HPV Status and Individual Characteristics of Human Papillomavirus Infection as Predictors for Clinical Outcome of Locally Advanced Cervical Cancer.

Liana Mkrtchian,Gunel Kulieva,Liudmila Krikunova,Olga Matchuk,Liubov Liubina,Valentina Kiseleva,Sergey Ivanov,Irina Zamulaeva,Andrey Kaprin

doi:10.3390/jpm11060479

Abstract

This study is aimed at searching for an informative predictor of the clinical outcome of cervical cancer (CC) patients. The study included 135 patients with locally advanced cervical cancer (FIGO stage II–III) associated with human papillomavirus (HPV) 16/18 types or negative status of HPV infection. Using logistic regression, we analyzed the influence of the treatment method, clinical and morphological characteristics, and the molecular genetic parameters of HPV on the disease free survival (DFS) of patients treated with radiotherapy or chemoradiotherapy. Multivariate analysis revealed three factors that have prognostic significance for DFS, i.e., HPV-related biomarker (HPV-negativity or HPV DNA integration into the cell genome) (OR = 9.67, p = 1.2 × 10−4), stage of the disease (OR = 4.69, p = 0.001) and age (OR = 0.61, p = 0.025). The predictive model has a high statistical significance (p = 5.0 × 10−8; Nagelkirk’s R2 = 0.336), as well as sensitivity (Se = 0.74) and specificity (Sp = 0.75). Thus, simultaneous accounting for the clinical and molecular genetic predictors (stage of the disease, patient age and HPV-related biomarker) makes it possible to effectively differentiate patients with prognostically favorable and unfavorable outcome of the disease.

Highlights

Cervical cancer (CC) continues to occupy one of the leading places in the morbidity and mortality of young women [1]
The human papillomavirus (HPV) status and genotype were determined in tumor material of 173 patients with CC stages II–III according to the classification developed by the International Federation of Gynecology and Obstetrics (FIGO)
HPV status was determined in scrapings from the cervix of 173 CC patients before treatment

Summary

Introduction

Cervical cancer (CC) continues to occupy one of the leading places in the morbidity and mortality of young women [1]. Despite the widespread implementation of screening programs, there is quite a high proportion of locally advanced CC, the treatment efficiency of which does not exceed 60% in some countries. The search for an informative predictor of unfavorable clinical outcome of CC can play a decisive role in the optimal planning of treatment for locally advanced forms of the disease. The clinical studies revealed the main factors influencing the effectiveness of CC treatment: degree of spread, form of growth, morphological structure of tumor, patient’s age, etc. It turned out that the treatment effectiveness can vary greatly between patients with the same clinical and morphological characteristics. The search for new prognostic biomarkers of the effectiveness of CC treatment remains relevant to this day [3,4]

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