The increased prevalence of HR-HPV–driven head or neck cancer (HNC), especially oropharynx malignancies, is due to cancer-causing high-risk papillomaviruses (HR-HPV). According to researchers, most individuals with HPV-driven OPC possess HR-HPV DNA in their breath at the initial diagnosis.
Saliva Testing May Help Detect Papillomavirus–Related Head and Neck Malignancies
The experts look for a new method that can offer reliable results within a short span, and hence the salvia test method got developed. However, they tested many cases and found the results at par with other methods, but the time taken for the test by this method was much short than others methods usually used for such tests.
This study shows a possibly life testing technique for earlier tumor identification and patients management relying on saliva HR-HPV DNA screening. The results were published in The Journal of Molecular Diagnostics.
“Despite the upsurge in HPV-driven HNC, there are no early detection methods or screening strategies for this cancer type, unlike cervical cancer, which is caused by the same virus. Biomarkers enabling early detection, monitoring, and disease prognostication are warranted to combat the rising incidence of HPV-driven OPC,” observed lead investigator Chamindie Punyadeera, Ph.D., head, Saliva & Liquid Biopsy Translational Laboratory, School of Biomedical Science, Faculty of Health, and Translational Research Institute, Brisbane.
Saliva screening was done on 491 individuals diagnosed with HNC for the initial occasion, and ten individuals were found with recurrent HNC. Salivary HR-HPV DNA was found in 43% of the participants. HPV16, a viruses type with a high risk of infection, is found in 92 percent of HPV-positive saliva samples. The oropharynx, particularly the papilla tonsils and the root of the mouth, had produced a great proportion of HPV-HNC cases, indicating that the oropharynx is a hotspot for such tumors. 72% of OPC individuals had HR-HPV DNA within the saliva, while 89.3% of them had tumor p16 expression. The numbers confirm the use of salivary screening as a diagnostic for detecting and detecting HR-HPV DNA earlier enough.
“When the noninvasive nature and convenience of the collection are considered, salivary HR-HPV testing is an ideal mode of screening asymptomatic individuals and the long-term monitoring of HPV-driven HNC patients. Our findings indicate that soon, salivary HR-HPV testing will become part of routine clinical management for HPV-driven OPC patients,” noted Dr. Punyadeera.
A total of 215 individuals with OPC are tracked for up to 5 years. Salivary HR-HPV–positive individuals fared better than salivary HR-HPV–negative individuals in terms of longevity. HR-HPV–positive individuals had a median occurrence survival of 205 months, relative to 82 months in HR-HPV–negative individuals. While the research only included a limited amount of individuals with recurring malignancy, the results show that saliva HR-HPV is reactive in the bulk of individuals at the locoregional place of recurrence.
“Liquid biopsy in HNC has the potential to be truly transformative,” explained co-investigator SarjuVasani, MD, Royal Brisbane, and Women’s Hospital. “It has the potential to personalize treatment selection and aid in assessing disease prognosis. It can help us select patients for adjuvant treatment and will alert us to recurrence before imaging or clinical examination has detected any specific abnormality. It is only a matter of time before these biomarkers translate from research settings to clinical practice.”
Patients are frequently diagnosed when they are in a late stage of their illness. These malignancies are difficult to detect in the early stages with imaging techniques or physical examination. The oropharynx is tough to reach, and detection is even more challenging if the smaller lesions are hidden in the tonsil crevices. Even though the initial tumor is undetectable in size, many tumors can spread at an early stage.
