title: Prognostic significance of high-risk HPV status in advanced cervical cancers and pelvic lymph nodes.
abstract: OBJECTIVE
  In this study, we investigated the presence of high-risk (HR) HPV types most prevalent in the Hungarian population in surgically removed cervical cancers and pelvic lymph nodes. The aim of our work was to determine the prognostic significance of HPV status in the lymph nodes draining the tumor.
  
  
  METHODS
  Primary tumor specimens from 150 patients and 900 lymph node samples (six per case) were studied. Fifty-six/150 were early (FIGO IA-IB) stage, while 94/150 were advanced (FIGO IIA-IIIB) stage cancers. Beside histopathological evaluation, DNA extracted from the tissue samples was subjected to nested PCR to detect characteristic type-specific sequences of HPVs 16, 18 and 33. Moreover, clinicopathological data were collected for an average 48-month postoperative follow-up period for the purposes of statistical analysis.
  
  
  RESULTS
  The presence of HR-HPV types in the lymph nodes shows no correlation with disease-free survival, whereas the presence of lymph node metastases significantly decreases life expectancy (P = 0.002). Lymph nodes with metastases more frequently carry HR-HPV than nodes with no evidence of tumorous infiltration (65% versus 36%, P < 0.001); however, a high number of metastases surrounding HR-HPV-positive tumors were found negative for the viruses (42/120).
  
  
  CONCLUSIONS
  HR-HPV status of pelvic lymph nodes draining cervical cancers has no noticeable influence on the life expectancy of the patients. HR-HPV-positive tumor cells do not necessarily have a selective advantage in forming metastases. Presumably, a number of alterations in cellular genes rather than the presence of papillomavirus DNA may have a decisive role in the progression of cervical cancers.
authors.affiliation: Molecular Pathology Research Group, Joint Research Organization of the Hungarian Academy of Sciences and Semmelweis University, Ulloi út 26, H-1085 Budapest, Hungary.
authors.forename: Tibor
authors.initials: T
authors.lastname: Füle
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Csapó
authors.forename: Miklós
authors.initials: M
authors.lastname: Máthé
authors.forename: Péter
authors.initials: P
authors.lastname: Tátrai
authors.forename: Viktória
authors.initials: V
authors.lastname: László
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Papp
authors.forename: Ilona
authors.initials: I
authors.lastname: Kovalszky
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000821:virology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000821:virology; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*
chemical_list: D004279:DNA, Viral