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Meta-Analysis
. 2023 Nov;45(11):2945-2954.
doi: 10.1002/hed.27515. Epub 2023 Sep 16.

It is time to improve the diagnostic workup of oropharyngeal cancer with circulating tumor HPV DNA: Systematic review and meta-analysis

Francesca Paolini  1   2 , Flaminia Campo  3 , Oreste Iocca  4 , Valentina Manciocco  1 , Armando De Virgilio  5   6 , Valentina De Pascale  7 , Silvia Moretto  3 , Gianluca Dalfino  3 , Antonello Vidiri  8 , Giovanni Blandino  9 , Fulvia Pimpinelli  10 , Aldo Venuti  1 , Raul Pellini  3
Affiliations
Meta-Analysis

It is time to improve the diagnostic workup of oropharyngeal cancer with circulating tumor HPV DNA: Systematic review and meta-analysis

Francesca Paolini et al. Head Neck. 2023 Nov.

Abstract

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.

Keywords: OPSCC; circulating tumor HPV-DNA; digital drop PRC; head and neck cancer; liquid biopsy; oropharyngeal squamous cell carcinoma.

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References

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