title: Presence of HPV DNA in convalescent salivary rinses is an adverse prognostic marker in head and neck squamous cell carcinoma.
abstract: Human papillomavirus (HPV) 16 is present in up to 60% of patients with head and neck squamous cell carcinoma (HNSCC) and confers a favorable prognosis in terms of recurrence and mortality. Previous reports demonstrated that HPV-16 DNA can be detected in the initial salivary rinses from these patients. In this study, we assessed the feasibility of post-treatment HPV DNA shed from the oral mucosa as a prognostic marker for persistent/recurrent head and neck cancer. Fresh tumor samples and pre- and post-treatment salivary rinses were collected from 59 patients with HNSCC. HPV-16 E6 and E7 DNA copy number in these samples were quantified by real time PCR. Twenty of 59 patients (33.9%) were HPV-16 positive in their tumors before treatment. Four of 20 HPV tumor positive patients ultimately developed recurrence, and two of these four patients were HPV-16 positive in surveillance salivary rinses (sensitivity=50%). Of the 39 (66.1%) HPV-16 negative patients on initial clinical presentation and the 16 HPV-16 positive patients who did not recur, none were HPV-16 positive in salivary rinses after treatment (specificity=100%). HPV-16 presence in follow-up salivary rinses preceded clinical detection of disease recurrence by an average of 3.5 months. Patients with presence of HPV-16 DNA in surveillance salivary rinses are at significant risk for recurrence. Quantitative measurement of salivary HPV-16 DNA has promise for surveillance and early detection of recurrence.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins Medical Institutions, 601 North Caroline Street, 6th Floor, Baltimore, MD, USA.
authors.forename: Alice Y
authors.initials: AY
authors.lastname: Chuang
authors.forename: Tony C
authors.initials: TC
authors.lastname: Chuang
authors.forename: Steven
authors.initials: S
authors.lastname: Chang
authors.forename: Shaoyu
authors.initials: S
authors.lastname: Zhou
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Begum
authors.forename: William H
authors.initials: WH
authors.lastname: Westra
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Ha
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Koch
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Califano
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis*; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000235:genetics / Q000821:virology*; D052162:Human papillomavirus 16 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000821:virology; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology*; D011379:Prognosis; D012463:Saliva / Q000821:virology*; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral