Significance of HPV DNA/mRNA in metastasissuspected tissues in carcinoma of the cervix : A prospective observational study

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Objective : to prospectively clarify the clinical significance of HPV DNA in nodal and other tissues, with special reference to its possible determinant in diagnosing occult metastasis in cervical cancer.Methods : 293 who were tested for HPV DNA of primary tumor before initiation of treatment, were prospectively analysed for a possible correlation between presence or absence of HPV DNA and histological findings in metastasis-suspected tissue samples. The polymerase chain reaction was performed using fresh tissue or cell specimens, immediately after sampling.Results : In 250 of 293 patients (85.3%), HPV DNA was detected in cervical tumor tissues. The positive rate by histology was 89.9% in squamous cell carcinoma, 93.8% in adenosquamous carcinoma and 51.4% in adenocarcinoma, and the former two figures were significantly higher than the latter (p<O.OO1 and p=O.OO2). HIPV type 16 was most predominant in squamous cell carcinoma, while type 18 was relatively high prevalent in adenocarcinoma … More . 52% were not determined for HPV types. After start of treatment, in 489 nodal and other tissue samples which were obtained from 113 of 250 HPV DNA-positive patients, HPV DNA was amplified in all of 55 samples metastasized and even in 12 of 434 not metastasized (2.8%). HPV types specified in these samples were always identical with the HPV types determined in their primary tumors. In 154 samples from 29 of 43 HPV DNA-negative patients, HPV DNA was not detected in both sapmles metastasized and not metastasized. Cancer-free but HPV DNA-positive tissues could be interpreted to be already involved at the time of examination, by checking them with clinical courses of the disease.Conclusions : in carcinoma of the cervix, oncogenic HPV DNA analysis of nodes and other tissues may be a useful adjunct to routine microscopic evaluation, possibly as a determinant of occult metastasis. Patietns who have tumor-free but HPV DNA-positive samples should be planned to receive some treatment for the sample sites and also monitored as a possible high-risk group of recurrence. Less