High-risk human papillomavirus DNA in the primary tumor, sentinel, and nonsentinel pelvic lymph nodes in patients with early-stage cervical cancer: a correlation with histopathology.
BACKGROUND
Metastatic involvement of pelvic lymph nodes is the most important prognostic parameter in early-stage cervical cancer. Still, approximately 15% of patients with negative pelvic nodes experience recurrence, most of them in the pelvis. The presence of human papillomavirus (HPV) DNA in histologically negative pelvic nodes is considered a subclinical metastatic spread.


METHODS
Patients with early-stage cervical cancer referred for surgical treatment were enrolled in the study. Cytobrush technique was used for sample collection from the fresh tissue to avoid any loss of material for histology.


RESULTS
Altogether, 49 patients were enrolled in the study. High-risk (HR) HPV DNA was identified in the tumor in 91.8% patients and in the sentinel node or other pelvic nodes in 49.9% patients. Among the 10 HR HPV genotypes detected, HPV 16 was the most frequently represented in both the tumor and the lymph nodes (66.7% and 71.4%, respectively). All metastatic lymph nodes were HR HPV positive.


CONCLUSIONS
The presence of HR HPV DNA in a sentinel node had a 100% positive predictive value for metastatic involvement of pelvic lymph nodes in our study. This could be considered a sign of an early subclinical metastatic spread; however, the prognostic value has to be evaluated through a longer follow-up.
Slama
Jiri
J
General Teaching Hospital, Department of Oncogynecology, 1st Medical School of Charles University, Prague 2, Czech Republic. slamajiri@centrum.cz
Drazdakova
Marcela
M
Dundr
Pavel
P
Fischerova
Daniela
D
Zikan
Michal
M
Pinkavova
Ivana
I
Freitag
Pavel
P
Pavlista
David
D
Zima
Tomas
T
Cibula
David
D
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008198:Lymph Nodes / Q000473:pathology* / Q000821:virology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery / Q000821:virology*
D004279:DNA, Viral; D002945:Cisplatin; D007069:Ifosfamide