title: Identification of human papillomavirus types 16 and 18 deoxyribonucleic acid sequences in bulky cervical cancer after chemotherapy.
abstract: OBJECTIVE
  The objectives of this study were to evaluate the effect of chemotherapy on the continual presence of human papillomavirus deoxyribonucleic acid sequences in bulky cervical cancer tissues and the relationship between the presence of human papillomavirus and the response of these patients to chemotherapy.
  
  
  METHODS
  Multiple tissue sections obtained from 33 patients with bulky cervical cancer both before and after chemotherapy were analyzed for the presence of human papillomavirus types 16 and 18 by deoxyribonucleic acid amplification.
  
  
  RESULTS
  The cytotoxic effects of chemotherapy did not significantly alter the continual presence of human papillomavirus deoxyribonucleic acid sequences in these tissues (p = 0.8048). The presence of human papillomavirus type 16 deoxyribonucleic acid in tumors treated with neoadjuvant chemotherapy was significantly associated with favorable tumor response compared with type 18-positive patients and type 16/18-negative patients (94.7% vs 42.9%, p = 0.0059 and 94.7% vs 44.4%, p = 0.0004, respectively). Additionally, patients with type 18 deoxyribonucleic acid had a significantly higher risk of recurrence than did type 16-positive patients (p = 0.0123).
  
  
  CONCLUSIONS
  These results seem to suggest that the presence of human papillomavirus deoxyribonucleic acid sequences may serve as a marker to predict the response of bulky cervical cancer to chemotherapy and may be useful in reassessing neoadjuvant treatment for those patients who are free of human papillomavirus or those with type 18 deoxyribonucleic acid.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
authors.forename: C J
authors.initials: CJ
authors.lastname: Tseng
authors.forename: L H
authors.initials: LH
authors.lastname: Tseng
authors.forename: C H
authors.initials: CH
authors.lastname: Lai
authors.forename: Y K
authors.initials: YK
authors.lastname: Soong
authors.forename: S
authors.initials: S
authors.lastname: Hsueh
authors.forename: C C
authors.initials: CC
authors.lastname: Pao
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery / Q000821:virology*; D017024:Chemotherapy, Adjuvant; D004279:DNA, Viral / Q000032:analysis*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D012008:Recurrence; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000821:virology*
chemical_list: D004279:DNA, Viral