OP089: Clinical importance of HPV markers in the follow up of patients with head and neck tumors

Abstract

The purpose of this study was to determine the correlation between the presence of HPV DNA in tumor tissue and its presence in oral rinses and between the presence of HPV DNA in tumor tissue and HPV specific antibody levels in sera. The second goal was to find out whether changes in HPV DNA prevalence in oral rinses and/or HPV-specific antibody levels in sera of patients with HPV positive tumors have prognostic significance. One hundred forty-two patients with oral/oropharyngeal tumors were enroled. The presence of HPV DNA was assayed in tumor tissue and oral rinses, and HPV-specific antibodies were assessed in sera. Oral rinses were collected before treatment and one year after treatment. Sera were drawn before treatment, one month and one year after the end of treatment. Altogether, 59.2% tumors were HPV positive. The presence of HPV DNA in the tumors strongly correlated with HPV DNA positivity in oral rinses as well as with the presence of HPV—specific antibodies in sera. All markers of HPV infection at enrollment were predictive of better survival and lower frequency of recurrences. A majority of patients cleared their HPV infection in oral rinses after treatment. Out of 66 patients with HPV positive oral rinses at enrollment, 84.8% became negative at one-year follow-up, while most patients sustained their seropositivity for HPV specific antigens. However the mean titers of HPV 16 E6 and E7 antibodies at follow-up were lower in comparison to those at enrollment and the differences were statistically significant. Of 16 patients with recurrences on the follow-up (alive at the time of second sampling), six were positive at enrollment for HPV 16 E6 and/or E7 antibodies. In five of these, no decrease in antibody levels was observed. In all patients titers of antibodies specific for HPV 16 capsid antigens did not change during the follow up. Our data suggest that the detection of seropositivity for HPV-specific antibodies to the HPV 16 E6 and E7 oncoproteins may serve not only as a marker of the HPV etiology, but also as a marker of recurrence and a prognostic indicator in patients with HPV positive tumors. Grant sponsor for this study was Granting Agency, Ministry of Health, Czech Republic with Grant No.: NT/12483.