The prognostic significance of HPV-16 genome status of the lymph nodes, the integration status and p53 genotype in HPV-16 positive cervical cancer: a long term follow up.
OBJECTIVE
Prognostic evaluation of HPV-16 genome status of the pelvic lymph nodes, the integration status of HPV-16 and p53 codon 72 polymorphism in cervical cancer.


METHODS
Prospective cohort study.


METHODS
Department of Gynaecological Oncology, University of Debrecen, Hungary.


METHODS
Thirty-nine patients with HPV-16 positive cervical cancer.


METHODS
Primary tumour specimens of 39 cervical cancer patients with HPV-16 positive primary tumour were subjected to multiplex polymerase chain reaction using HPV-16 E1/E2, E7 and p53 codon 72 allele-specific primers. Pelvic lymph nodes of the same patients were also tested for the presence of HPV-16 DNA and for its integration status using HPV-16 E7 and E1/E2 ORF specific primers, respectively.


METHODS
Progression-free survival.


RESULTS
Metastatic lymph nodes carried HPV-16 DNA more frequently than nodes with no evidence of disease (100.0% vs 35.7%, P = 0.001). Cases with HPV-16 positive nodes had higher recurrence rate than those with HPV-16 negative nodes (42.9% vs 11.1%, P = 0.009). There was no difference between cases with and without histologically proven nodal disease with regard to integration status of HPV-16 DNA in the primary tumour (integrated 90.9% vs 71.4%, episomal 9.1% vs 21.4%, mixed 0% vs 7.1%) and p53 codon 72 polymorphism (Arg/Arg 54.5% vs 67.9%, Pro/Pro 0 vs 7.1%, Arg/Pro 45.5% vs 21.4%).


CONCLUSIONS
Regardless of the presence of nodal metastasis, HPV-16 status of the nodes is a significant predictor of recurrent disease. HPV-16 integration status and p53 codon 72 genotype do not seem to have a bearing on disease outcome in cervical cancer with HPV-16 positive primary.
Hernádi
Zoltán
Z
Department of Gynaecologic Oncology, University of Debrecen, Medical and Health Science Center, Hungary.
Szarka
Krisztina
K
Sápy
Tamás
T
Krasznai
Zoárd
Z
Veress
György
G
Póka
Róbert
R
D000328:Adult; D015139:Blotting, Southern; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000821:virology*; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016158:Genes, p53 / Q000235:genetics*; D016679:Genome, Viral; D006801:Humans; D008207:Lymphatic Metastasis / Q000235:genetics; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000821:virology; D009856:Oncogene Proteins, Viral / Q000032:analysis*; D027383:Papillomaviridae / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000235:genetics / Q000821:virology*
D004279:DNA, Viral; D009856:Oncogene Proteins, Viral