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Transcervical sonography and human papillomavirus 16 E6 antibodies are sensitive for the detection of oropharyngeal cancer.
Lang Kuhs, Krystle A; Wood, C Burton; Wiggleton, Jamie; Aulino, Joseph M; Latimer, Brian; Smith, Derek K; Bender, Noemi; Rohde, Sarah; Mannion, Kyle; Kim, Young; Sinard, Robert; Langerman, Alexander; Fleischer, Arthur; Fakhry, Carole; Waterboer, Tim; Netterville, James L.
Afiliación
  • Lang Kuhs KA; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Wood CB; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Wiggleton J; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Aulino JM; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Latimer B; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Smith DK; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Bender N; German Cancer Research Center, Heidelberg, Germany.
  • Rohde S; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Mannion K; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Kim Y; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Sinard R; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Langerman A; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Fleischer A; Vanderbilt University Medical Center, Nashville, Tennessee.
  • Fakhry C; Johns Hopkins University, Baltimore, Maryland.
  • Waterboer T; German Cancer Research Center, Heidelberg, Germany.
  • Netterville JL; Vanderbilt University Medical Center, Nashville, Tennessee.
Cancer ; 126(11): 2658-2665, 2020 06 01.
Article en En | MEDLINE | ID: mdl-32129894
ABSTRACT

BACKGROUND:

Human papillomavirus 16 (HPV-16) E6 seropositivity is a promising early marker of human papillomavirus-driven oropharyngeal cancer (HPV-OPC), yet more sensitive imaging modalities are needed before screening is considered. The objective of this study was to determine the sensitivity of transcervical sonography (TCS) for detecting clinically apparent HPV-OPC in comparison with computed tomography (CT) and positron emission tomography (PET)/CT.

METHODS:

Fifty-one patients with known or suspected HPV-OPC without prior treatment underwent oropharyngeal TCS and blood collection (for HPV multiplex serology testing). Eight standard sonographic images were collected; primary-site tumors were measured in 3 dimensions if identified. Each patient underwent a full diagnostic workup as part of standard clinical care. The pathologic details, HPV status, final staging, and imaging findings were abstracted from the medical record. The sensitivity of each imaging modality was compared with the final clinical diagnosis (the gold standard).

RESULTS:

Twenty-four base of tongue cancers (47%), 22 tonsillar cancers (43%), and 2 unknown primary cancers (4%) were diagnosed; 3 patients (6%) had no tumors. All p16-tested patients were positive (n = 47). Primary-site tumors were correctly identified in 90.2% (95% confidence interval [CI], 78.6%-96.7%) with TCS, in 69.4% (95% CI, 54.6%-81.7%) with CT, and in 83.3% (95% CI, 68.6%-93.0%) with PET/CT. TCS identified tumors in 10 of 14 cases missed by CT and recognized the absence of tumors in 3 cases for which CT or PET/CT was falsely positive. The smallest sonographically identified primary-site tumor was 0.5 cm in its greatest dimension; the average size was 2.3 cm. Among p16-positive patients, 76.1% (95% CI, 61.2%-87.4%) were seropositive for HPV-16 E6.

CONCLUSIONS:

TCS and HPV-16 E6 antibodies are sensitive for the diagnosis of HPV-OPC.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Proteínas Represoras / Neoplasias Orofaríngeas / Proteínas Oncogénicas Virales / Ultrasonografía / Anticuerpos Antivirales Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2020 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Proteínas Represoras / Neoplasias Orofaríngeas / Proteínas Oncogénicas Virales / Ultrasonografía / Anticuerpos Antivirales Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Año: 2020 Tipo del documento: Article