The presence of HPV DNA in cervical cancer:: Correlation with clinico-pathologic parameters and prognostic significance:: 10 years experience at the Department of Obstetrics and Gynecology of the Mainz University
The presence of HPV DNA in cervical cancer:: Correlation with clinico-pathologic parameters and prognostic significance:: 10 years experience at the Department of Obstetrics and Gynecology of the Mainz University
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DOI：
10.1046/j.1525-1438.2001.011001039.x
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发表时间：
2001-01-01
影响因子：
4.8
通讯作者：
Knapstein, PG
中科院分区：
文献类型：
--
作者：
Pilch, H;Günzel, S;Knapstein, PG
本研究的目的是评估宫颈癌中人乳头瘤病毒(HPV)DNA的存在和/或HPV DNA的几种基因型是否与几个具有明确预后意义的临床病理参数相关，以及病毒学参数是否可以预测癌症患者的长期生存。204例(91.4%)患者接受了生存和死因检查，平均随访时间为4.4年。用高灵敏的聚合酶链式反应(PCR)方法检测HPV DNA，然后进行HPV基因分型。这些结果与明确的临床病理参数和生存数据相关联。在193例宫颈癌患者的组织标本中，有150例(73.4%)用聚合酶链式反应检测到HPVDNA。DNA序列分析显示HPV16型68例(45.3%)，18型49例(32.6%)，少见型33例(22.1%)。HPV基因分型与组织学肿瘤类型、淋巴结状态、肿瘤氧合、血管侵犯和淋巴间隙侵犯显著相关。在单因素COX回归分析中，宫颈癌中HPVDNA的存在以及HPV16型也可以被确认为显著的预后因素(RR 2.856，P<；0.003)。RR 3.444，P<；0.0001)。然而，在多变量分析中，HPV DNA状态与预后无关。独有的HPV16似乎对宫颈患者的总存活率有独立影响(RR 3.653，P<；0.002)。结论：HPV16型检测对宫颈癌患者的预后判断有重要的辅助作用。HPV DNA在宫颈原发肿瘤中的临床影响有待进一步研究，而RPV影响宫颈癌患者预后的确切机制还有待进一步研究。
The objective of this study was to assess whether the presence of human papillomavirus (HPV) DNA and/or several genotypes of HPV DNA in cervical cancer are correlated with several clinicopathologic parameters of well-defined prognostic significance and whether virologic parameters are predictors of long-term survival in cancer patients.Two hundred twenty three cases of cervical cancer patients included in this retrospective study underwent follow-up evaluation. Survival and cause of death were examined for 204 (91.4%) patients, with a mean follow-up time of 4.4 years. HPV DNA was detected using the highly sensitive polymerase chain reaction (PCR) method followed by HPV DNA sequencing for HPV genotyping. These results were correlated with well-defined clinicopathologic parameters and survival data.HPV DNA was detected by PCR in 150 of 193 (73.4%) tissue specimens of cervical cancer patients. DNA sequence analysis revealed the presence of HPV 16 (n = 68, 45.3%), HPV 18 (n = 49, 32.6%) and rare HPV types (n = 33, 22.1%). HPV genotypes correlated significantly with histologic tumor types, node status, tumor oxygenation, blood vessel invasion, and lymph space involvement. The presence of HPV DNA in cervical cancer as well as the genotype of HPV 16 could also be confirmed as significant prognostic factors in the univariate Cox regression analysis (RR 2.856, P < 0.003 resp. RR 3.444, P < 0.0001). In the multivariate analysis, however, HPV DNA status failed to be of prognostic relevance. Exclusively HPV 16 appears to have an independent impact on the overall survival in cervical patients (RR 3.653, P < 0.002). We conclude that the detection of HPV 16 genotype may play an important adjunct role in assessing prognosis of cervical cancer patients. The clinical impact of the presence of HPV DNA in primary tumors of uterine cervix remains to be investigated in further studies, and the exact mechanisms by which RPV influences the prognosis of cervical cancer patients have to be defined.