Can recurrence of cervical cancer be predicted by human papillomavirus DNA in nodes or plasma?
OBJECTIVE
To determine if human papillomavirus (HPV) DNA in pelvic lymph nodes or plasma of women with early-stage cervical cancer is a marker for recurrence.


METHODS
Twenty-eight women undergoing radical hysterectomy for cervical cancer stage IB had HPV DNA testing in cervical tissue, plasma, and the largest lymph nodes. Human papillomavirus genotyping was done by restriction fragment length polymorphism/line blot assay. Human papillomavirus quantitation was performed with specific primers for types 16 and 18. Women were followed up to determine recurrence of disease.


RESULTS
Human papillomavirus DNA was detected in cervical tumor tissue from all the women. Twenty-two women had genotype 16, 5 women had HPV18, and 1 had type 31. Human papillomavirus viral load in cervical biopsies significantly correlated with the viral loads in the lymph nodes (r = 0.97; p = 0). Nine women had nodal metastasis, but only 3 of them had HPV DNA in lymph nodes. Recurrence was seen in 4 women, of whom 3 had tumor in the lymph nodes at initial surgery and none had HPV.


CONCLUSIONS
Human papillomavirus DNA can be detected in lymph nodes even when they are not obviously involved by tumor metastasis. This study did not show plasma or lymph node HPV DNA to be a prognostic marker.
Peedicayil
Abraham
A
Departments of Obstetrics & Gynaecology, Christian Medical College, Vellore, India. Abraham@cmcvellore.ac.in
Sathish
Narayanan
N
Gnanamony
Manu
M
John
Subhashini
S
Viswanathan
Faith Rangad
FR
Naseema
Parveen Shaikh
PS
Abraham
Priya
P
D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D002277:Carcinoma / Q000473:pathology / Q000601:surgery / Q000821:virology*; D015331:Cohort Studies; D004279:DNA, Viral / Q000302:isolation & purification*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology*; D008875:Middle Aged; D010388:Pelvis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*; D019562:Viral Load
D004279:DNA, Viral