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Abstract
The aim of the study was to evaluate the diagnostic accuracy of Human Papillomavirus (HPV) techniques in oropharyngeal cancer. PubMed, EMBASE, the Cochrane Library and clinicaltrials.org were systematically searched for studies reporting methods of HPV detection. Primary outcomes were sensitivity and specificity of HPV detection. In this case, 27 studies were included (n = 5488, 41.6% HPV+). In this case, 13 studies evaluated HPV detection in tumour tissue, nine studies examined HPV detection in blood samples and five studies evaluated HPV detection in oral samples. Accuracy of HPV detection in tumour tissue was high for all detection methods, with pooled sensitivity ranging from 81.1% (95% CI 71.9–87.8) to 93.1% (95% CI 87.4–96.4) and specificity ranging from 81.1% (95% CI 71.9–87.8) to 94.9% (95% CI 79.1–98.9) depending on detection methods. Overall accuracy of HPV detection in blood samples revealed a sensitivity of 81.4% (95% CI 62.9–91.9) and a specificity of 94.8% (95% CI 91.4–96.9). In oral samples pooled sensitivity and specificity were lower (77.0% (95% CI 68.8–83.6) and 74.0% (95% CI 58.0–85.4)). In conclusion, we found an overall high accuracy for HPV detection in tumour tissue regardless of the HPV detection method used. HPV detection in blood samples may provide a promising new way of HPV detection.
Highlights
The incidence of oropharyngeal squamous cell carcinomas (OPSCCs) caused by human papillomavirus (HPV) is increasing worldwide [1,2]
We excluded studies that did not focus on the diagnostic accuracy of Human Papillomavirus (HPV) detection (n = 975), other reviews, case reports and editorials (n = 218) and lastly, studies regarding
When looking at the diagnostic accuracy in oral samples obtained from OPSCC patients, our study revealed a lower diagnostic accuracy than the other specimen types with a sensitivity and specificity of 77.6% and 72.1%, respectively
Summary
The incidence of oropharyngeal squamous cell carcinomas (OPSCCs) caused by human papillomavirus (HPV) is increasing worldwide [1,2]. The main causes of OPSCCs were smoking and alcohol consumption but today up to 70% of cases in most parts of the Western world are associated with HPV-driven carcinogenesis [3–7]. HPV+ OPSCC has a unique epidemiologic profile, molecular composition and histopathological features compared to the tobacco and alcohol associated OPSCC [3,8–10]. With fewer co-morbidities and have a better prognosis [11–13]. A surrogate marker for HPV infection is tumour suppressor protein p16 positivity (p16+). P16+ OPSCC has shown better prognosis compared to p16 negative (p16−) tumours. Double positivity, i.e., tumours being positive for both HPV and p16 have shown better prognostication compared to a single marker of positivity [14]
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