Lymph node human papillomavirus DNA positivity in uterine cervical cancers and its relationship with prognostic factors.

Abstract

Uterine cervical cancer is a major health care issue worldwide. Human papillomavirus (HPV) DNA positivity in regional lymph nodes has been proposed as a risk factor for recurrence in a number of studies. The aim of our study was to determine the correlation between well-known prognostic factors and HPV DNA positivity in regional lymph nodes of patients with cervical cancer who were treated surgically. Thirty-seven patients who underwent radical hysterectomy (Piver class III) with regional lymph node dissection for International Federation of Gynecology and Obstetrics stage IB uterine cervical cancer were assessed for nodal HPV DNA status using polymerase chain reaction. Human papillomavirus DNA presence and types were analyzed in paraffin-embedded tissues from all primary tumors and 746 regional lymph nodes. The correlation between HPV DNA positivity of the lymph nodes and prognostic factors (stage at the time of diagnosis, status of the regional nodes, status of parametrial and surgical margins, tumor size, histological type, cervical stromal invasion depth, and lymphovascular space invasion was investigated. Lymph node HPV DNA positivity increased in larger tumors (P < 0.05). In addition, lymph node metastasis and primary tumor HPV DNA status were closely correlated with the HPV DNA status of the lymph nodes (P < 0.05). Human papillomavirus DNA presence in the lymph nodes of patients with uterine cervical cancer may have an influence on disease survival and requires further research. Future studies with prospective design and large sample sizes using fresh operative specimens and quantitative HPV DNA detection methods are needed.