人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌总体预后良好，但一部分患者会经历毁灭性的疾病复发。目前检测复发性疾病的监测标准并不完善。人们对通过使用能够检测循环肿瘤 HPV DNA 的基于血浆的检测来改善复发性疾病的检测越来越感兴趣。尽管大多数循环肿瘤 HPV DNA 检测仍处于研究领域，但循环肿瘤组织修饰的病毒 HPV DNA 检测已成为于 2020 年初在美国上市，并越来越多地用于临床环境。随着 HPV 阳性口咽鳞状细胞癌发病率的迅速增加以及该疾病生物标志物能力的扩展，重新审视当前的治疗后监测实践并确定是否可以使用新兴技术来改善不断增长的幸存者群体的预后至关重要。不过，建议谨慎行事；目前尚不清楚基于生物标志物的监测是否真正有益，而且与任何干预措施一样，它都有可能造成伤害。本文以玛格丽特·佩佩 (Margaret Pepe) 的经典的早期癌症检测生物标志物开发的 5 个阶段为框架，回顾当前的知识状况，强调现有的知识差距，并建议应优先进行研究，以了解基于生物标志物的监测与患者结果之间的关联。鉴于市售的肿瘤组织修饰病毒 HPV DNA 检测的临床应用不断增加，它受到了特别关注。这篇综述可以作为未来研究的路线图，并为临床医生考虑在实践中采用它提供指导。应优先考虑将患者纳入纳入基于生物标志物监测的临床试验。

Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma has an overall favorable prognosis, yet a subset of patients will experience devastating disease recurrence. Current surveillance standards for detection of recurrent disease are imperfect. There is growing interest in improving detection of recurrent disease through the use of plasma-based assays able to detect circulating tumor HPV DNA.Although most circulating tumor HPV DNA assays remain in the research domain, the circulating tumor tissue-modified viral HPV DNA assay became commercially available in the United States in early 2020 and has been increasingly used in the clinical setting. With the rapidly increasing incidence of HPV-positive oropharyngeal squamous cell carcinoma and concomitant expansion of biomarker capabilities for this disease, it is critical to reexamine current posttreatment surveillance practices and to determine whether emerging technologies may be used to improve outcomes for a growing survivor population. However, caution is advised; it is not yet known whether biomarker-based surveillance is truly beneficial, and as is true with any intervention, it has the capacity to cause harm.Using Margaret Pepe's classic 5 phases of biomarker development for early detection of cancer as a framework, this article reviews the current state of knowledge, highlights existing knowledge gaps, and suggests research that should be prioritized to understand the association between biomarker-based surveillance and patient outcomes. Specific attention is paid to the commercially available tumor tissue-modified viral HPV DNA assay, given its increasing clinical use. This review may serve as a road map for future research and a guide for clinicians considering its adoption in practice. Enrollment of patients into clinical trials incorporating biomarker-based surveillance should be prioritized.