Department of Obstetrics and Gynecology, Chonnam National University Medical School, 8 Hakdong, Dong-gu, Gwangju, Republic of Korea
Gynecol Oncol. 2011 Jun 1;121(3):546-50. doi: 10.1016/j.ygyno.2011.01.015. Epub 2011 Feb 21.
This study was conducted to determine the prognostic significance of the human papillomavirus (HPV) genotype using the HPV DNA chip (HDC) test and the HPV viral load by the hybrid capture II assay (HC2) in FIGO stage IB-IIA cervical cancer undergoing radical hysterectomy.
Between January 2001 and December 2005, 204 consecutive patients who underwent radical hysterectomy with pelvic lymphadenectomy for International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer were retrospectively reviewed. The Cox proportional hazard models adjusted for covariates were used for analyses and a receiver operating characteristic (ROC) curve was used to determine the HPV viral load in predicting disease progression.
Of the 204 cases, the HDC was positive in 195 (95.6%) and the HC2 was positive in 192 (94.1%). The 5-year progression-free survival (PFS) was 78.4%. On multivariate analysis, HPV-18 positivity was an independent prognostic factor predictive for disease progression. The risk of recurrence was higher for HPV-18 positivity (hazard ratio=2.664; 95% confidence interval [CI], 1.437-4.938; P=0.003). The 5-year PFS rate for patients who were HPV-18-negative was 83.8%, which was higher than the 5-year PFS for patients who were HPV-18-positive (54.1%; P<0.001). The area under the ROC curve for the HPV viral load was 0.550 (P=0.314; 95% CI, 0.455-0.644).
The HPV-18 genotype is a reliable prognostic factor of early-stage cervical cancer; however, the HPV viral load may not be helpful in predicting disease prognosis.
本研究旨在通过 HPV DNA 芯片（HDC）检测和杂交捕获二代（HC2）检测 HPV 病毒载量，确定人乳头瘤病毒（HPV）基因型在接受根治性子宫切除术的国际妇产科联合会（FIGO）分期 IB-IIA 宫颈癌患者中的预后意义。
回顾性分析 2001 年 1 月至 2005 年 12 月期间 204 例接受根治性子宫切除术和盆腔淋巴结切除术的 FIGO 分期 IB1-IIA 宫颈癌患者。采用 Cox 比例风险模型进行分析，并使用受试者工作特征（ROC）曲线来确定 HPV 病毒载量在预测疾病进展中的作用。
在 204 例患者中，HDC 阳性者 195 例（95.6%），HC2 阳性者 192 例（94.1%）。5 年无进展生存率（PFS）为 78.4%。多因素分析显示，HPV-18 阳性是疾病进展的独立预后因素。HPV-18 阳性患者的复发风险更高（危险比=2.664；95%置信区间[CI]，1.437-4.938；P=0.003）。HPV-18 阴性患者的 5 年 PFS 率为 83.8%，高于 HPV-18 阳性患者的 5 年 PFS 率（54.1%；P<0.001）。HPV 病毒载量的 ROC 曲线下面积为 0.550（P=0.314；95%CI，0.455-0.644）。
HPV-18 基因型是早期宫颈癌的可靠预后因素；然而，HPV 病毒载量可能无助于预测疾病预后。
