Clinical effect of human papillomavirus genotypes in patients with cervical cancer undergoing primary radiotherapy.
OBJECTIVE
To study the prognostic value of the human papillomavirus (HPV) genotypes in cervical cancer patients undergoing radiotherapy.


METHODS
A total of 1,010 patients with cervical cancer after radiotherapy between 1993 and 2000 were eligible for this study. The HPV genotypes were determined by a genechip, which detects 38 types of HPV. The patient characteristics and treatment outcomes were analyzed using the Cox regression hazard model and classification and regression tree decision tree method.


RESULTS
A total of 25 genotypes of HPV were detected in 992 specimens (98.2%). The leading 8 types were HPV16, 58, 18, 33, 52, 39, 31, and 45. These types belong to two high-risk HPV species: alpha-7 (HPV18, 39, 45) and alpha-9 (HPV16, 31, 33, 52, 58). Three HPV-based risk groups, which were independent of established prognostic factors, such as International Federation of Gynecology and Obstetrics stage, age, pathologic features, squamous cell carcinoma antigen, and lymph node metastasis, were associated with the survival outcomes. The high-risk group consisted of the patients without HPV infection or the ones infected with the alpha-7 species only. Patients co-infected with the alpha-7 and alpha-9 species belonged to the medium-risk group, and the others were included in the low-risk group.


CONCLUSIONS
The results of the present study have confirmed the prognostic value of HPV genotypes in cervical cancer treated with radiotherapy. The different effect of the alpha-7 and alpha-9 species on the radiation response deserves additional exploration.
Department of Radiation Oncology, Chang Gung Memorial Hospital, Department of Medical Imaging and Radiological Science, Chang Gung University School of Medicine, Taoyuan, Taiwan.
Chun-Chieh
CC
Wang
Chyong-Huey
CH
Lai
Huei-Jean
HJ
Huang
Angel
A
Chao
Chee-Jen
CJ
Chang
Ting-Chang
TC
Chang
Hung-Hsueh
HH
Chou
Ji-Hong
JH
Hong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000532:radiotherapy / Q000821:virology; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000532:radiotherapy / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000821:virology; D015344:DNA Probes, HPV; D003663:Decision Trees; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics*; D030361:Papillomavirus Infections / Q000401:mortality / Q000821:virology*; D011379:Prognosis; D016016:Proportional Hazards Models; D013045:Species Specificity; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000821:virology*; D055815:Young Adult
D015344:DNA Probes, HPV