HUMAN PAPILLOMAVIRUS DNA AND ANTIBODIES TO HUMAN PAPILLOMAVIRUS-16 E2, L2, AND E7 PEPTIDES AS PREDICTORS OF SURVIVAL IN PATIENTS WITH SQUAMOUS-CELL CERVICAL-CANCER

Purpose: 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. Subjects and Methods: Fou r hundred seventy-one cases included in two population-led case-contro l studies underwent follow-up evaluation. The survival and cause of de ath were ascertained for 410 cases (87%), with a median fellow-up time of 4.6 years after diagnosis. HPV DNA was assessed using an L1 polyme rase chain reaction (PCR)-based system and Southern hybridization (SH) an scraped cytologic specimens or biopsies. HPV 16 antibodies to E2, L2, and E7 peptides were detected with enzyme-linked immunosorbent ass ay (ELISA). Results: Clinical stage was the only independent prognosti c factor for recurrence or survival. Although seropositivity to HPV 16 E7/3 peptide predicted a twofold excess risk of mortality (adjusted h azards ratio [HRa] = 2.0; 95% confidence interval [CI], 1.2 to 3.3), t he 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 HP V viral load and the HPV type identified were not predictors of tumor recurrence or survival. Conclusion: The presence of antibodies to HPV 16 E7 proteins 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. (C) 1991 by American Society of Clinical Oncology.