title: Different Association of Human Papillomavirus 16 Variants with Early and Late Presentation of Cervical Cancer.
abstract: The median age of cervical cancer (CC) presentation coincides with the mean age of menopause presentation (49 years) in Mexico. Here, we investigated the association between different HPV16 variants and early (≤ 49 years) or delayed (≥ 50 years) CC presentation. We conducted a case-case study that included 462 CCs, 386 squamous cell carcinomas (SCC), 63 adenocarcinomas (ACC), and 13 additional cell types. Variants were identified by PCR and DNA sequencing. The risk conferred by each variant for developing CC earlier than 50 years was analyzed using a univariate logistic regression model considering old-aged patients (≥ 50 years) and non-HPV16 cases as the reference variables. Overall, the frequency of HPV16 was 50.9%, and the only identified variants were the European A1/2 (31.2%) and the Asian-American D2 (10.8%), and D3 (8.9%). D2 was mainly associated with ≤ 49-year-old patients (15.9%); A1/2 was uniformly distributed between the two age groups (~31%), whereas D3 increased with age to a frequency of 11.8% in the older group. Only the D2 variant conferred a 3.3-fold increase in the risk of developing CC before 50 years of age (OR = 3.3, 95% CI = 1.7-6.6, p < 0.001) in relation with non-HPV16 cases. Remarkably, this risk was higher for ACC (OR = 6.0, 95% CI = 1.1-33, p < 0.05) than for SCC (OR = 2.8, 95% CI = 1.3-5.9, p < 0.01). Interestingly, when analyzing only the HPV16-positive CC, D2 increases (OR = 2.5, 95% CI = 1.2-5, p < 0.05) and D3 decreases (OR = 0.45, 95% CI 0.2-0.9, p < 0.05) the risk to develop CC before 50 years old in relation with A1/2 variant. These results indicated that D2 variant is associated with early and D3 with delayed CC presentation, whereas A1/2 variant was uniformly distributed between the two age groups.
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.
authors.forename: Ana
authors.initials: A
authors.lastname: Alfaro
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.
authors.forename: Eligia
authors.initials: E
authors.lastname: Juárez-Torres
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Medina-Martínez
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.
authors.forename: Norma
authors.initials: N
authors.lastname: Mateos-Guerrero
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.
authors.forename: Maura
authors.initials: M
authors.lastname: Bautista-Huerta
authors.affiliation: Servicio de Oncología, Hospital General de México, México City, México.
authors.forename: Edgar
authors.initials: E
authors.lastname: Román-Bassaure
authors.affiliation: Departamento de Biomedicina Molecular, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, México City, México.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Villegas-Sepúlveda
authors.affiliation: Unidad de Medicina Genómica, Facultad de Medicina, Universidad Nacional Autónoma de México / Hospital General de México, México City, México.|Departamento de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, México.
authors.forename: Jaime
authors.initials: J
authors.lastname: Berumen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000821:virology*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D052162:Human papillomavirus 16 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral