THE ROLE OF HUMAN-PAPILLOMAVIRUS DNAS IN CERVICAL-CARCINOMA AND RISK OF LYMPH-NODE METASTASIS - ASSOCIATION WITH 72-KILODALTON METALLOPROTEINASE IMMUNOSTAINING

BACKGROUND, The role of human papillomavirus (HPV) as a prognostic fac tor in cervical carcinoma is not understood completely and little is k nown regarding the intrinsic mechanisms involved in the metastatic pro cess of HPV positive carcinoma. The authors evaluated HPV status with respect to clinical features in early stage cervical carcinoma, with s pecial emphasis on lymph node spread. The authors also analyzed the re lation between HPV, lymph node involvement, and 72-kilodalton (kDa) me talloproteinase immunostaining, an enzyme that cleaves Type IV collage n and may play a role in tumor metastasis. METHODS, Thirty-two patient s with international Federation of Gynecology and Obstetrics Stage I a nd IIA squamous cell cervical carcinoma treated by primary radical sur gery were reviewed. Histologic grade of differentiation, tumor size, f ractional depth of invasion, and lymph node spread were evaluated with respect to HPV status and 72-kDa metalloproteinase immunostaining. HP V DNA was detected by polymerase chain reaction and the primers potent ially recognized at least the following HPV subtypes: 6, 11, 16, 18, 3 1, 33, 34, 35, 42, 51, 56, and 58. Immunohistochemical staining was pe rformed using the avidin-biotin complex technique. Affinity-purified r abbit anti-72-kDa metalloproteinase antibody was used. RESULTS, HPV DN A was detected in a total of 69% of cases, and HPV-16 was the most fre quent type detected. HPV positive carcinomas showed a significantly hi gher rate of lymph node metastases than HPV negative carcinomas (45% v s, 10%; P = 0.03); similarly, 72-kDa metalloproteinase index was signi ficantly higher (P = 0.001). CONCLUSIONS, These findings suggest a rel ation between HPV and risk of lymph node metastasis, which may be medi ated by an increased production of 72-kDa metalloproteinase. (C) 1998 American Cancer Society.