HUMAN PAPILLOMAVIRUS DETECTION IN CERVICAL-CARCINOMA TISSUES AND PARAAORTIC LYMPH-NODES BY THE POLYMERASE CHAIN-REACTION

Tissues of 45 cervical cancers and paraaortic lymph nodes from the same patients were evaluated by polymerase chain reaction with L1 consensus primers and hybridization with type-specific oligomer probes of HPV-6, -11, -16, -18, -31, -33, -35, and -45 for the detection and classification of subtypes of human papillomavirus (HPV). The clinicohistologic findings of surgical specimens from radical hysterectomy were compared with the results of HPV detection to use as a possible prognostic marker for the early detection of paraaortic nodes involvement. Metastasis to paraaortic nodes in cervical cancer, suggesting extrapelvic involvement of tumor, is clinically important to predict prognosis. The HPV-16 DNA was most prevalent in cervical cancers (76%; 34/45). Five tumors were positive for HPV-18, two tumors each were positive for HPV-31 or -33, one tumor was hybridized to HPV-45, and one woman had an unidentified type of HPV. No HPV was detected in three cases of cervical cancer. The histologic types of the cervical cancers were correlated with the HPV types. Of the 39 tissue specimens of squamous carcinomas analyzed, only 2 (5%) showed HPV-18, in contrast to 30 (77%) of 39 squamous carcinomas having HPV-16. Of the 5 cases of adenocarcinomas, 3 (50%) showed HPV-18, and 3 (50%) showed HPV-16. HPV DNAs were detected in histologically negative paraaortic lymph nodes (31%; 14/45): the HPV-positive PCR products from paraaortic nodes were only hybridized to HPV-16. The nature of the relationship between the presence of HPV DNA and node tumor involvement is still not known. HPV-16 DNA in paraaortic nodes may suggest subclinical early metastasis or tumor cells destroyed by immune cells and may provide important information in decisions regarding postoperative adjuvant treatment. The prognostic significance of HPV DNA in histologically negative paraaortic lymph nodes remains to be established after several years of follow-up.