(Press-News.org) The presence of persistent human papillomavirus (HPV) type 16 DNA in oral rinses after treatment for HPV-related oropharyngeal cancer was rare but it appears to be associated with poor prognosis and therefore may have potential as a long-term tool for tumor surveillance, according to an article published online by JAMA Oncology.
HPV infection is responsible for the majority of oropharyngeal carcinomas in the United States. In 10 percent to 25 percent of patients with HPV-positive tumors, the cancer will progress after treatment and earlier diagnoses of progressive or recurrent disease may result in earlier treatment and better outcomes. HPV16 DNA in oral exfoliated cells is detected in as many as two-thirds of HPV-positive cancers before treatment and persists in a small subset of patients after treatment.
Gypsyamber D'Souza, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and coauthors examined HPV DNA detection in oral rinses after treatment for HPV-related oropharyngeal cancer with disease recurrence and survival to understand the implications for prognosis.
The study included 124 patients with new HPV-related oropharyngeal caner who had one or more posttreatment oral rinses.
The authors found oral HPV16 DNA was common at diagnosis (67 of 124 participants). However, it was detected in only six patients after treatment, including five patients with persistent oral HPV16 DNA that was also detected at diagnosis.
Although infrequent, the detection of persistent oral HPV16 DNA in posttreatment oral rinses was associated with worse disease-free survival and overall survival. All five patients with persistent oral HPV16 DNA developed recurrent disease and three died of the disease. In contrast, only 9 of 119 patients without persistent oral HPV16 DNA developed recurrent disease.
The authors note that the conclusions of their study are limited by the infrequency of persistent oral HPV16 DNA detection and the small number of deaths and recurrences.
"Our data suggest that persistent HPV16 DNA detection in posttreatment oral rinses, although uncommon, is associated with poor prognosis and may be predictive of disease recurrence, in particular local recurrence. Therefore, HPV16 DNA detection in oral rinses is a potentially useful tool for long-term tumor surveillance for the growing population of HPV-OPC (human papillomavirus-related oropharyngeal carcinoma) survivors," the study concludes.
(JAMA Oncol. Published online July 30, 2015. doi:10.1001/jamaoncol.2015.2524. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: This research was supported by a variety of sources. Authors also made conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Not Just Spitting in the Wind
In a related commentary, Julie E. Bauman, M.D., M.P.H., and Robert L. Ferris, of the University of Pittsburgh, write: "Human papillomavirus-specific biomarkers in OPSCC [oropharyngeal squamous cell carcinoma] may be used to improve clinical outcomes, and this pioneering study demonstrates an association between persistent oral HPV16 DNA detection and recurrence. ... Meanwhile, the high negative predictive value of oral rinse HPV16 DNA detection raises the promise of deintensifying surveillance visits and/or costly imaging, particularly if on a prospective trial."
(JAMA Oncol. Published online July 30, 2015. doi:10.1001/jamaoncol.2015.2606. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
INFORMATION:
Media Advisory: To contact corresponding author Gypsyamber D'Souza, Ph.D., or author Eleni M. Rettig, M.D., call Barbara Benham at 410-614-6029 or email bbenham1@jhu.edu. To contact corresponding commentary author Julie E. Bauman, M.D., M.P.H., call Jennifer C. Yates at 412-647-9966 or email yatesjc@upmc.edu.
(Boston)--New evidence highlights the importance of the liver in immunity against bacterial pneumonia. The study is the first of its kind to directly show such a link between liver-produced molecules and pneumonia susceptibility during sepsis.
Led by researchers at Boston University School of Medicine (BUSM), the study appears in the journal Infection and Immunity.
Pneumonia, according to the World Health Organization, is the leading infectious cause of death in children worldwide, taking more than 900,000 lives of children under the age of 5 in 2013 alone. Pneumonia, ...
A new piece of research led by the University of Southampton has found that the behaviour of fruit flies, which are commonly used in laboratory experiments, is altered by electric fields.
