Diagnostic accuracy of serum antibodies to human papillomavirus type 16 early antigens in the detection of human papillomavirus–related oropharyngeal cancer

Kristina R. Dahlstrom, Karen Anderson, Matthew S. Field, Diego Chowell, Jing Ning, Nan Li, Qingyi Wei, Guojun Li, Erich M. Sturgis

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    Abstract

    BACKGROUND: Because of the current epidemic of human papillomavirus (HPV)–related oropharyngeal cancer (OPC), a screening strategy is urgently needed. The presence of serum antibodies to HPV-16 early (E) antigens is associated with an increased risk for OPC. The purpose of this study was to evaluate the diagnostic accuracy of antibodies to a panel of HPV-16 E antigens in screening for OPC. METHODS: This case-control study included 378 patients with OPC, 153 patients with nonoropharyngeal head and neck cancer (non-OPC), and 782 healthy control subjects. The tumor HPV status was determined with p16 immunohistochemistry and HPV in situ hybridization. HPV-16 E antibody levels in serum were identified with an enzyme-linked immunosorbent assay. A trained binary logistic regression model based on the combination of all E antigens was predefined and applied to the data set. The sensitivity and specificity of the assay for distinguishing HPV-related OPC from controls were calculated. Logistic regression analysis was used to calculate odds ratios with 95% confidence intervals for the association of head and neck cancer with the antibody status. RESULTS: Of the 378 patients with OPC, 348 had p16-positive OPC. HPV-16 E antibody levels were significantly higher among patients with p16-positive OPC but not among patients with non-OPC or among controls. Serology showed high sensitivity and specificity for HPV-related OPC (binary classifier: 83% sensitivity and 99% specificity for p16-positive OPC). CONCLUSIONS: A trained binary classification algorithm that incorporates information about multiple E antibodies has high sensitivity and specificity and may be advantageous for risk stratification in future screening trials. Cancer 2017;123:4886-94.

    Original languageEnglish (US)
    Pages (from-to)4886-4894
    Number of pages9
    JournalCancer
    Volume123
    Issue number24
    DOIs
    StatePublished - Dec 15 2017

    Fingerprint

    Oropharyngeal Neoplasms
    Human papillomavirus 16
    Antigens
    Antibodies
    Serum
    Sensitivity and Specificity
    Logistic Models
    Head and Neck Neoplasms
    Neoplasms
    Serology
    Early Detection of Cancer
    In Situ Hybridization
    Case-Control Studies
    Healthy Volunteers
    Enzyme-Linked Immunosorbent Assay
    Immunohistochemistry
    Odds Ratio
    Regression Analysis
    Confidence Intervals

    Keywords

    • head and neck neoplasms
    • human papillomavirus
    • oropharyngeal cancer
    • papillomavirus oncogene proteins
    • serum antibodies

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

    Cite this

    Diagnostic accuracy of serum antibodies to human papillomavirus type 16 early antigens in the detection of human papillomavirus–related oropharyngeal cancer. / Dahlstrom, Kristina R.; Anderson, Karen; Field, Matthew S.; Chowell, Diego; Ning, Jing; Li, Nan; Wei, Qingyi; Li, Guojun; Sturgis, Erich M.

    In: Cancer, Vol. 123, No. 24, 15.12.2017, p. 4886-4894.

    Research output: Contribution to journalArticle

    Dahlstrom, Kristina R. ; Anderson, Karen ; Field, Matthew S. ; Chowell, Diego ; Ning, Jing ; Li, Nan ; Wei, Qingyi ; Li, Guojun ; Sturgis, Erich M. / Diagnostic accuracy of serum antibodies to human papillomavirus type 16 early antigens in the detection of human papillomavirus–related oropharyngeal cancer. In: Cancer. 2017 ; Vol. 123, No. 24. pp. 4886-4894.
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    title = "Diagnostic accuracy of serum antibodies to human papillomavirus type 16 early antigens in the detection of human papillomavirus–related oropharyngeal cancer",
    abstract = "BACKGROUND: Because of the current epidemic of human papillomavirus (HPV)–related oropharyngeal cancer (OPC), a screening strategy is urgently needed. The presence of serum antibodies to HPV-16 early (E) antigens is associated with an increased risk for OPC. The purpose of this study was to evaluate the diagnostic accuracy of antibodies to a panel of HPV-16 E antigens in screening for OPC. METHODS: This case-control study included 378 patients with OPC, 153 patients with nonoropharyngeal head and neck cancer (non-OPC), and 782 healthy control subjects. The tumor HPV status was determined with p16 immunohistochemistry and HPV in situ hybridization. HPV-16 E antibody levels in serum were identified with an enzyme-linked immunosorbent assay. A trained binary logistic regression model based on the combination of all E antigens was predefined and applied to the data set. The sensitivity and specificity of the assay for distinguishing HPV-related OPC from controls were calculated. Logistic regression analysis was used to calculate odds ratios with 95{\%} confidence intervals for the association of head and neck cancer with the antibody status. RESULTS: Of the 378 patients with OPC, 348 had p16-positive OPC. HPV-16 E antibody levels were significantly higher among patients with p16-positive OPC but not among patients with non-OPC or among controls. Serology showed high sensitivity and specificity for HPV-related OPC (binary classifier: 83{\%} sensitivity and 99{\%} specificity for p16-positive OPC). CONCLUSIONS: A trained binary classification algorithm that incorporates information about multiple E antibodies has high sensitivity and specificity and may be advantageous for risk stratification in future screening trials. Cancer 2017;123:4886-94.",
    keywords = "head and neck neoplasms, human papillomavirus, oropharyngeal cancer, papillomavirus oncogene proteins, serum antibodies",
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    T1 - Diagnostic accuracy of serum antibodies to human papillomavirus type 16 early antigens in the detection of human papillomavirus–related oropharyngeal cancer

