Prognostic Implication of Persistent Human Papillomavirus Type 16 DNA Detection in Oral Rinses for Human Papillomavirus-Related Oropharyngeal Carcinoma.
Prognostic Implication of Persistent Human Papillomavirus Type 16 DNA Detection in Oral Rinses for Human Papillomavirus-Related Oropharyngeal Carcinoma.
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DOI：
10.1001/jamaoncol.2015.2524
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发表时间：
2015-10
期刊：
影响因子：
28.4
通讯作者：
D'Souza G
中科院分区：
文献类型：
--
作者：
Rettig EM;Wentz A;Posner MR;Gross ND;Haddad RI;Gillison ML;Fakhry C;Quon H;Sikora AG;Stott WJ;Lorch JH;Gourin CG;Guo Y;Xiao W;Miles BA;Richmon JD;Andersen PE;Misiukiewicz KJ;Chung CH;Gerber JE;Rajan SD;D'Souza G
人乳头瘤病毒相关口咽癌（HPV-OPC）在美国的发病率正在增加。虽然HPV-OPC预后良好，但10%至25%的HPV-OPC复发。口腔冲洗液中人乳头瘤病毒（HPV）DNA的检测与HPV-OPC相关，但其作为预后生物标志物的潜力尚不清楚。确定HPV-OPC治疗后口腔冲洗液中HPV DNA检测是否与复发和生存相关。对2009年至2013年在美国4个学术三级转诊癌症中心诊断的HPV-OPC患者进行的前瞻性队列研究。在诊断和治疗后（诊断后9，12，18和24个月）收集口腔冲洗样本，并评估HPV DNA。在最初的157名接受治疗性治疗的HPV-OPC患者中，124名患者有1次或多次治疗后口腔冲洗，并被纳入本研究。采用Kaplan-Meier法估计无病生存期（DFS）和总生存期（OS），采用考克斯回归分析口腔冲洗液中HPV DNA检测与生存期的关系。口腔HPV 16型（HPV 16）DNA在诊断时很常见（124名参与者中有67名[54%]）。相比之下，治疗后仅在6名参与者（5%）中检测到口腔HPV 16 DNA，其中5名在诊断时也检测到HPV 16 DNA（持续性口腔HPV 16 DNA）。2年DFS和OS分别为92%（95% CI，94%-100%）和98%（95% CI，93%-99%）。持续口服HPV 16 DNA与DFS（风险比，29.7 [95% CI，9.0-98.2]）和OS（风险比，23.5 [95% CI，4.7-116.9]）恶化相关。所有5名持续性口腔HPV 16 DNA的参与者都发生了复发性疾病，3名伴有局部疾病。相比之下，119名没有持续口服HPV 16 DNA的参与者中只有9名（8%）复发，只有1名（11%）有局部疾病。从治疗后最早的口服HPV 16 DNA检测到复发的中位（范围）时间为7.0（3.7-10.9）个月。口腔清洗液中的人乳头瘤病毒16型DNA在诊断时很常见，但在HPV-OPC治疗后很少见。我们的数据表明，虽然不常见，但治疗后口腔冲洗液中持续存在HPV 16 DNA与预后不良相关，是长期肿瘤监测的潜在工具，对于局部复发可能更是如此。
Human papillomavirus–related oropharyngeal carcinoma (HPV-OPC) is increasing in incidence in the United States. Although HPV-OPC has favorable prognosis, 10% to 25% of HPV-OPCs recur. Detection of human papillomavirus (HPV) DNA in oral rinses is associated with HPV-OPC, but its potential as a prognostic biomarker is unclear. To determine whether HPV DNA detection in oral rinses after treatment for HPV-OPC is associated with recurrence and survival. Prospective cohort study of patients with incident HPV-OPC diagnosed from 2009 to 2013 at 4 academic tertiary referral cancer centers in the United States. Oral rinse samples were collected at diagnosis and after treatment (9, 12, 18, and 24 months after diagnosis), and evaluated for HPV DNA. Among an initial cohort of 157 participants with incident HPV-OPC treated with curative intent, 124 had 1 or more posttreatment oral rinses available and were included in this study. Disease-free survival (DFS) and overall survival (OS) were estimated by the Kaplan-Meier method, and the association of HPV DNA detection in oral rinses with survival was evaluated using Cox regression analysis. Oral HPV type 16 (HPV16) DNA was common at diagnosis (67 of 124 participants [54%]). In contrast, oral HPV16 DNA was detected in only 6 participants after treatment (5%), including 5 with HPV16 DNA also detected at diagnosis (persistent oral HPV16 DNA). Two-year DFS and OS were 92% (95% CI, 94%-100%) and 98% (95% CI, 93%-99%). Persistent oral HPV16 DNA was associated with worse DFS (hazard ratio, 29.7 [95% CI, 9.0-98.2]) and OS (hazard ratio, 23.5 [95% CI, 4.7-116.9]). All 5 participants with persistent oral HPV16 DNA developed recurrent disease, 3 with local disease involvement. In contrast, just 9 of 119 participants (8%) without persistent oral HPV16 DNA developed recurrent disease, only 1 (11%) with local disease involvement. Median (range) time from earliest posttreatment oral HPV16 DNA detection to recurrence was 7.0 (3.7-10.9) months. Human papillomavirus type 16 DNA in oral rinses is common at diagnosis but rare after treatment for HPV-OPC. Our data suggest that, although infrequent, persistent HPV16 DNA in posttreatment oral rinses is associated with poor prognosis and is a potential tool for long-term tumor surveillance, perhaps more so for local recurrence.
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影响因子：
8.8
作者：
Broutian, Tatevik R.;He, Xin;Gillison, Maura L.
通讯作者：
Gillison, Maura L.
影响因子：
6.4
作者：
Chaturvedi, Anil K.;Graubard, Barry I.;Gillison, Maura L.
通讯作者：
Gillison, Maura L.
影响因子：
11.5
作者：
Agrawal, Yuri;Koch, Wayne M.;Xiao, Weihong;Westra, William H.;Trivett, Anna L.;Symer, David E.;Gillison, Maura L.
通讯作者：
Gillison, Maura L.
DOI：
10.1093/jnci/djr003
发表时间：
2011-03-16
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Koshiol J;Rotunno M;Gillison ML;Van Doorn LJ;Chaturvedi AK;Tarantini L;Song H;Quint WG;Struijk L;Goldstein AM;Hildesheim A;Taylor PR;Wacholder S;Bertazzi PA;Landi MT;Caporaso NE
通讯作者：
Caporaso NE
影响因子：
45.3
作者：
Fakhry, Carole;Zhang, Qiang;Gillison, Maura
通讯作者：
Gillison, Maura