High-risk human papillomaviruses (HR-HPV) have led to an increase in the incidence of certain head and neck cancers (HNC), especially oropharyngeal cancers (OPC), but methods for screening and early detection of these types of HPV-driven cancers have lagged behind the rising threat. Now, researchers at the Queensland University of Technology and University of Queensland have found that saliva testing could be a viable method for early detection of HR-HPV DNA through qPCR methods.
Researchers performed saliva testing on more than 500 patients with HNC and tested the samples for the viral DNA. Forty-three percent of the patients tested positive for salivary HR-HPV DNA, and HPV16, an especially high-risk strain, was detected in 92% of the HPV-positive samples. The researchers noted that the oropharynx is a “hotspot” for these HPV-driven cancers, as the majority of patients had cancer arising from the palatine tonsils or base of the tongue. Seventy-two percent of patients with OPC tested positive for HR-HPV DNA in their saliva, and tumor p16 overexpression was also observed in 89.3% of these patients.
The findings supported the use of saliva testing as a method for early detection and screening of HR-HPV DNA, but researchers were also interested in studying salivary HR-HPV as a prognostic biomarker for OPC. By following up on 215 OPC patients after a five year period, the research team found that patients who tested positive for HR-HPV DNA in their saliva had a significant survival advantage compared to those who tested negative. The median event-free survival for HR-HPV-positive patients was 205 months, compared with just 82 months for HR-HPV-negative patients. This research was published in The Journal of Molecular Diagnostics.
“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 in the near future, salivary HR-HPV testing will become part of routine clinical management for HPV-driven OPC patients,” said lead investigator Chamindie Punyadeera, head of the Saliva & Liquid Biopsy Translational Laboratory at the Queensland University of Technology.
Co-investigator Sarju Vasani, a University of Queensland researcher and physician at Royal Brisbane and Women’s Hospital, added that the testing could help to personalize treatments for HNC patients and aid in assessing disease prognosis.
Photo: Lead investigator Chamindie Punyadeera (right), PhD, performs saliva testing. Credit: Chamindie Punyadeera