Detection and typing of human papillomavirus in cervical carcinomas in Russian women - A prognostic study

BACKGROUND. The correlation between human papillomavirus (HPV) infection an d tumor prognosis in 159 Russian women with cervical carcinoma was investig ated. The presence of various HPV types was correlated with the histologic parameters of the carcinomas and with their immunoreactivity with antibodie s to p53, Ki-67-Ag, and bcl-2. METHODS. Formalin fixed, paraffin embedded tissue specimens representing 15 9 cases of International Federation of Gynecology and Obstetrics Stage I an d II were used. HPV DNA was detected by polymerase chain reaction (PCR) usi ng a general primer set that targets the L1 region and synthesizes a produc t of only 65 base pairs. The HPV types were determined by direct sequencing and compared with known HPV types. RESULTS. ALL 159 carcinomas were positive for HPV. HPV 16 (64.8%) was most frequently found, followed by HPV 18 (10.7%) and HPV 45 (8.2%). In 6 patien ts (3.8%), HPV types could not been further classified, and these cases wer e therefore categorized as HPV X. Although a trend was noted toward poorer prognosis for women with carcinomas harboring HPV types 16, 18, and 45 than for patients with carcinomas harboring HPV types 31, 33, 35, 52, 56, 58, a nd 68, the differences were not statistically significant. The prevalence o f adenocarcinoma and adenosquamous carcinoma was higher among HPV 18 positi ve patients than among patients with the other known HPV types (P = 0.0002) . CONCLUSIONS, The rate of HPV positivity in these 159 cervical carcinomas wa s 100%. These findings challenge the assumption that HPV negative cervical carcinomas exist. This high rate might be attributed to the use of a new br oad-spectrum HPV PCR test. HPV typing in cervical carcinoma was not signifi cantly related to clinical outcome. HPV 18 was significantly more frequentl y found in adenocarcinoma and adenosquamous carcinoma. The possibility of c lassifying HPV 45 as an oncogenic high risk type should be considered. (C) 1999 American Cancer Society.