Usefulness of circulating tumor DNA by targeting human papilloma virus-derived sequences as a biomarker in p16-positive oropharyngeal cancer

In head and neck cancer, early detection of recurrence after treatment is important. The contemporary development of therapeutic agents have improved the prognosis after recurrence; however, no biomarker has been established for evaluating therapeutic effects or detecting recurrence. Recently, circulating tumor DNA (ctDNA), which comprises DNA derived from tumor cells and exists in the form of cell-free DNA in the blood, has attracted attention as a minimally invasive and repeatable biomarker for detecting cancer. We validated the usefulness of ctDNA of human papilloma virus (HPV)-derived sequences as a biomarker in HPV-related p16-positive oropharyngeal cancer by assessing 25 patients with p16-positive oropharyngeal cancer. Blood samples were collected from each patient at multiple time points during the treatment, and the plasma was preserved. The ctDNA was extracted from the plasma and analyzed using digital polymerase chain reaction. HPV-derived ctDNA was detected in 14 (56%) of the 25 patients. In all the patients, the samples were found to be ctDNA-negative after initial treatment. Cancer recurrence was observed in 2 of the 14 patients; HPV-derived ctDNA was detected at the time of recurrence. Our results indicate that HPV-derived ctDNA can be a prospective biomarker for predicting the recurrence of p16-positive oropharyngeal cancer.

Human Papilloma Virus Vaccination and Oropharyngeal Cancer: Knowledge, Perception and Attitude among Italian Pediatric Dentists

Background: Pediatric dentists could play a key role in the prevention of human papilloma virus (HPV)-related oropharyngeal cancer (OP-cancer). The aim of this study was to assess knowledge, perception, and attitude on HPV-related OP-cancer, HPV infection, and HPV vaccination among Italian pediatric dentists. Methods: A cross-sectional study was conducted. Pediatric dentists received, by email, a link to participate in the questionnaire online. The questionnaire comprised four parts: (i) demographic information, (ii) knowledge on HPV-related OP-cancer, HPV infection, and HPV vaccine, (iii–iiii) perceptions and attitude on HPV-related OP-cancer, HPV infection, and HPV vaccine. Data were statistically analyzed with Kruskal–Wallis and Mann–Whitney test and Pearson’s chi-square test. Results: A total of 271 pediatric dentists completed the questionnaire. Results showed a good overall knowledge; a positive perception of their role in HPV disease prevention; a good attitude in discussing sensitive topics; a need for acquiring more information about HPV’s connection to cancer, HPV infection, and HPV vaccine. Conclusions: Improving educational training programs, as well as informing about prevention of HPV-related OP-cancer, will place pediatric dentists in the front line of HPV diseases primary prevention.

Dysbiosis of vaginal microbiota associated with persistent high-risk human papilloma virus infection

Background The status of vaginal microbiota in persistent high-risk human papilloma virus (HR-HPV) infection is unclear. The present work aimed to identify the vaginal microbiota of persistent HPV infection and explore the possible underlying microbiota factors. Methods A total of 100 women were recruited in this study, of which 28 presented HR-HPV persistent infection (P group), 30 showed clearance of any subtype of HR-HPV (C group), and 42 had no history of any HR-HPV infection (NC group). The vaginal microbiota and the community structure of the three groups were compared based on the 16S rRNA sequencing of the V3–V4 region. The microbiota diversity and differential analysis were carried out to detect the potential factors associated with HR-HPV infection. Results P and C groups showed an increase of Firmicutes and Actinobacteriota but a decrease in Proteobacteria compared to the NC group. The Chao1 index indicated that the microbial richness of the NC group was greater than C group (P < 0.05).The principal co-ordinate analysis(PCoA) revealed differences between the NC and P/C groups.The linear discriminant analysis effect size (LEfSe) method indicated that Proteobacteria phylum was significantly different in the mean relative abundance in the NC group,but the P and C groups did not show such indicative taxa. The Wilcox rank-sum test indicated that the Bifidobacterium (P = 0.002) and Lactobacillus (P = 0.005) of the C group were in a high mean relative abundance compared to the NC group. Conclusions The persistent HR-HPV infection is associated with dysbiosis of the vaginal microbiota. Microbiome regulation with Bifidobacteria and Lactobacillus may affect the clearance of HPV.

UPAYA PENCEGAHAN KANKER SERVIKS MELALUI PENINGKATAN PENGETAHUAN KESEHATAN REPRODUKSI WANITA DAN PEMERIKSAAN METODE IVA (INSPEKSI VISUAL ASAM ASETAT) DI WILAYAH KERJA PUSKESMAS GUNUNG LINGKAS

Kanker leher rahim atau disebut juga kanker serviks adalah sejenis kanker yang 99,7% disebabkan oleh human papilloma virus (HPV) onkogenik, yang menyerang leher rahim. Kelompok berisiko untuk terjadinya kanker serviks adalah wanita di atas usia 30 tahun yang memiliki banyak anak dan dengan perilaku menjaga kesehatan reproduksi yang masih kurang. Kebiasaan gonta ganti pasangan seksual merupakan salah satu faktor utama penularan virus HPv penyebab kanker serviks ini terjadi. Di Indonesia hanya 5 persen yang melakukan penapisan kanker leher rahim, sehingga 76,6 persen pasien ketika terdeteksi sudah memasuki Stadium Lanjut (IIIB ke atas), karena kanker leher rahim biasanya tanpa gejala apapun pada stadium awalnya. Penapisan dapat dilakukan dengan melakukan tes Pap smear dan juga Inspeksi Visual Asam Asetat (IVA). Di negara berkembang, penggunaan secara luas program pengamatan leher rahim mengurangi insiden kanker leher rahim yang invasif sebesar 50% atau lebih. Pada kegiatan ini akan dilakukan penyuluhan kepada kelompok berisiko tentang kesehatan organ reproduksi wanita. Isi dari penyuluhan memuat pengetahuan mengenai pengertian kanker serviks, gejala, faktor risiko dan juga cara pencegahannya. Setelah dilakukan penyuluhan akan disaring peserta penyuluhan yang bersedia untuk diikutkan dalam pemeriksaan skrining kanker serviks melalui metode IVA (Inspeksi Visual Asam asetat) pada hari berikutnya. Tujuan pemeriksaan ini adalah untuk memastikan bahwa tidak ditemukannya kelainan pada serviks dan jika memang ditemukan adanya kelainan pada serviks (dengan berbagai stadium) dapat disarankan tindakan pencegahan lebih lanjut agar tidak berkembang menjadi kanker. Jika ditemukan pasien yang positif menderita kanker serviks juga akan diberikan saran agar segera memeriksaan diri ke rumahsakit untuk dilakukan penatalaksanaan segera.