Analysis of HPV 16 early protein antibodies and identification of patients at high risk for HPV-driven oropharyngeal cancer in the prospective cohort of the Hamburg City Health Study

Introduction In Germany, the HPV-attributable fraction in oropharyngeal cancer (OPC) has been rising constantly over the last decades. Although epidemiological and molecular evidence supports a causal role of HPV, mainly type 16, in OPC, we still have limited understanding of how oncogenic oral HPV infections progress into cancer. Thus, early detection of HPV-driven OPC remains challenging. Antibodies to HPV16 early proteins, especially E6, are strongly associated with incident but also prospective HPV-OPC. Within a prospective epidemiological cohort we analyzed HPV16 serum antibodies to identify patients at high risk for HPV-driven OPC.

Patients and Methods The study is embedded within the Hamburg City Health Study (HCHS), a single center, prospective, epidemiologic cohort study to improve risk stratification, early diagnosis and survival. 45.000 participants of the city of Hamburg age 45 – 74 years will be recruited between 2017 and 2023. Of the first enrollment batch of 5000 HCHS participants 4203 sera were locally tested with a HPV16 E6 screening ELISA to identify participants with high antibody titer (> 0.25 OD); screen-positive sera were validated by ELISA additionally targeting HPV16 E1, E2, and E7.

Results Forty-eight (1.1 %) sera were HPV16 E6 screening ELISA positive. Four had antibodies to at least one additional E protein; these were considered as high risk individuals for prevalent or developing OPC. Upon re-contact, and head and neck medical examination, one patient was identified with an asymptomatic OPC (cT2 cN1 cM0).

Conclusions Screening and validation HPV16 ELISA is locally feasible and appears to have favorable characteristics to identify patients at high risk for HPV-OPC at an early stage.

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Publication History

Article published online:
10 June 2020