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Purpose <p>To evaluate the diagnostic performance of circulating tumor HPVDNA (ctHPVDNA) for detecting residual or recurrent disease in patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) compared with positron emission tomography–computed tomography (PET-CT).</p> Methods <p>Data sources, including MEDLINE, Embase, CENTRAL, and Scopus, were searched from 2015 to May 2025 for studies evaluating the detection of circulating tumor DNA after treatment for HPV-positive OPSCC, using PET-CT as the reference standard.</p> <p>A systematic review and meta-analysis were conducted and registered with PROSPERO (CRD420251037973). Two reviewers independently extracted data according to the PRISMA guidelines and assessed quality using the QUADAS-2 tool. A hierarchical random-effects model was used to estimate pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios (DORs).</p> Results <p>Ten studies comprising 596 patients met the inclusion criteria. Pooled sensitivity for ctHPVDNA was 0.86 (95% CI, 0.68–0.95), specificity was 0.96 (95% CI, 0.88–0.99), and DOR was 153.0 (95% CI, 45.3–516.1). Subgroup analyses revealed the highest performance in studies using droplet digital polymerase chain reaction (ddPCR) and in those with sampling times greater than 12 weeks after treatment. PET-CT showed sensitivity of 0.89 (95% CI, 0.81–0.94) and specificity of 0.83 (95% CI, 0.30–0.98), with greater heterogeneity driven by threshold effects.</p> Conclusions <p>ctHPV DNA demonstrates high specificity and good sensitivity for detecting post-treatment recurrence in HPV-positive OPSCC, outperforming PET-CT in specificity and complementing its role in surveillance.</p>

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Circulating tumor HPV DNA versus PET-CT for surveillance in oropharyngeal squamous cell carcinoma: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Mohammad Mahmoud Aouf,
  • László Tamás,
  • Hussein A. El-Shirbeny,
  • Mohamed Abdel-Maboud,
  • Kornél Dános

摘要

Purpose

To evaluate the diagnostic performance of circulating tumor HPVDNA (ctHPVDNA) for detecting residual or recurrent disease in patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) compared with positron emission tomography–computed tomography (PET-CT).

Methods

Data sources, including MEDLINE, Embase, CENTRAL, and Scopus, were searched from 2015 to May 2025 for studies evaluating the detection of circulating tumor DNA after treatment for HPV-positive OPSCC, using PET-CT as the reference standard.

A systematic review and meta-analysis were conducted and registered with PROSPERO (CRD420251037973). Two reviewers independently extracted data according to the PRISMA guidelines and assessed quality using the QUADAS-2 tool. A hierarchical random-effects model was used to estimate pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios (DORs).

Results

Ten studies comprising 596 patients met the inclusion criteria. Pooled sensitivity for ctHPVDNA was 0.86 (95% CI, 0.68–0.95), specificity was 0.96 (95% CI, 0.88–0.99), and DOR was 153.0 (95% CI, 45.3–516.1). Subgroup analyses revealed the highest performance in studies using droplet digital polymerase chain reaction (ddPCR) and in those with sampling times greater than 12 weeks after treatment. PET-CT showed sensitivity of 0.89 (95% CI, 0.81–0.94) and specificity of 0.83 (95% CI, 0.30–0.98), with greater heterogeneity driven by threshold effects.

Conclusions

ctHPV DNA demonstrates high specificity and good sensitivity for detecting post-treatment recurrence in HPV-positive OPSCC, outperforming PET-CT in specificity and complementing its role in surveillance.