Lombard I, Vincent-Salomon A, Validire P, Zafrani B, de la Rochefordière A, Clough K, Favre M, Pouillart P, Sastre-Garau X
Department of Biostatistics, Institut Curie, Paris, France.
J Clin Oncol. 1998 Aug;16(8):2613-9. doi: 10.1200/JCO.1998.16.8.2613.
To determine whether the prognosis of invasive cancers of the uterine cervix is related to the type of human papillomavirus (HPV) associated with the tumor.
Two hundred ninety-seven patients with invasive cervical cancer were prospectively registered from 1986 to 1994. HPV typing was performed on DNA extracted from frozen tumor specimens by means of Southern blot hybridization (SBH) and polymerase chain reaction (PCR) techniques. The median follow-up was 38 months.
HPV sequences were detected in 246 patients (83%): 150 patients had HPV16, 31 patients had HPV18, and 14 patients had one of the intermediate-oncogenic-risk HPV types (HPV31, 33, 35, 52, 58). In 51 patients, HPV type remained undetermined, and in 51 patients, no viral sequences were found. No significant associations were observed between virologic data and tumor stage or node status. The 5-year disease-free survival (DFS) rate was 100% for patients with intermediate-risk HPV-associated tumors, 58% for patients with HPV16-positive tumors, and 38% for patients with HPV18-positive tumors (P = .02). In multivariate analysis, patients with HPV18-associated tumors had a relative risk (RR) of death 2.4 times greater (95% confidence interval [CI], 1.29-4.59) than that for patients with HPV16, and 4.4 times greater (95% CI, 3.48-5.32) than that for patients with a tumor associated with a viral type different from HPV16/18.
The prognosis for invasive cancers of the uterine cervix is dependent on the oncogenic potential of the associated HPV type. HPV typing may provide a prognostic indicator for individual patients and is of potential use in defining specific therapies against HPV-harboring tumor cells.
确定子宫颈浸润癌的预后是否与肿瘤相关的人乳头瘤病毒（HPV）类型有关。
1986年至1994年对297例子宫颈浸润癌患者进行前瞻性登记。通过Southern印迹杂交（SBH）和聚合酶链反应（PCR）技术对从冷冻肿瘤标本中提取的DNA进行HPV分型。中位随访时间为38个月。
246例患者（83%）检测到HPV序列：150例患者为HPV16，31例患者为HPV18，14例患者为中等致癌风险HPV类型之一（HPV31、33、35、52、58）。51例患者HPV类型未确定，51例患者未发现病毒序列。病毒学数据与肿瘤分期或淋巴结状态之间未观察到显著关联。中等风险HPV相关肿瘤患者的5年无病生存率（DFS）为100%，HPV16阳性肿瘤患者为58%，HPV18阳性肿瘤患者为38%（P = 0.02）。多因素分析显示，HPV18相关肿瘤患者的死亡相对风险（RR）比HPV16相关肿瘤患者高2.4倍（95%置信区间[CI]，1.29 - 4.59），比与HPV16/18不同病毒类型相关肿瘤患者高4.4倍（95% CI，3.48 - 5.32）。
子宫颈浸润癌的预后取决于相关HPV类型的致癌潜能。HPV分型可为个体患者提供预后指标，并可能用于确定针对携带HPV的肿瘤细胞的特异性治疗方法。
