[Follow-up of high risk, human papillomavirus (HPV)-positive patients with cancer of the uterine cervix]

Orv Hetil. 1997 May 18;138(20):1249-53.
[Article in Hungarian]

Abstract

The study population consisted of 30 cervical cancer patients stage I.a-II.b. (FIGO) stages operated on according to the Wertheim technique. A parallel histological evaluation and HPV status determination were carried out on biopsies from the primary tumors and on the regional lymph nodes. A general primer mediated polymerase chain reaction (PCR) was performed at first and the samples not amplified were examined by type-specific primers. All except one primary tumors contained DNA-sequences characteristic for high risk HPV-types. The lymph nodes of these HPV-positive patients proved to be also HPV-positive with a frequency of 25/30 (83%). The frequency of the HPV-positivity was higher (100%) in the group of patients with HPV-18 positive status, than in the HPV-16 positive group. Two thirds of the evaluated regional lymph nodes were HPV-positive in the HPV-16 group of patients. The same HPV-types were harboured by the primary tumors and by the regional lymph nodes both in the HPV-16 positive and HPV-18 positive groups of patients. In the HPV-16-positive group of patients metastatic lymph nodes occurred with a frequency of 3/16, while the frequency of HPV-16 positivity in the same nodes was 11/15. In the group of patients with HPV-18 positivity the difference was even greater, 1/12 v. 12/12. Early recurrences were detected in a relation of 3 to 1 in the group of patients with histologically tumor-free and metastatic-positive lymph node status. At the same time all of the lymph nodes in this group with early recurrency (4/4) contained DNA-sequences characteristic for the HPV-18 type. These findings raise the hypothesis that the HPV-specific nucleic acids detected in the lymph nodes can be taken as sensitive indicators of metastases. The follow-up results support these hypothesis as patients with HPV-18 positive lymph node status showed early recurrencies and short survival that is poor prognosis not corresponding to the early stage of cervical cancer with histologically negative lymph node status.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Papillomaviridae*
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / virology*
  • Polymerase Chain Reaction
  • Prognosis
  • Risk Factors
  • Tumor Virus Infections / complications
  • Tumor Virus Infections / diagnosis
  • Tumor Virus Infections / virology*
  • Uterine Cervical Neoplasms / complications*
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / virology