Diagnostic and prognostic significance of circulating HPV cfDNA in cervical cancer: A systematic review and meta-analysis

IF 5.6 2区医学 Q1 HEMATOLOGY

Critical reviews in oncology/hematology Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI:10.1016/j.critrevonc.2026.105161

Preetiparna Parida , Ankita Mehta , Elstin Anbu Raj , Shyamala Guruvare , Mahadev Rao , Rama Rao Damerla , Shirley Lewis

{"title":"Diagnostic and prognostic significance of circulating HPV cfDNA in cervical cancer: A systematic review and meta-analysis","authors":"Preetiparna Parida , Ankita Mehta , Elstin Anbu Raj , Shyamala Guruvare , Mahadev Rao , Rama Rao Damerla , Shirley Lewis","doi":"10.1016/j.critrevonc.2026.105161","DOIUrl":null,"url":null,"abstract":"<div><h3>Importance</h3><div>Human papillomavirus circulating free DNA (HPV cfDNA) is an emerging biomarker with potential utility in the detection and treatment monitoring of cervical cancer.</div></div><div><h3>Objective</h3><div>To conduct a systematic review and meta-analysis evaluating the diagnostic and prognostic performance of HPV cfDNA in cervical cancer.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in PubMed, CINAHL, Cochrane Library, Scopus, and Embase through April 2025. Eligible studies reported or allowed calculation of diagnostic performance of HPV cfDNA in HPV-positive cervical cancer patients and/or included serial HPV cfDNA testing during post-treatment follow-up. Meta-analyses were conducted using a random-effects model. Heterogeneity was assessed with the I² statistic. The review followed PRISMA guidelines, and study quality was assessed using QUADAS-2.</div></div><div><h3>Results</h3><div>Of 106 studies screened, 20 met the inclusion criteria. Eleven studies contributed to the diagnostic meta-analysis and six to the prognostic analysis. The pooled sensitivity and specificity of HPV cfDNA for cervical cancer detection were 0.47 (95 % CI, 0.43–0.52) and 0.96 (95 % CI, 0.92–0.98), respectively. Positive and negative likelihood ratios were 10.49 and 0.28, with a diagnostic odds ratio of 71.31. The area under the SROC curve was 0.9825, indicating excellent overall diagnostic performance. Prognostically, HPV cfDNA positivity at 3 months post-treatment was significantly associated with reduced progression-free survival (HR = 8.50; 95 % CI, 4.69–15.41; I² = 0 %).</div></div><div><h3>Conclusions and relevance</h3><div>HPV cfDNA shows high specificity and strong prognostic value, supporting its clinical utility in cervical cancer detection and treatment surveillance.</div></div>","PeriodicalId":11358,"journal":{"name":"Critical reviews in oncology/hematology","volume":"220 ","pages":"Article 105161"},"PeriodicalIF":5.6000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical reviews in oncology/hematology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S104084282600048X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Importance

Human papillomavirus circulating free DNA (HPV cfDNA) is an emerging biomarker with potential utility in the detection and treatment monitoring of cervical cancer.

Objective

To conduct a systematic review and meta-analysis evaluating the diagnostic and prognostic performance of HPV cfDNA in cervical cancer.

Methods

A comprehensive literature search was conducted in PubMed, CINAHL, Cochrane Library, Scopus, and Embase through April 2025. Eligible studies reported or allowed calculation of diagnostic performance of HPV cfDNA in HPV-positive cervical cancer patients and/or included serial HPV cfDNA testing during post-treatment follow-up. Meta-analyses were conducted using a random-effects model. Heterogeneity was assessed with the I² statistic. The review followed PRISMA guidelines, and study quality was assessed using QUADAS-2.

Results

Of 106 studies screened, 20 met the inclusion criteria. Eleven studies contributed to the diagnostic meta-analysis and six to the prognostic analysis. The pooled sensitivity and specificity of HPV cfDNA for cervical cancer detection were 0.47 (95 % CI, 0.43–0.52) and 0.96 (95 % CI, 0.92–0.98), respectively. Positive and negative likelihood ratios were 10.49 and 0.28, with a diagnostic odds ratio of 71.31. The area under the SROC curve was 0.9825, indicating excellent overall diagnostic performance. Prognostically, HPV cfDNA positivity at 3 months post-treatment was significantly associated with reduced progression-free survival (HR = 8.50; 95 % CI, 4.69–15.41; I² = 0 %).

Conclusions and relevance

HPV cfDNA shows high specificity and strong prognostic value, supporting its clinical utility in cervical cancer detection and treatment surveillance.

查看原文本刊更多论文

循环HPV cfDNA在宫颈癌中的诊断和预后意义：系统综述和荟萃分析。

重要性：人乳头瘤病毒循环游离DNA （HPV cfDNA）是一种新兴的生物标志物，在宫颈癌的检测和治疗监测中具有潜在的用途。目的：通过系统回顾和荟萃分析，评价HPV cfDNA在宫颈癌中的诊断和预后表现。方法：到2025年4月，在PubMed、CINAHL、Cochrane Library、Scopus和Embase中进行全面的文献检索。符合条件的研究报告或允许计算HPV阳性宫颈癌患者的HPV cfDNA诊断性能和/或包括治疗后随访期间的连续HPV cfDNA检测。采用随机效应模型进行meta分析。异质性评价采用I²统计量。研究遵循PRISMA指南，使用QUADAS-2评估研究质量。结果：筛选的106项研究中，20项符合纳入标准。11项研究用于诊断荟萃分析，6项用于预后分析。HPV cfDNA检测宫颈癌的总敏感性和特异性分别为0.47 （95% CI, 0.43-0.52）和0.96 （95% CI, 0.92-0.98）。阳性和阴性似然比分别为10.49和0.28，诊断优势比为71.31。SROC曲线下面积为0.9825，总体诊断效果良好。在预后方面，治疗后3个月HPV cfDNA阳性与无进展生存期降低显著相关（HR = 8.50; 95% CI, 4.69-15.41; I²= 0%）。结论及意义：HPV cfDNA具有高特异性和较强的预后价值，支持其在宫颈癌检测和治疗监测中的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Critical reviews in oncology/hematology 医学-血液学

CiteScore

11.00

自引率

3.20%

发文量

213

审稿时长

55 days

期刊介绍： Critical Reviews in Oncology/Hematology publishes scholarly, critical reviews in all fields of oncology and hematology written by experts from around the world. Critical Reviews in Oncology/Hematology is the Official Journal of the European School of Oncology (ESO) and the International Society of Liquid Biopsy.