Predictive value of HPV DNA in lymph nodes in surgically treated cervical carcinoma patients--a prospective study.
OBJECTIVE
High-risk types of HPV are etiological factors in cervical cancer. Lymph node involvement in cervical cancer patients reduces 5-year survival rates by 25-60%. However, the influence on survival of HPV DNA positivity in histopathologically negative lymph nodes remains unresolved.


METHODS
The study included 116 of 148 patients who underwent Piver type III radical hysterectomy and pelvic lymphadenectomy and who showed HPV DNA positivity in the primary lesion. Lymph node tissues were tested for the presence of HPV DNA, using a PCR technique.


RESULTS
We found the presence of HPV DNA sequences in lymph nodes dissected intraoperatively in 81 (69.83%) cases. In analysis, we compared patients from 3 groups: HPV- and metastatic-negative (LN HPV-M-); HPV-positive metastatic-negative (LN HPV+M-); and metastatic-positive (LN M+). We discovered that survival in groups LN M+ and LN HPV+M- did not differ statistically (p=0.37). However, the survival periods in these two groups differed when compared with LN HPV-M- patients (p<0.001). Using Cox's proportional hazards model, we found that the presence of lymph node HPV DNA, and FIGO stage, and primary lesion volume were independent parameters correlating with survival and mortality risk.


CONCLUSIONS
We conclude that the presence of HPV DNA in lymph nodes is an early sign of metastasis and should be treated as such in prognostic outlook and planning the therapeutic strategy.
Lukaszuk
Krzysztof
K
Department of Gynaecological Endocrinology, Medical University of Gdansk, Poland.
Liss
Joanna
J
Gulczynski
Jacek
J
Nowaczyk
Monika
M
Nakonieczny
Miroslaw
M
Piatkowski
Mariusz
M
Sliwinski
Wojciech
W
Baay
Marc
M
Wozniak
Izabela
I
Maj
Bozena
B
Lukaszuk
Mariusz
M
D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology*; D008875:Middle Aged; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology*; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*
D004279:DNA, Viral