The research indicates that the wings of the insects are disturbed by static electric fields, leading to changes in avoidance behaviour and the neurochemical balance of their brains.
The paper, published in the Proceeding of the Royal Society B, suggests that the plastic housing laboratory fruit flies are commonly kept in (which hold their own static electric charge) could agitate the ...
In a survey of hospital medical physicians across the United States, women made nearly $15,000 less than their male counterparts, with a portion of this disparity explained by female doctors' tendency to prioritize collegiality and control over personal time, rather than substantial pay. The figure was determined after controlling for a number of factors, including age, geography, specialty, and amount and type of clinical work.
Optimal workload was the top priority for both male and female physicians, 776 of whom responded to survey questions on work priorities. Substantial ...
A new study led by a University of York scientist addresses an important question in climate science: how accurate are climate model projections?
Climate models are used to estimate future global warming, and their accuracy can be checked against the actual global warming observed so far. Most comparisons suggest that the world is warming a little more slowly than the model projections indicate. Scientists have wondered whether this difference is meaningful, or just a chance fluctuation.
Dr Kevin Cowtan, of the Department of Chemistry at York, led an international study ...
July 30, 2015 - Some women with breast cancer can now undergo a "one and done" approach combining nipple-sparing mastectomy with immediate single-stage implant (SSI) breast reconstruction in a single procedure, according to a report in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
In the article, ASPS Member Surgeon Dr. Mark A. Codner of Emory University, Atlanta, shares his approach to single-stage implant (SSI) breast reconstruction after mastectomy for breast cancer. Coauthor ...
July 30, 2015 - More women are expressing interest in plastic surgery to restore a more youthful figure after having children. An update on combined procedures for postpartum body contouring--addressing the abdomen, breasts, and other problem areas--is presented in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Sometimes called the "mommy makeover," postpartum body contouring combines a "tummy tuck"(abdominoplasty) with breast lift surgery (mastopexy) and other procedures to ...
Some 10-15 percent of combat veterans struggle with wounds invisible to the naked eye: post-traumatic stress. Their lives are ridden with debilitating symptoms: insomnia, flashbacks, depression, anxiety, guilt, and ever-present tension. While there is no cure-all for post-traumatic stress disorder (PTSD), cognitive behavioral therapy -- which actively reprocesses traumatic events to reduce symptoms -- has seen some success.
A new study from researchers at Tel Aviv University, Creighton University in Omaha, Nebraska, and the National Institute of Mental Health suggests ...
On July 30, 2015, researchers from Sichuan University, Sun Yat-sen University, University of California, BGI, etc, reported the latest study on congenitalcataracts. The finding, published on Nature, identifies lanosterol as a key molecule in the prevention of lens protein aggregation and points to a novel strategy for cataract prevention and treatment.
Cataracts are the most common cause of blindness worldwide, accounting for over half of all cases of blindness worldwide. Currently the only treatment is surgical removal of cataractous lenses. High concentrations of crystallin ...
If you have hypertension, it pays to include a pharmacist in a medical care team.
That's the upshot from research by the University of Iowa that found patients with uncontrolled hypertension had better blood pressure control when being cared for by pharmacists working in care teams (with a physician, for example) than patients who relied mostly on a doctor for medication guidance.
The researchers showed pharmacist-included care teams delivered more hands-on and tailored medication regimens to patients, which yielded more effective blood-pressure control results than ...
A new automated data mining system researched and developed at the University of Kent could lead to a dramatic increase in the detection of potentially illegal online sales of elephant ivory through eBay.
Law enforcement agencies and conservationist are expected to make use of the system - developed by researchers from the University's Centre for Cyber Security - in their ongoing battle against illegal ivory sales.
At the moment, identifying illegal elephant ivory being sold online is a laborious, tedious and expensive task, even for experts.
A search for items ...
