Sensitivity and specificity of antibodies against HPV16 E6 and other early proteins for the detection of HPV16-driven oropharyngeal squamous cell carcinoma.
To determine the sensitivity and specificity of HPV16 serology as diagnostic marker for HPV16-driven oropharyngeal squamous cell carcinoma (OPSCC), 214 HNSCC patients from Germany and Italy with fresh-frozen tumor tissues and sera collected before treatment were included in this study. Hundred and twenty cancer cases were from the oropharynx and 94 were from head and neck cancer regions outside the oropharynx (45 oral cavity, 12 hypopharynx and 35 larynx). Serum antibodies to early (E1, E2, E6 and E7) and late (L1) HPV16 proteins were analyzed by multiplex serology and were compared to tumor HPV RNA status as the gold standard. A tumor was defined as HPV-driven in the presence of HPV16 DNA and HPV16 transformation-specific RNA transcript patterns (E6*I, E1∧E4 and E1C). Of 120 OPSCC, 66 (55%) were HPV16-driven. HPV16 E6 seropositivity was the best predictor of HPV16-driven OPSCC (diagnostic accuracy 97% [95%CI 92-99%], Cohen's kappa 0.93 [95%CI 0.8-1.0]). Of the 66 HPV-driven OPSCC, 63 were HPV16 E6 seropositive, compared to only one (1.8%) among the 54 non-HPV-driven OPSCC, resulting in a sensitivity of 96% (95%CI 88-98) and a specificity of 98% (95%CI 90-100). Of 94 HNSCC outside the oropharynx, six (6%) were HPV16-driven. In these patients, HPV16 E6 seropositivity had lower sensitivity (50%, 95%CI 19-81), but was highly specific (100%, 95%CI 96-100). In conclusion, HPV16 E6 seropositivity appears to be a highly reliable diagnostic marker for HPV16-driven OPSCC with very high sensitivity and specificity, but might be less sensitive for HPV16-driven HNSCC outside the oropharynx.
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Dana
0000-0002-5010-5236
D
Holzinger
Department of Otorhinolaryngology, University Hospital Leipzig, Leipzig, Germany.
Gunnar
G
Wichmann
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.|Department of Oncology and Surgical Sciences, University of Padua, Padua, Italy.
Lorena
L
Baboci
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Angelika
A
Michel
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Daniela
D
Höfler
Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany.
Manuel
M
Wiesenfarth
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Lea
L
Schroeder
Department of Neurosciences, ENT Clinic and Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy.
Paolo
P
Boscolo-Rizzo
Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University, Heidelberg, Germany.|Department of Neurosurgery, Division of Experimental Neurosurgery, Heidelberg University, Heidelberg, Germany.
Christel
C
Herold-Mende
Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University, Heidelberg, Germany.
Gerhard
G
Dyckhoff
Department of Otorhinolaryngology, University Hospital Leipzig, Leipzig, Germany.
Andreas
A
Boehm
Department of Immunology and Molecular Oncology, IRCCS Veneto Institute of Oncology (IOV), Padua, Italy.
Annarosa
A
Del Mistro
Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University, Heidelberg, Germany.
Franz X
FX
Bosch
Department of Otorhinolaryngology, University Hospital Leipzig, Leipzig, Germany.
Andreas
A
Dietz
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Michael
M
Pawlita
Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Tim
T
Waterboer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D005260:Female; D054884:Host-Pathogen Interactions / Q000276:immunology; D052162:Human papillomavirus 16 / Q000235:genetics / Q000276:immunology* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000235:genetics / Q000276:immunology*; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D030361:Papillomavirus Infections / Q000276:immunology* / Q000821:virology; D012097:Repressor Proteins / Q000235:genetics / Q000276:immunology*; D012680:Sensitivity and Specificity
D000914:Antibodies, Viral; C068651:E6 protein, Human papillomavirus type 16; D009856:Oncogene Proteins, Viral; D012097:Repressor Proteins
biomarker; diagnosis; early proteins; head and neck squamous cell carcinoma; human papillomavirus; oropharynx; serology