title: Prognostic value of HPV18 DNA viral load in patients with early-stage neuroendocrine carcinoma of the uterine cervix.
abstract: OBJECTIVE
  To evaluate the clinicopathologic correlation and prognostic value of HPV18 DNA viral load in patients with early-stage cervical neuroendocrine carcinoma (NECA).
  
  
  METHODS
  Formalin-fixed, paraffin- embedded tissue of cervical NECA patients with known HPV18 infection and clinicopathologic data including follow-up results were collected. The HPV18 DNA load was assessed with quantitative PCR targeting the HPV18 E6E7 region.
  
  
  RESULTS
  Twenty-one patients with early-stage (IB-IIA) cervical NECA were identified. HPV18 DNA viral load ranged from 0.83 to 55,174 copies/cell (median 5.90). Disease progression, observed in 10 cases (48%), was not significantly associated with any clinicopathologic variables. However, the group of patients with progressive disease tended to have a higher rate of pelvic lymph node metastasis (50% versus 9%, p=0.063) and a lower median value of HPV18 DNA viral load (4.37 versus 8.17 copies/cell, p=0.198) compared to the non-recurrent group. When stratified by a cut-off viral load value of 5.00 copies/cell, the group of patients with viral load ≤5.00 copies/cell had a significantly shorter disease-free survival than the group with viral load >5.00 copies/cell (p=0.028). The group with a lower viral load also tended to have a higher rate of disease progression (75% versus 31%, p=0.080). No significant difference in the other clinicopathologic variables between the lower and higher viral load groups was identified.
  
  
  CONCLUSIONS
  THPV18 DNA viral load may have a prognostic value in patients with early-stage NECA of the cervix. A low viral load may be predictive of shortened disease-free survival in these patients.
authors.affiliation: Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Sumalee
authors.initials: S
authors.lastname: Siriaunkgul
authors.forename: Utaiwan
authors.initials: U
authors.lastname: Utaipat
authors.forename: Supaporn
authors.initials: S
authors.lastname: Suwiwat
authors.forename: Jongkolnee
authors.initials: J
authors.lastname: Settakorn
authors.forename: Kornkanok
authors.initials: K
authors.lastname: Sukpan
authors.forename: Jatupol
authors.initials: J
authors.lastname: Srisomboon
authors.forename: Surapan
authors.initials: S
authors.lastname: Khunamornpong
mesh_terms: D000328:Adult; D018278:Carcinoma, Neuroendocrine / Q000235:genetics / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D052161:Human papillomavirus 18 / Q000235:genetics*; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000235:genetics / Q000473:pathology* / Q000821:virology*; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000235:genetics* / Q000473:pathology / Q000821:virology; D019562:Viral Load
chemical_list: D004279:DNA, Viral