title: Human papillomavirus DNA and antibodies to human papillomaviruses 16 E2, L2, and E7 peptides as predictors of survival in patients with squamous cell cervical cancer.
abstract: OBJECTIVE
  To assess whether human papillomavirus (HPV) DNA detection in cervical cancer specimens, or antibodies to selected HPV 16 peptides are predictors of tumor recurrence and long-term survival in patients with squamous cell invasive cervical cancer.
  
  
  METHODS
  Four hundred seventy-one cases included in two population-based case-control studies underwent follow-up evaluation. The survival and cause of death were ascertained for 410 cases (87%), with a median follow-up time of 4.6 years after diagnosis. HPV DNA was assessed using an L1 polymerase chain reaction (PCR)-based system and Southern hybridization (SH) on scraped cytologic specimens or biopsies. HPV 16 antibodies to E2, L2, and E7 peptides were detected with enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Clinical stage was the only independent prognostic factor for recurrence or survival. Although seropositivity to HPV 16 E7/3 peptide predicted a twofold excess risk of mortality (adjusted hazards ratio [HRa] = 2.0; 95% confidence interval [CI], 1.2 to 3.3), the association was restricted to stage I (HRa = 6.6; 95% CI, 1.2 to 37.6) and II (HRa = 5.9; 95% CI, 2.1 to 16.5) patients. The presence of HPV DNA (HRa = 0.9; 95% CI, 0.5 to 1.5), different estimates of the HPV viral load and the HPV type identified were not predictors of tumor recurrence or survival.
  
  
  CONCLUSIONS
  The presence of antibodies to HPV 16 E7 proteins is of prognostic value in early-stage cervical cancer. Our results provide strong evidence that detection and typing of HPV DNA in cervical cells or tissues is not a prognostic factor for recurrence or survival.
authors.affiliation: Institut Catala d'Oncologia, Servei d'Epidemiologia i Registre del Cáncer, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Viladiu
authors.forename: F X
authors.initials: FX
authors.lastname: Bosch
authors.forename: X
authors.initials: X
authors.lastname: Castellsagué
authors.forename: N
authors.initials: N
authors.lastname: Muñoz
authors.forename: J M
authors.initials: JM
authors.lastname: Escribà
authors.forename: E
authors.initials: E
authors.lastname: Hamsíkova
authors.forename: V
authors.initials: V
authors.lastname: Hofmannova
authors.forename: E
authors.initials: E
authors.lastname: Guerrero
authors.forename: A
authors.initials: A
authors.lastname: Izquierdo
authors.forename: C
authors.initials: C
authors.lastname: Navarro
authors.forename: P
authors.initials: P
authors.lastname: Moreo
authors.forename: I
authors.initials: I
authors.lastname: Izarzugaza
authors.forename: N
authors.initials: N
authors.lastname: Ascunce
authors.forename: M
authors.initials: M
authors.lastname: Gili
authors.forename: M T
authors.initials: MT
authors.lastname: Muñoz
authors.forename: L
authors.initials: L
authors.lastname: Tafur
authors.forename: K V
authors.initials: KV
authors.lastname: Shah
authors.forename: V
authors.initials: V
authors.lastname: Vonka
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000302:isolation & purification*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D027383:Papillomaviridae / Q000235:genetics* / Q000276:immunology*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011379:Prognosis; D012306:Risk; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral