title: Detection of human papillomavirus types 16 and 18 mRNA in peripheral blood of advanced cervical cancer patients and its association with prognosis.
abstract: OBJECTIVE
  To evaluate the feasibility of detecting human papillomavirus E6 (HPVE6) gene mRNA in the peripheral blood of patients with locally advanced cervical cancer, and the relationship of the circulating HPV viral-specific mRNA with clinicopathologic factors and prognosis of locally advanced cervical cancer.
  
  
  METHODS
  The presence of types 16 and 18 HPVE6 gene mRNA was determined by reverse transcription followed by nested polymerase chain reaction. Thirty-five patients with locally advanced cervical cancer who were positive for HPV type 16 or 18 DNA were included in the study. All patients received external-beam radiation therapy followed by intracavitary brachytherapy.
  
  
  RESULTS
  Eighteen (51.4%) of 35 HPV DNA-positive cervical cancer patients had HPV-specific mRNA in their peripheral blood cells, compared with none of 17 HPV DNA-negative cervical cancer patients and none of 12 control volunteers. The presence of HPVE6 gene mRNA in peripheral blood was associated with bulky tumor volume (> 4 cm) and pelvic lymph node metastasis (tumor volume, P = .03; lymph node status, P = .03). After a median follow-up of 22 months, patients who were positive for peripheral-blood HPVE6 gene mRNA had a significantly higher risk of recurrence than those who were negative (10 of 18 v three of 17, P = .02; mean recurrent time, 20.7 months v 12.6 months, P = .02). There was also a statistically significant association of peripheral-blood HPVE6 gene mRNA positivity with distant metastasis (eight of 18 vone of 17; P = .01).
  
  
  CONCLUSIONS
  Results of this study seem to suggest that the presence of HPVE6 gene mRNA in peripheral blood may provide an early marker that identifies patients who are at risk for metastasis.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. jantseng@ms1.hinet.net
authors.forename: C J
authors.initials: CJ
authors.lastname: Tseng
authors.forename: C C
authors.initials: CC
authors.lastname: Pao
authors.forename: J D
authors.initials: JD
authors.lastname: Lin
authors.forename: Y K
authors.initials: YK
authors.lastname: Soong
authors.forename: J H
authors.initials: JH
authors.lastname: Hong
authors.forename: S
authors.initials: S
authors.lastname: Hsueh
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood / Q000302:isolation & purification*; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification*; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000473:pathology / Q000821:virology*
chemical_list: D012333:RNA, Messenger; D012367:RNA, Viral