title: Human papillomavirus DNA in tumor-free regional lymph nodes: a potential prognostic marker in cervical carcinoma.
abstract: OBJECTIVE
  The medical management of women with cervical carcinoma would benefit from a test that might predict which patients have a high risk of progression or recurrence. The detection of micrometastases in regional lymph nodes may be such a test. At least 90% of cervical carcinomas worldwide contain human papillomavirus (HPV) DNA. In a pilot study, we evaluated a polymerase chain reaction-based method for the detection of human papillomavirus DNA in archival routine sections of regional lymph nodes as a marker of micrometastasis in patients with a long-term follow-up period.
  
  
  METHODS
  We analyzed 134 archival routine slides of histologically tumor-free lymph nodes derived from 21 patients with clinically and pathologically determined stage Ib, IIa, and IIb HPV-16 positive cervical carcinoma. The patients had been selected for good (still alive with a follow-up time of at least 5 years) or fatal outcome (dead of disease within 3 years). The amount of HPV-16 DNA was estimated by comparison with standards.
  
  
  RESULTS
  All patients without strongly HPV-positive lymph nodes survived. In contrast, 8 of 12 women with strongly HPV-positive lymph nodes died of cervical carcinoma.
  
  
  CONCLUSIONS
  In patients with cervical cancer, an approach based on a PCR test for HPV DNA in tumor-free regional lymph nodes may allow early identification of women at high risk for relapse who should receive adjuvant treatment.
authors.affiliation: Department of Gynecology and Obstetrics, University of Freiburg, Freiburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Ikenberg
authors.forename: I
authors.initials: I
authors.lastname: Wiegering
authors.forename: J
authors.initials: J
authors.lastname: Pfisterer
authors.forename: M
authors.initials: M
authors.lastname: Kiechle-Schwarz
authors.forename: B
authors.initials: B
authors.lastname: Schmitt
authors.forename: W
authors.initials: W
authors.lastname: Sauerbrei
authors.forename: A
authors.initials: A
authors.lastname: Pfleiderer
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000821:virology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D010865:Pilot Projects; D016133:Polymerase Chain Reaction; D011379:Prognosis; D014412:Tumor Virus Infections / Q000401:mortality / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral