循环肿瘤 HPV DNA 和 TTMV-HPVDNA 监测 HPV 口咽癌的前景:系统回顾和荟萃分析。

IF 11.4 1区 医学 Q1 ONCOLOGY
Flaminia Campo, Oreste Iocca, Francesca Paolini, Valentina Manciocco, Silvia Moretto, Armando De Virgilio, Claudio Moretti, Antonello Vidiri, Aldo Venuti, Paolo Bossi, Giovanni Blandino, Raul Pellini
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引用次数: 0

摘要

背景:与人乳头状瘤病毒(HPV)相关的口咽癌发病率迅速上升,可能很快就会占到所有头颈部癌症的大多数。因此,公共卫生迫切需要改进监测和监控方法:目的是通过对ctHPVDNA和TTMV-HPVDNA的元分析研究,强调液体活检目前的潜力和局限性。该研究利用三个不同的数据库对2023年12月之前发表的文章进行了文献检索:MEDLINE、Embase 和 Cochrane Library。这些研究评估了HPV + OPSCC患者治疗后的ctHPVDNA和TTMV-HPVDNA,报告了复发诊断准确性的完整数据,或可提取真阳性、假阳性、真阴性和假阴性的数量,并明确定义了病毒DNA的检测方法。荟萃分析是根据流行病学观察性研究荟萃分析(MOOSE)报告指南进行的。该荟萃分析旨在评估 ddPCR 检测ctHPVDNA 和 TTMV 的灵敏度、特异性和准确性,以确定其在临床环境中随访 HPV-OPSCC 的有效性:纳入荟萃分析的 12 项研究共对 1311 名患者进行了分析(ctHPVDNA 评估了 398 名患者,TTMV-HPVDNA 评估了 913 名患者)。汇总灵敏度和特异度分别为86%(95% CI:78%-91%)和96%(95% CI:91%-99%);阴性和阳性似然比分别为0.072(95% CI:0.057-0.093)和24.7(95% CI:6.5-93.2);汇总DOR为371.66(95% CI:179.1-918)。曲线下面积(AUC)为 0.81(95% CI,0.67-0.91)。通过液体活检鉴定细胞游离DNA可能会提早发现HPV+OPSCC患者的复发。目前,液体活检方案尚需标准化,液体活检还不能用于临床。未来,将多种临床、放射学和实验室数据联系起来的多维综合方法将有助于为HPV-OPSCC的随访制定最佳的随访策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The landscape of circulating tumor HPV DNA and TTMV-HPVDNA for surveillance of HPV-oropharyngeal carcinoma: systematic review and meta-analysis.

Background: Human papilloma virus (HPV) related cancers of the oropharynx are rapidly increasing in incidence and may soon represent the majority of all head and neck cancers. Improved monitoring and surveillance methods are thus an urgent need in public health.

Main text: The goal is to highlight the current potential and limitations of liquid biopsy through a meta analytic study on ctHPVDNA and TTMV-HPVDNA. It was performed a Literature search on articles published until December 2023 using three different databases: MEDLINE, Embase, and Cochrane Library. Studies that evaluated post-treatment ctHPVDNA and TTMV-HPVDNA in patients with HPV + OPSCC, studies reporting complete data on the diagnostic accuracy in recurrence, or in which the number of true positives, false positives, true negatives, and false negatives was extractable, and methods of detection of viral DNA clearly defined. The meta-analysis was conducted following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) reporting guidelines. The aim of this meta-analysis was to evaluate the sensitivity, specificity, and accuracy of ctHPVDNA and TTMV by ddPCR to define its efficacy in clinical setting for the follow up of HPV-OPSCC.

Conclusion: The 12 studies included in the meta-analysis provided a total of 1311 patients for the analysis (398 valuated with ctHPVDNA and 913 with TTMV-HPVDNA). Pooled sensitivity and specificity were 86% (95% CI: 78%-91%) and 96% (95% CI: 91%-99%), respectively; negative and positive likelihood ratios were 0.072 (95% CI: 0.057-0.093) and 24.7 (95% CI: 6.5-93.2), respectively; pooled DOR was 371.66 (95% CI: 179.1-918). The area under the curve (AUC) was 0.81 (95% CI, 0.67-0.91). Liquid biopsy for the identification of cell free DNA might identify earlier recurrence in HPV + OPSCC patients. At the present time, liquid biopsy protocol needs to be standardized and liquid biopsy cannot yet be used in clinical setting. In the future, a multidimensional integrated approach which links multiple clinical, radiological, and laboratory data will contribute to obtain the best follow-up strategies for the follow-up of HPV-OPSCC.

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来源期刊
CiteScore
18.20
自引率
1.80%
发文量
333
审稿时长
1 months
期刊介绍: The Journal of Experimental & Clinical Cancer Research is an esteemed peer-reviewed publication that focuses on cancer research, encompassing everything from fundamental discoveries to practical applications. We welcome submissions that showcase groundbreaking advancements in the field of cancer research, especially those that bridge the gap between laboratory findings and clinical implementation. Our goal is to foster a deeper understanding of cancer, improve prevention and detection strategies, facilitate accurate diagnosis, and enhance treatment options. We are particularly interested in manuscripts that shed light on the mechanisms behind the development and progression of cancer, including metastasis. Additionally, we encourage submissions that explore molecular alterations or biomarkers that can help predict the efficacy of different treatments or identify drug resistance. Translational research related to targeted therapies, personalized medicine, tumor immunotherapy, and innovative approaches applicable to clinical investigations are also of great interest to us. We provide a platform for the dissemination of large-scale molecular characterizations of human tumors and encourage researchers to share their insights, discoveries, and methodologies with the wider scientific community. By publishing high-quality research articles, reviews, and commentaries, the Journal of Experimental & Clinical Cancer Research strives to contribute to the continuous improvement of cancer care and make a meaningful impact on patients' lives.
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