{"title":"HPV+ 口咽癌治疗中的循环肿瘤 HPV DNA 及其与核磁共振成像的相关性。","authors":"Flaminia Campo PhD, Francesca Paolini PhD, Valentina Manciocco PhD, Silvia Moretto MD, Barbara Pichi MD, Claudio Moretti MD, Giovanni Blandino MD, Valentina De Pascale MD, Maria Benevolo MD, Fulvia Pimpinelli MD, Antonello Vidiri MD, Simona Marzi MD, Sergio Ruggiero MD, Irene Terrenato MD, Oreste Iocca MD, Aldo Venuti PhD, Raul Pellini MD","doi":"10.1002/hed.27866","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.27866","citationCount":"0","resultStr":"{\"title\":\"Circulating tumor HPV DNA in the management of HPV+ oropharyngeal cancer and its correlation with MRI\",\"authors\":\"Flaminia Campo PhD, Francesca Paolini PhD, Valentina Manciocco PhD, Silvia Moretto MD, Barbara Pichi MD, Claudio Moretti MD, Giovanni Blandino MD, Valentina De Pascale MD, Maria Benevolo MD, Fulvia Pimpinelli MD, Antonello Vidiri MD, Simona Marzi MD, Sergio Ruggiero MD, Irene Terrenato MD, Oreste Iocca MD, Aldo Venuti PhD, Raul Pellini MD\",\"doi\":\"10.1002/hed.27866\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":55072,\"journal\":{\"name\":\"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.27866\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hed.27866\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hed.27866","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:第一个目的是比较ctHPVDNA的ddPCR测定与p16 IHC和定性HPV PCR。第二个目的是进行纵向血液采样,检测ctHPVDNA与组织学确诊复发的关联性。第三个目的是进行多维评估,其中包括(1)临床特征;(2)ctHPVDNA;(3)基于MRI的原发肿瘤(PT)和宫颈淋巴结转移(CLNM)的肿瘤大小测量:方法:收集治疗前和随访期间的血浆样本,使用包含HPV16、HPV33和HPV35的E6的ddPCR检测:本研究对 117 例患者进行了诊断,结果显示 ctHPVDNA 的敏感性为 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)。在随访期间,ctHPVDNA检测复发的敏感性为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%为100%(95% CI 94.3-100)。结论:ctHPVDNA在诊断时识别HPV-OPSCC方面优于p16。ctHPVDNA的引入超出了诊断范围,是改善OPSCC患者随访方案的绝佳机会。
Circulating tumor HPV DNA in the management of HPV+ oropharyngeal cancer and its correlation with MRI
Background
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).
Methods
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.
Results
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.
Conclusions
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.
期刊介绍:
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.