Abstract
Nasopharyngeal cancer (NPC) is known to be associated with Epstein–Barr virus (EBV). Pre-treatment and post-treatment detection of plasma cell-free EBV DNA has been shown to be useful as a diagnostic as well as a prognostic factor in NPC. On the other hand, the incidence of human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is increasing. In contrast to cervical cancer, which is classically known to be an HPV-associated malignancy, HPV testing is not clinically applied for OPC, except for p16 immunostaining as a surrogate marker of HPV infection. One of the major characteristics of HPV-associated OPC is its association with a good prognosis compared with non-HPV-associated OPC. However, some patients still have a poor prognosis. Another characteristic of HPV-associated OPC is the distinct risk factor of high sexual activity. Establishing a biomarker for the prediction of the prognosis before and/or after initial treatment, as well as for diagnosis in populations at high risk, is of marked interest. With this background, HPV DNA detection in plasma and oral rinses has become an area of focus. In this review, the current significance of HPV DNA detection in plasma and oral rinse samples, as well as serum HPV antibody levels, is evaluated.
Highlights
Pre-treatment and post-treatment detection of plasma cell-free Epstein–Barr virus (EBV) DNA has been shown to be useful as a diagnostic as well as a prognostic factor in nasopharyngeal cancer (NPC)
Quantitation of plasma/serum cell-free EBV DNA has had an impact as a biomarker for NPC diagnosis and prognosis after treatment [3]
We focus on viral DNA in virus-associated head and neck cancer, and summarize the usefulness of human papillomavirus (HPV) DNA detection in oral rinse samples, as well as in plasma, as a diagnostic and prognostic marker of HPV-associated oropharyngeal cancer (OPC)
Summary
The most well-known virus-associated head and neck cancer is nasopharyngeal cancer (NPC), which is closely associated with Epstein–Barr virus (EBV). Quantitation of plasma/serum cell-free EBV DNA has had an impact as a biomarker for NPC diagnosis and prognosis after treatment [3]. A meta-analysis of 14 published papers revealed that both patients with high plasma EBV DNA before treatment and those with persistent plasma EBV DNA after treatment showed significantly poorer overall survival (hazard ratio (HR), 2.81; 95% CI, 2.44–3.24; p < 0.00001, and HR, 4.26; 95% CI, 3.26–5.57; p < 0.00001, respectively) [5]. Microorganisms 2021, 9, 1150 survival (p < 0.0001) and relapse-free survival (p < 0.0001) [7] Based on these findings, clinical studies investigating the significance of adjuvant chemotherapy in patients with residual plasma EBV DNA are ongoing
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