title: Human papillomavirus (HPV) genome status & cervical cancer outcome--A retrospective study.
abstract: OBJECTIVE
  Persistent infections with high-risk (HR) human papillomaviruses such as HPV 16, 18, 31, 33 and 45 have been identified as the major aetiological factor for cervical cancer. The clinical outcome of the disease is often determined by viral factors such as viral load, physical status and oncogene expression. The aim of the present study was to evaluate the impact of such factors on clinical outcome in HPV16 positive, locally advanced cervical cancer cases.
  
  
  METHODS
  One hundred and thirty two pretreatment cervical tumour biopsies were selected from patients undergoing radiotherapy alone (n=63) or concomitant chemo-radiation (n=69). All the samples were positive for HPV 16. Quantitative real time-PCR was carried out to determine viral load and oncogene expression. Physical status of the virus was determined for all the samples by the ratio of E2 copies /E7 copies ; while in 73 cases, the status was reanalyzed by more sensitive APOT (amplification of papillomavirus oncogene transcripts) assay. Univariate analysis of recurrence free survival was carried out using Kaplan-Meier method and for multivariate analysis the Cox proportional hazard model was used.
  
  
  RESULTS
  The median viral load was 19.4 (IQR, 1.9- 69.3), with viral integration observed in 86 per cent cases by combination of the two methodologies. Both univariate and multivariate analyses identified viral physical status as a good predictor of clinical outcome following radiation treatment, with episomal form being associated with increased recurrence free survival.
  
  
  CONCLUSIONS
  The present study results showed that viral physical status might act as an important prognostic factor in cervical cancer.
authors.forename: Poulami
authors.initials: P
authors.lastname: Das
authors.forename: Asha
authors.initials: A
authors.lastname: Thomas
authors.forename: Sadhana
authors.initials: S
authors.lastname: Kannan
authors.forename: Kedar
authors.initials: K
authors.lastname: Deodhar
authors.forename: Shyam K
authors.initials: SK
authors.lastname: Shrivastava
authors.forename: Umesh
authors.initials: U
authors.lastname: Mahantshetty
authors.affiliation: Advanced Centre for Treatment, Research & Education in Cancer (ACTREC), Tata Memorial Centre, Navi Mumbai, India.
authors.forename: Rita
authors.initials: R
authors.lastname: Mulherkar
mesh_terms: D052685:Alphapapillomavirus / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D005814:Genes, Viral; D006801:Humans; D016254:Mutagenesis, Insertional; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000821:virology*
chemical_list: D014408:Biomarkers, Tumor