Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.
Department of Physiology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Gynecol Oncol. 2018 Jan;148(1):97-102. doi: 10.1016/j.ygyno.2017.11.003. Epub 2017 Nov 15.
Although the relationship between human papilloma virus (HPV) and cervical cancer is well established, the prognostic value of HPV status has not been determined, largely because previous studies have yielded conflicting results. This study aimed to investigate the prognostic value of pre-treatment HPV DNA for predicting tumor recurrence in cervical cancer.
The study included 248 eligible patients who provided cervical cell specimens for HPV genotyping before surgery or concurrent chemoradiotherapy (CCRT). Of these 248 patients, 108 were treated with radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer, and 140 were treated with CCRT for FIGO stage IB2-IV cervical cancer.
HPV 16 and 18 were the two most common HPV types detected, with prevalence rates of 52.4% and 12.5%, respectively. The pre-treatment HPV DNA test showed that 18.5% of cervical cancers were HPV negative. Multivariate analysis showed that HPV negativity was associated with poorer disease-free survival (DFS) than HPV-positive status (hazard ratio [HR], 3.97; 95% confidence interval [CI], 1.84-8.58; p=0.0005), and patients with HPV 16-positive cancers had better DFS (HR, 0.41; 95% CI, 0.23-0.72; p=0.0019). In the surgery group, only HPV 16 positivity was significantly correlated with DFS (HR, 0.34; 95% CI, 0.12-0.96; p=0.0416). In the CCRT group, only HPV negativity was significantly correlated with DFS (HR, 3.75; 95% CI, 1.78-7.90; p=0.0005).
Pre-treatment HPV DNA status may be a useful prognostic biomarker in cervical cancer. The presence of HPV 16 DNA was associated with better DFS, and HPV negativity was associated with worse DFS. However, larger sample sizes and more comprehensive studies are required to verify our findings.
虽然人乳头瘤病毒（HPV）与宫颈癌之间的关系已得到充分证实，但 HPV 状态的预后价值仍未确定，主要是因为之前的研究结果存在矛盾。本研究旨在探讨治疗前 HPV DNA 预测宫颈癌肿瘤复发的预后价值。
本研究纳入了 248 名符合条件的患者，他们在手术前或同期放化疗（CCRT）前提供了宫颈细胞标本进行 HPV 基因分型。在这 248 名患者中，108 名接受了国际妇产科联合会（FIGO）IB1-IIA 期宫颈癌根治性子宫切除术治疗，140 名接受了 FIGO IB2-IV 期宫颈癌 CCRT 治疗。
HPV16 和 18 是最常见的两种 HPV 类型，检出率分别为 52.4%和 12.5%。治疗前 HPV DNA 检测显示，18.5%的宫颈癌 HPV 阴性。多因素分析显示，HPV 阴性与无病生存（DFS）较差相关，HPV 阳性状态的 HR 为 3.97（95%CI，1.84-8.58；p=0.0005），HPV16 阳性癌症患者的 DFS 更好（HR，0.41；95%CI，0.23-0.72；p=0.0019）。在手术组中，只有 HPV16 阳性与 DFS 显著相关（HR，0.34；95%CI，0.12-0.96；p=0.0416）。在 CCRT 组中，只有 HPV 阴性与 DFS 显著相关（HR，3.75；95%CI，1.78-7.90；p=0.0005）。
治疗前 HPV DNA 状态可能是宫颈癌的一个有用的预后生物标志物。HPV16 DNA 的存在与较好的 DFS 相关，而 HPV 阴性与较差的 DFS 相关。然而，需要更大的样本量和更全面的研究来验证我们的发现。
