HUMAN PAPILLOMAVIRUS DNA AS A FACTOR DETERMINING THE SURVIVAL OF BLADDER-CANCER PATIENTS

The natural history of transitional cell carcinoma (TCC) of the urinar y bladder is somewhat variable. with a significant number of tumour re currences that occasionally evolve towards an infiltrating disease. Th e aim of this study was to investigate the presence of human papilloma virus (HPV) DNA in 76 TCC specimens, and then correlate such findings with the overall patient survival. However, other classical prognostic clinical and pathological variables such as pathological grade and st age, koilocytosis, age and sex were also tested. HPV DNA was investiga ted by means of the highly sensitive polymerase chain reaction (PCR). DNA primers specific for HPV types 6, 11, 16 and 18 were used. Our res ults showed that 7 (9.21%) out of 76 such cases were reactive for HPV 16 DNA: one of them also reacted with HPV 6 DNA. The statistical analy sis was done by the Kaplan-Meier method, Wilcoxon's generalised test F or studying the differences in survival curves and Cox's regression an alysis For independent prognostic factors. A significant P-value was f ound for pathological grade (P < 0.0001) and stage (P < 0.0001), HPV 1 6 DNA (P = 0.0418) and koilocytosis (P = 0.0140). Thus, pathological g rade was the only independent factor in the bladder cancer survival. T hese observations may prove useful in prognostic stratification of pat ients with TCC of the bladder.