DETECTION OF HUMAN PAPILLOMA-VIRUS DNA IN LYMPH-NODES EXTIRPATED AT RADICAL SURGERY FOR CERVICAL-CANCER IS NOT PREDICTIVE OF RECURRENCE

In women with recurrent cervical cancer after radical surgery, lymph n ode metastasis is detectable histologically at the time of surgery in only about 50% of cases. The present study was designed to determine w hether the detection of human papilloma virus (HPV) DNA in lymph nodes extirpated at operation, as an indication of micrometastasis, is pred ictive of recurrence. Using polymerase chain reaction (PCR), a total o f 140 lymph nodes from 31 patients with HPV 16 DNA positive primary ce rvical tumours were tested for the presence of an HPV 16 LCR/E6 gene f ragment. HPV 16 DNA was detected in extirpated lymph nodes in 75% (6/8 ) of patients with recurrence (and who died within 5 years after surge ry) and in 70% (16/23) of recurrence-free patients. In only four of th e patients with recurrence (three of whom had HPV 16 DNA positive lymp h nodes) was metastasis detectable histologically at surgery. HPV DNA positive lymph nodes were found in 91% (10/11) of patients with histol ogically detectable metastasis at surgery and in 60% (12/20) of patien ts without metastasis. It is concluded that the presence of HPV DNA in extirpated lymph nodes at cervical cancer operation does not appear t o be predictive of tumour recurrence. (C) 1998 Wiley-Liss, Inc.