Monitoring circulating cell-free HPV DNA in metastatic or recurrent cervical cancer: clinical significance and treatment implications.

IF 6.4 1区生物学 Q1 BIOLOGY

eLife Pub Date : 2025-09-17 DOI:10.7554/eLife.101887

Zhuomin Yin, Tao Feng, Qing Xu, Wumin Dai, Maowei Ni, Juan Ni, Hanmei Lou

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引用次数: 0

Abstract

Background: Monitoring circulating HPV cell-free DNA (cfDNA) offers a minimally invasive method for surveillance in HPV-associated cancers, particularly cervical cancer. However, the role of dynamic HPV cfDNA monitoring in guiding clinical treatment decisions for recurrent or metastatic cervical cancer remains underexplored.

Methods: In this prospective pilot observational study, levels of HPV cfDNA in serum samples from 28 patients with recurrent or metastatic HPV-positive cervical cancer were measured via digital droplet polymerase chain reaction. Results for HPV cfDNA levels were matched to clinical outcomes and to serum levels of squamous cell carcinoma antigen (SCC-Ag) to assess the clinical potential of HPV cfDNA as a tumor marker.

Results: HPV cfDNA was detected in all 28 patients. Notably, median baseline HPV cfDNA levels varied according to the metastatic pattern observed in individual patients (p=0.019). All participants exhibited changes in HPV cfDNA levels over a median monitoring period of 2 months (range 0.3-16.9 months) prior to evaluations for treatment response or disease progression. Among 26 patients initially diagnosed with squamous cell cervical cancer, the positivity rate was 100% for HPV cfDNA and 69.2% for SCC-Ag (p=0.004, 95% confidence interval (CI), 0-0.391). Among 20 patients longitudinally monitored for squamous cell cervical cancer, the concordance with changes in disease status was 90% for HPV cfDNA and 50% for SCC-Ag (p=0.014, 95% CI, 0.022-0.621).

Conclusions: Our study demonstrates that HPV cfDNA is a promising tumor marker for monitoring of recurrent or metastatic HPV-positive cervical cancer.

Funding: This work was supported by the Key R&D Program of Zhejiang (2022C04001), the Zhejiang Province Medicine and Health Science and Technology Program (2020KY454), the Zhejiang Science and Technology Department Public Welfare Project (LGF22H160075).

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监测循环细胞游离HPV DNA在转移性或复发性宫颈癌：临床意义和治疗意义。

背景：监测循环HPV无细胞DNA （cfDNA）为HPV相关癌症，特别是宫颈癌的监测提供了一种微创方法。然而，动态HPV cfDNA监测在指导复发或转移性宫颈癌临床治疗决策中的作用仍未得到充分探讨。方法：在这项前瞻性先导观察研究中，通过数字液滴聚合酶链反应检测了28例复发或转移性HPV阳性宫颈癌患者血清样本中HPV cfDNA的水平。HPV cfDNA水平与临床结果和血清鳞状细胞癌抗原（SCC-Ag）水平相匹配，以评估HPV cfDNA作为肿瘤标志物的临床潜力。结果：28例患者均检出HPV cfDNA。值得注意的是，中位基线HPV cfDNA水平根据个体患者观察到的转移模式而变化（p=0.019）。在评估治疗反应或疾病进展之前，所有参与者在2个月的中位监测期间（范围0.3-16.9个月）表现出HPV cfDNA水平的变化。在26例初诊为宫颈鳞状细胞癌的患者中，HPV cfDNA阳性率为100%，SCC-Ag阳性率为69.2% （p=0.004, 95%可信区间（CI）， 0-0.391）。在20例宫颈鳞状细胞癌的纵向监测中，HPV cfDNA与疾病状态变化的一致性为90%，SCC-Ag与疾病状态变化的一致性为50% （p=0.014, 95% CI, 0.022-0.621）。结论：我们的研究表明，HPV cfDNA是一种很有前景的肿瘤标志物，用于监测复发或转移的HPV阳性宫颈癌。项目资助：浙江省重点研发计划项目（2022C04001）、浙江省医药卫生科技计划项目（2020KY454）、浙江省科技厅公益项目（LGF22H160075）。

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

eLife BIOLOGY-

CiteScore

12.90

自引率

3.90%

发文量

3122

审稿时长

17 weeks

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