    AU - Dahlstrom, Kristina R.

    AU - Anderson, Karen

    AU - Field, Matthew S.

    AU - Chowell, Diego

    AU - Ning, Jing

    AU - Li, Nan

    AU - Wei, Qingyi

    AU - Li, Guojun

    AU - Sturgis, Erich M.

    PY - 2017/12/15

    Y1 - 2017/12/15

    N2 - BACKGROUND: Because of the current epidemic of human papillomavirus (HPV)–related oropharyngeal cancer (OPC), a screening strategy is urgently needed. The presence of serum antibodies to HPV-16 early (E) antigens is associated with an increased risk for OPC. The purpose of this study was to evaluate the diagnostic accuracy of antibodies to a panel of HPV-16 E antigens in screening for OPC. METHODS: This case-control study included 378 patients with OPC, 153 patients with nonoropharyngeal head and neck cancer (non-OPC), and 782 healthy control subjects. The tumor HPV status was determined with p16 immunohistochemistry and HPV in situ hybridization. HPV-16 E antibody levels in serum were identified with an enzyme-linked immunosorbent assay. A trained binary logistic regression model based on the combination of all E antigens was predefined and applied to the data set. The sensitivity and specificity of the assay for distinguishing HPV-related OPC from controls were calculated. Logistic regression analysis was used to calculate odds ratios with 95% confidence intervals for the association of head and neck cancer with the antibody status. RESULTS: Of the 378 patients with OPC, 348 had p16-positive OPC. HPV-16 E antibody levels were significantly higher among patients with p16-positive OPC but not among patients with non-OPC or among controls. Serology showed high sensitivity and specificity for HPV-related OPC (binary classifier: 83% sensitivity and 99% specificity for p16-positive OPC). CONCLUSIONS: A trained binary classification algorithm that incorporates information about multiple E antibodies has high sensitivity and specificity and may be advantageous for risk stratification in future screening trials. Cancer 2017;123:4886-94.

    AB - BACKGROUND: Because of the current epidemic of human papillomavirus (HPV)–related oropharyngeal cancer (OPC), a screening strategy is urgently needed. The presence of serum antibodies to HPV-16 early (E) antigens is associated with an increased risk for OPC. The purpose of this study was to evaluate the diagnostic accuracy of antibodies to a panel of HPV-16 E antigens in screening for OPC. METHODS: This case-control study included 378 patients with OPC, 153 patients with nonoropharyngeal head and neck cancer (non-OPC), and 782 healthy control subjects. The tumor HPV status was determined with p16 immunohistochemistry and HPV in situ hybridization. HPV-16 E antibody levels in serum were identified with an enzyme-linked immunosorbent assay. A trained binary logistic regression model based on the combination of all E antigens was predefined and applied to the data set. The sensitivity and specificity of the assay for distinguishing HPV-related OPC from controls were calculated. Logistic regression analysis was used to calculate odds ratios with 95% confidence intervals for the association of head and neck cancer with the antibody status. RESULTS: Of the 378 patients with OPC, 348 had p16-positive OPC. HPV-16 E antibody levels were significantly higher among patients with p16-positive OPC but not among patients with non-OPC or among controls. Serology showed high sensitivity and specificity for HPV-related OPC (binary classifier: 83% sensitivity and 99% specificity for p16-positive OPC). CONCLUSIONS: A trained binary classification algorithm that incorporates information about multiple E antibodies has high sensitivity and specificity and may be advantageous for risk stratification in future screening trials. Cancer 2017;123:4886-94.

    KW - head and neck neoplasms

    KW - human papillomavirus

    KW - oropharyngeal cancer

    KW - papillomavirus oncogene proteins

    KW - serum antibodies

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