Viladiu P, Bosch F X, Castellsagué X, Muñoz N, Escribà J M, Hamsíkova E, Hofmannova V, Guerrero E, Izquierdo A, Navarro C, Moreo P, Izarzugaza I, Ascunce N, Gili M, Muñoz M T, Tafur L, Shah K V, Vonka V
Institut Catala d'Oncologia, Servei d'Epidemiologia i Registre del Cáncer, Barcelona, Spain.
J Clin Oncol. 1997 Feb;15(2):610-9. doi: 10.1200/JCO.1997.15.2.610.
To assess whether human papillomavirus (HPV) DNA detection in cervical cancer specimens, or antibodies to selected HPV 16 peptides are predictors of tumor recurrence and long-term survival in patients with squamous cell invasive cervical cancer.
Four hundred seventy-one cases included in two population-based case-control studies underwent follow-up evaluation. The survival and cause of death were ascertained for 410 cases (87%), with a median follow-up time of 4.6 years after diagnosis. HPV DNA was assessed using an L1 polymerase chain reaction (PCR)-based system and Southern hybridization (SH) on scraped cytologic specimens or biopsies. HPV 16 antibodies to E2, L2, and E7 peptides were detected with enzyme-linked immunosorbent assay (ELISA).
Clinical stage was the only independent prognostic factor for recurrence or survival. Although seropositivity to HPV 16 E7/3 peptide predicted a twofold excess risk of mortality (adjusted hazards ratio [HRa] = 2.0; 95% confidence interval [CI], 1.2 to 3.3), the association was restricted to stage I (HRa = 6.6; 95% CI, 1.2 to 37.6) and II (HRa = 5.9; 95% CI, 2.1 to 16.5) patients. The presence of HPV DNA (HRa = 0.9; 95% CI, 0.5 to 1.5), different estimates of the HPV viral load and the HPV type identified were not predictors of tumor recurrence or survival.
The presence of antibodies to HPV 16 E7 proteins is of prognostic value in early-stage cervical cancer. Our results provide strong evidence that detection and typing of HPV DNA in cervical cells or tissues is not a prognostic factor for recurrence or survival.
评估宫颈癌标本中人类乳头瘤病毒（HPV）DNA检测，或针对特定HPV 16肽段的抗体是否为鳞状细胞浸润性宫颈癌患者肿瘤复发和长期生存的预测指标。
纳入两项基于人群的病例对照研究的471例患者接受随访评估。确定了410例患者（87%）的生存情况和死亡原因，诊断后中位随访时间为4.6年。采用基于L1聚合酶链反应（PCR）的系统和Southern杂交（SH）对刮取的细胞学标本或活检组织进行HPV DNA评估。采用酶联免疫吸附测定（ELISA）检测针对E2、L2和E7肽段的HPV 16抗体。
临床分期是复发或生存的唯一独立预后因素。虽然HPV 16 E7/3肽段血清阳性预测死亡风险增加两倍（校正风险比[HRa]=2.0；95%置信区间[CI]，1.2至3.3），但该关联仅限于I期（HRa=6.6；95%CI，1.2至37.6）和II期（HRa=5.9；95%CI，2.1至16.5）患者。HPV DNA的存在（HRa=0.9；95%CI，0.5至1.5）、HPV病毒载量的不同估计值以及鉴定出的HPV类型均不是肿瘤复发或生存的预测指标。
HPV 16 E7蛋白抗体的存在对早期宫颈癌具有预后价值。我们的结果提供了强有力的证据，表明宫颈细胞或组织中HPV DNA的检测和分型不是复发或生存的预后因素。
