a more sensitive and cost-effective method for identifying patients requiring further evaluation.
Conclusions: HPV-HR DNA testing is a promising, cost-effective surveillance tool with higher sensitivity and NPV than PET/CT. Its clinical use may reduce PET/CT need, improve safety, and lower costs, requiring further validation.
Impact: HPV-HR DNA testing offers a cost-effective alternative to PET/CT, reducing costs, unnecessary imaging, and improving accessibility.
期刊介绍：
Cancer Epidemiology, Biomarkers & Prevention publishes original peer-reviewed, population-based research on cancer etiology, prevention, surveillance, and survivorship. The following topics are of special interest: descriptive, analytical, and molecular epidemiology; biomarkers including assay development, validation, and application; chemoprevention and other types of prevention research in the context of descriptive and observational studies; the role of behavioral factors in cancer etiology and prevention; survivorship studies; risk factors; implementation science and cancer care delivery; and the science of cancer health disparities. Besides welcoming manuscripts that address individual subjects in any of the relevant disciplines, CEBP editors encourage the submission of manuscripts with a transdisciplinary approach.
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