虽然人乳头瘤病毒 (HPV) 阳性口咽鳞状细胞癌 (OPSCC) 的生存结果有利，但早期诊断可以最大限度地减少与治疗相关的发病率和死亡率。本研究评估了循环肿瘤组织修饰病毒 (TTMV)-HPV DNA 血浆检测，以促进 HPV 阳性 OPSCC 的早期诊断。在这项前瞻性探索性队列研究中，前往耳鼻喉头颈外科诊所就诊的患者出现不明原因的体征或症状2021 年 3 月至 2022 年 10 月期间招募了被认为 HPV 阳性高风险的 OPSCC。进行了循环 TTMV-HPV DNA 检测，并将结果与​​受试者和治疗临床医生共享。临床医生接受了关于该测试的临床实用性的调查。其中包括 39 名受试者。大多数受试者是女性（N = 23, 59%）、白人（N = 32, 82%）和从不吸烟者（N = 20, 51%），中位年龄为 60 岁。在 2/39 名受试者中检测到循环 TTMV-HPV DNA，两人随后均被诊断为 HPV 阳性 OPSCC。两人都是 70-80 岁的白人男性，颈部有肿块。一名 TTMV-HPV DNA 无法检测到的受试者也通过切除颈部肿块活检被诊断为 HPV 阳性 OPSCC。其他最终诊断包括 3 例 HPV 阴性头颈鳞状细胞癌和 4 例其他恶性肿瘤。 26/38 (68%) 受试者认为检测有助于临床决策，32/37 (86%) 受试者认为检测对未来类似患者有用。循环 TTMV-HPV DNA 检测是可行的，并且具有作为诊断的潜力协助 HPV 阳性 OPSCC 以及标准临床检查。临床医生应该认识到其局限性，因为阴性检测并不一定表明没有疾病。需要进一步研究来评估其实用性。版权所有 © 2023 Elsevier Ltd。保留所有权利。

While survival outcomes are favorable for Human Papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs), early diagnosis may minimize treatment-related morbidity and mortality. This study evaluated circulating tumor tissue-modified viral (TTMV)-HPV DNA plasma testing to facilitate early diagnosis of HPV-positive OPSCCs.In this prospective exploratory cohort study, patients presenting to an Otolaryngology-Head and Neck Surgery clinic with unexplained signs or symptoms considered high-risk for HPV-positive OPSCC were recruited between March 2021-October 2022. Circulating TTMV-HPV DNA testing was performed, and results were shared with subjects and treating clinicians. Clinicians were surveyed regarding the perceived clinical utility of the test.Thirty-nine subjects were included. Most subjects were women (N = 23, 59 %), white (N = 32, 82 %) and never-smokers (N = 20, 51 %) with median age 60 years. Circulating TTMV-HPV DNA was detected in 2/39 subjects, both subsequently diagnosed with HPV-positive OPSCC. Both were white men aged 70-80 years with a neck mass. One subject with undetectable TTMV-HPV DNA was also diagnosed with HPV-positive OPSCC through excisional neck mass biopsy. Other eventual diagnoses included 3 HPV-negative head and neck squamous cell carcinomas and 4 other malignancies. Testing was perceived as helpful in clinical decision-making for 26/38 (68 %) subjects, and useful for similar future patients for 32/37 (86 %) subjects.Circulating TTMV-HPV DNA testing is feasible and holds potential as a diagnostic aid for HPV-positive OPSCC alongside standard clinical workup. Clinicians should be cognizant of its limitations, as a negative test does not necessarily indicate the absence of disease. Further studies to evaluate its utility are warranted.Copyright © 2023 Elsevier Ltd. All rights reserved.