HPV status and HPV16 viral load in anal cancer and its association with clinical outcome.

Autor: Guerendiain D; Scottish HPV Reference Laboratory, NHS Lothian, Edinburgh, UK.; School of Medicine, University of St Andrews, St Andrews, UK., Grigorescu R; Pathology, NHS Lothian, Edinburgh, UK., Kirk A; Centre for Virus Research, Institute of Infection Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK., Stevenson A; Centre for Virus Research, Institute of Infection Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK., Holden MTG; School of Medicine, University of St Andrews, St Andrews, UK., Pan J; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK., Kavanagh K; Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK., Graham SV; Centre for Virus Research, Institute of Infection Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK., Cuschieri K; Scottish HPV Reference Laboratory, NHS Lothian, Edinburgh, UK.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2022 Nov; Vol. 11 (22), pp. 4193-4203. Date of Electronic Publication: 2022 Jul 04.
DOI: 10.1002/cam4.4771
Abstrakt: Background: The incidence of anal cancer is increasing globally. Evidence-based improvement in early detection and management of this morbid cancer is thus required. In other cancers associated with Human Papillomavirus (HPV), viral status and dynamics, including viral load (VL) has been shown to influence clinical outcome. Our aim was to determine the influence of HPV status and HPV16 VL on the clinical outcomes of anal cancer patients.
Methods: A total of 185 anal cancer lesions were genotyped for HPV. Of the HPV16 positive component, VL was determined using a digital droplet PCR assay. The association of qualitative HPV status and VL (low (<12.3), medium (12.3-57) and high (>57 copies/cell)) on overall survival and hazard of death was assessed.
Results: Of the 185 cases, 164 (88.6%) samples were HPV positive. HPV16 was detected in 154/185 samples (83.2%). HPV positive status was associated with improved overall survival in the univariate analysis [hazard ratio (HR) of 0.44, 0.23-0.82, p = 0.01]. When adjusted by age, sex, stage and response to treatment, the association of positive HPV status with improved survival remained (HR 0.24 [0.11-0.55] p < 0.001). High VL was associated with improved overall survival in the univariate analysis with a HR of 0.28 (0.11-0.71, p = 0.007). When adjusted only by age and sex, high VL was associated with better overall survival (HR 0.27, 0.11-0.68 p = 0.006).
Conclusions: HPV status appears to be independently associated with improved outcomes in anal cancer patients. Moreover, HPV viral load quantification may be informative for further risk stratification and warrants further investigation.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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