是时候用循环肿瘤HPV DNA改进口咽癌的诊断工作流程了：系统综述和荟萃分析。
It is time to improve the diagnostic workup of oropharyngeal cancer with circulating tumor HPV DNA: Systematic review and meta-analysis.
发表日期：2023 Sep 16
作者：
Francesca Paolini, Flaminia Campo, Oreste Iocca, Valentina Manciocco, Armando De Virgilio, Valentina De Pascale, Silvia Moretto, Giuanluca Dalfino, Antonello Vidiri, Giovanni Blandino, Fulvia Pimpinelli, Aldo Venuti, Raul Pellini
来源：
Epigenetics & Chromatin
摘要：
已经有几篇报告表明，在咽喉癌患者的血浆中检测到循环肿瘤乳头状瘤病毒DNA（ctHPVDNA）的可能性。然而，这些数据来自小样本群体，并且用于检测ctHPVDNA的现有测试还没有完全验证。该研究的目的是通过ddPCR评估ctHPVDNA的敏感性、特异性和准确性，以确定其在临床设置中对于HPV阳性咽部鳞状细胞癌（HPV + OPSCC）的诊断效果。对MEDLINE、Embase和Cochrane图书馆数据库进行了全面搜索。共有13项研究对998名患者进行了评估。其中，OPSCC p16+病例有729例，而对照组p16-病例有269例。荟萃分析研究估计了ctHPVDNA的诊断性能：其敏感性和特异性的汇总分别为0.90（95% CI：0.82-0.94）和0.94（95% CI：0.85-0.98）；阳性似然比和阴性似然比分别为12.6（95% CI：4.9-32.1）和0.05（95% CI：0.02-0.13）。ddPCR用于ctHPVDNA的诊断具有良好的准确性、敏感性和特异性。ctHPVDNA动力学代表了提高癌症患者诊断和治疗管理的可靠机会，并可能为了解肿瘤生物学开辟新的视角。© 2023 The Authors. Head & Neck published by Wiley Periodicals LLC.
The possibility of detecting circulating tumor HPV DNA (ctHPVDNA) in plasma in patients with oropharyngeal cancer has been demonstrated in several reports. However, these data are from small cohorts and available tests for detection of ctHPVDNA are not fully validated. The aim is to evaluate sensitivity, specificity, and accuracy of ctHPVDNA by ddPCR to define its efficacy in the clinical setting for the diagnosis of HPV + OPSCC. A comprehensive search of three different databases: MEDLINE, Embase, and Cochrane Library databases. A total of 998 patients were evaluated from the 13 studies. OPSSC p16+ were 729, while controls p16- were 269. The meta-analytic study estimated the diagnostic performance of ctHPVDNA as follows: pooled sensitivity and specificity of 0.90 (95% CI: 0.82-0.94) and 0.94 (95% CI: 0.85-0.98), respectively; positive and negative likelihood ratios of 12.6 (95% CI: 4.9-32.1) and 0.05 (95% CI: 0.02-0.13), respectively. ddPCR for ctHPVDNA has good accuracy, sensitivity, and specificity for diagnosis of HPV + OPSCC. ctHPVDNA kinetic represents a great reliable opportunity to improve diagnostic and therapeutic management of cancer patients and could open new perspectives for understanding tumor biology.© 2023 The Authors. Head & Neck published by Wiley Periodicals LLC.