Background: There are definite reasons to implement molecular diagnostics based on the measurement of human papillomavirus (HPV) DNA in liquid biopsy into clinical practice. It is a quick, repeatable, and health-safe test for cancer biomarkers in the blood. In this study, we investigated whether the circulating tumor-related HPV16 (ctHPV16) viral load (VL) in patients with oropharyngeal squamous cell carcinoma (OPSCC) was important for determining the risk of locoregional recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS). Methods: This study included 91 patients with ctHPV16-positive OPSCC who had been treated with radical radiotherapy and chemotherapy. The VL was measured using quantitative PCR (qPCR) and a probe specific for HPV16. Based on 10 years of follow-up, the 2-, 3-, 5-, and 9-year LRFS, MFS, and OS were estimated. Results: The 5-year actuarial LRFS, MFS, and OS rates of patients with ctHPV16-positive/OPSCC were 88%, 90%, and 81%, respectively. The VL was significantly higher in patients who subsequently developed distant metastases (DM) than in those who did not (VL 4.09 vs. 3.25;p= 0.009). In a Cox proportional hazards regression model for MFS, a higher ctHPV16 VL appeared to be a significant independent prognostic factor for the occurrence of DM (HR 2.22,p= 0.015). The ROC curve revealed a cutoff value of 3.556 for VL (p= 0.00001). Conclusions: A high VL before treatment indicates patients with a significant risk of DM, and should be used in OPSCC treatment stratification.
背景：将基于液体活检中人乳头瘤病毒（HPV）DNA检测的分子诊断技术应用于临床实践具有明确依据。这是一种快速、可重复且对健康安全的血液癌症生物标志物检测方法。本研究旨在探讨口咽鳞状细胞癌（OPSCC）患者循环肿瘤相关HPV16（ctHPV16）病毒载量（VL）是否对评估局部区域无复发生存期（LRFS）、无转移生存期（MFS）和总生存期（OS）的风险具有重要意义。方法：本研究纳入91例接受根治性放化疗的ctHPV16阳性OPSCC患者。采用定量PCR（qPCR）及HPV16特异性探针检测病毒载量。基于10年随访数据，评估患者2年、3年、5年及9年的LRFS、MFS和OS。结果：ctHPV16阳性/OPSCC患者的5年精算LRFS、MFS和OS率分别为88%、90%和81%。后续发生远处转移（DM）患者的VL显著高于未转移患者（VL 4.09 vs. 3.25；p=0.009）。在MFS的Cox比例风险回归模型中，较高的ctHPV16 VL是DM发生的显著独立预后因素（HR 2.22，p=0.015）。ROC曲线显示VL的临界值为3.556（p=0.00001）。结论：治疗前高VL提示患者存在显著的DM风险，应将其纳入OPSCC治疗分层体系。
肿瘤(癌症)患者之家