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- Title
Human papillomavirus 16 E6 antibodies are sensitive for human papillomavirus-driven oropharyngeal cancer and are associated with recurrence.
- Authors
Lang Kuhs, Krystle A.; Kreimer, Aimée R.; Trivedi, Sumita; Holzinger, Dana; Pawlita, Michael; Pfeiffer, Ruth M.; Gibson, Sandra P.; Schmitt, Nicole C.; Hildesheim, Allan; Waterboer, Tim; Ferris, Robert L.; Kreimer, Aimée R
- Abstract
<bold>Background: </bold>Human papillomavirus 16 (HPV16) E6 antibodies may be an early marker of the diagnosis and recurrence of human papillomavirus-driven oropharyngeal cancer (HPV-OPC).<bold>Methods: </bold>This study identified 161 incident oropharyngeal cancer (OPC) cases diagnosed at the University of Pittsburgh (2003-2013) with pretreatment serum. One hundred twelve had preexisting clinical HPV testing with p16 immunohistochemistry and HPV in situ hybridization (87 were dual-positive [HPV-OPC], and 25 were dual-negative [HPV-negative]); 62 had at least 1 posttreatment serum sample. Eighty-six of the 161 tumors were available for additional HPV16 DNA/RNA testing (45 were dual-positive [HPV16-OPC], and 19 were dual-negative [HPV16-negative). HPV16 E6 antibody testing was conducted with multiplex serology. The following were evaluated: 1) the sensitivity and specificity of HPV16 E6 serology for distinguishing HPV-OPC and HPV16-OPC from HPV-negative OPC, 2) HPV16 E6 antibody decay after treatment with linear models accommodating correlations in variance estimates, and 3) pre- and posttreatment HPV16 E6 levels and the risk of recurrence with Cox proportional hazards models.<bold>Results: </bold>Seventy-eight of 87 HPV-OPCs were HPV16 E6-seropositive (sensitivity, 89.7%; 95% confidence interval [CI], 81.3%-95.2%), and 24 of 25 HPV-negative OPCs were HPV16 E6-seronegative (specificity, 96.0%; 95% CI, 79.6%-99.9%). Forty-two of 45 HPV16-OPCs were HPV16 E6-seropositive (sensitivity, 93.3%; 95% CI, 81.7%-98.6%), and 18 of 19 HPV16-negative OPCs were HPV16 E6-seronegative (specificity, 94.7%; 95% CI, 74.0%-99.9%). Posttreatment HPV16 E6 antibody levels did not decrease significantly from the baseline (P = .575; median follow-up, 307 days) and were not associated with the risk of recurrence. However, pretreatment HPV16 E6 seropositivity was associated with an 86% reduced risk of local/regional recurrence (hazard ratio, 0.14; 95% CI, 0.03-0.68; P = .015).<bold>Conclusions: </bold>HPV16 E6 antibodies may have potential clinical utility for the diagnosis and/or prognosis of HPV-OPC. Cancer 2017;123:4382-90. © 2017 American Cancer Society.
- Subjects
OROPHARYNGEAL cancer; PAPILLOMAVIRUSES; VIRAL antibodies; IMMUNOHISTOCHEMISTRY; SEROLOGY; CANCER relapse; DIAGNOSIS; PAPILLOMAVIRUS disease diagnosis; PAPILLOMAVIRUS diseases; PROGNOSIS; PROTEINS; RESEARCH funding; DISEASE relapse; PREDICTIVE tests; NEOPLASTIC cell transformation; DISEASE complications
- Publication
Cancer (0008543X), 2017, Vol 123, Issue 22, p4382
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.30966