Abstract
BACKGROUND
The aim of the current study was to explore the clinical implications and prognostic value of human papillomavirus (HPV) genotype in cervical carcinomas.
METHODS
A total of 152 patients diagnosed with International Federation of Gynecology and Obstetrics Stage I–IV cervical carcinoma were studied between 1992–1999. HPV DNA status was assessed from paraffin‐embedded, formaldehyde‐fixed cervical carcinoma specimens by polymerase chain reaction‐based methods using E7 type‐specific and L1 modified general primers (MY11/GP6+ and GP5+/GP6+). The authors divided the patients into four groups: HPV‐16‐related, HPV‐18‐related, HPV‐31‐related, and HPV‐58‐related types. The relations with clinicopathologic data and overall survival were evaluated.
RESULTS
HPV DNA was detected in 98% of the tumor specimens and 28.9% of the tumor specimens contained multiple HPV types. The HPV‐16‐related types were detected more often in squamous cell carcinomas, whereas the HPV‐18‐related types were more prevalent in adenocarcinomas and adenosquamous carcinomas. In addition, Stage I–II diseases were found more frequently in the HPV‐16‐related group than in the other groups (P = 0.001). Otherwise, no significant correlation between the HPV genotype and other clinicopathologic parameters was found. After a median follow‐up of 64.5 months, the 5‐year survival rate was 92% in the HPV‐31‐related group compared with 70% in the HPV‐16‐related group, 69% in the HPV‐18‐related group, and 36% in the HPV‐58‐related group. The survival rates statistically differed among the four groups by log‐rank test (P = 0.02). However, the presence of multiple HPV types was not associated with prognosis. After stratifying for clinical stage, multivariate analysis demonstrated that HPV genotype was an independent prognostic factor. Compared with the HPV‐16‐related group, the long‐term mortality rate was 73 % lower in the HPV‐31‐related group (relative risk, 0.27; 95% confidence interval, 0.09–0.76; P = 0.013).
CONCLUSIONS
The presence of HPV‐31‐related types was an independent predictor of better survival in patients with cervical carcinoma. Therefore, HPV genotyping of cervical carcinomas may have profound implications for future patient management. Cancer 2004;100:327–34. © 2003 American Cancer Society.