Comparison Of Clinicopathological Features, Genetic Differences, Survival Analysis And Related Meta-analysis Of Human Papillomavirus (HPV)-negative Cervical Cancer With HPV16 (+) And HPV18 (+) Types

Objective:to systematically evaluate the clinicopathological features of HPV negative and positive cervical cancer.Methods: Computer retrieval of Pub Med,Chinese journal full-text database(CNKI),Wan Fang Data and other databases was conducted to collect casecontrol studies related to the clinicopathological features of HPV negative cervical cancer.After two evaluators independently screened the literature,extracted the data and evaluated the bias risk evaluation included in the study,Rev Man 5.3 software was used for statistical analysis.Results: A total of 6,497 patients in 12 case-control studies were included,including 311 cases of hpv-negative cervical cancer and 4,634 cases of HPVpositive cervical cancer.Meta-analysis results showed that: The differences in tumor size,FIGO stage,medium and low differentiation,and LVSI involvement between HPV negative and positive cervical cancer were not statistically significant(P>0.05);The differences in pathological types,high differentiation,lymph node metastasis and muscle infiltration between HPV positive and negative cervical cancer were statistically significant(P< 0.05).Conclusion: The histological types of HPV-negative cervical cancer showed less squamous carcinoma than HPV-positive ones,and more adenocarcinomas.The tissue differentiation of hp V-positive cervical cancer was less than that of HPV-positive ones,and hp V-negative cervical cancer was more prone to lymph node metastasis and deep muscular invasion than hp V-positive ones.Objective: To investigate the clinicopathological characteristics,genetic differences and survival analysis of HPV-negative cervical cancer and Type 16 HPV positive cervical cancer and Type 18 HPV positive cervical cancer.Methods: Selection in January 2013-December 2019 in our hospital fu tumor section at the beginning of the first option of HPV cure cervical cancer patients with 30 cases,as HPV negative group,according to the principle of similar FIGO staging,respectively over the same period in our department in the hospital treatment of HPV16 type(+)in 37 patients with cervical cancer and HPV18 type(+)10 cases of cervical cancer patients,respectively,as a group type(+)group and HPV18 type(+)group.The clinicopathological characteristics,including age,FIGO stage,pathological type,tumor size,degree of differentiation,depth of muscular layer infiltration,lymph node metastasis,P16,KI-67 and total survival time of the three groups were analyzed.Results: In the HPV negative group,squamous cell carcinoma accounted for 63.3%,adenocarcinoma 36.7%,squamous cell carcinoma 83.8%,adenocarcinoma 16.2%,squamous cell carcinoma 30.0% and adenocarcinoma 70.0% in the HPV16(+)group,and the comparison of pathological types of cervical cancer in the three groups was statistically significant(P=0.004).HPV negative group of low differentiation is 50.0%,the differentiation among the 36.7%,the high differentiation(13.3%),poorly differentiated type group(+)group is 43.2%,the differentiation among the 51.4%,the high differentiation(5.4%),poorly differentiated type HPV18(+)group is 10.0%,the differentiation among the50.0%,the high differentiation(40.0%),comparison of three groups of cervical cancer histological grade differences statistically significant(P = 0.032);In the HPV negative group,13.3% were neuroinvasive,10.8% were HPV16(+),and90.0% were HPV18(+).The difference of neuroinvasive among the three groups was statistically significant(P=0.000).On the basis of statistical significance in the comparison of pathological type,differentiation degree and nerve invasion of cervical cancer patients in the three groups,Bonferroni method was used to correct pair comparison among the three groups(P < 0.0167 was statistically significant).In the comparison between HPV negative group and HPV16 type(+)group,there were no statistically significant differences in pathological type,differentiation degree and nerve invasion between the two groups(P > 0.0167).In the comparison between the HPV negative group and the HPV18 type(+)group,neurological invasion accounted for 13.3% in the HPV negative group and 90.0% in the HPV18 type(+)group.The difference in neurological invasion between the two groups was statistically significant(P=0.000),indicating that compared with the HPV18 type(+)group,the probability of neurological invasion in the HPV-negative group was lower.There was no statistically significant difference in pathological type and differentiation degree between the two groups(P > 0.0167).Survival analysis: The total survival time was(29.33±19.48)months in the HPV negative group,(32.24±19.46)months in the HPV16(+)group,and(25.30±12.62)months in the HPV18(+)group.The overall survival rates of HPV negative group,HPV16(+)group and HPV18(+)group were 90.0%,94.6% and 90.0%,respectively.The survival rate of cervical cancer patients among the three groups was compared,and the difference was not statistically significant(P > 0.05).Pairwise survival analysis was conducted for the hpv-negative group,HPV16(+)group and HPV18(+)group,respectively,and the difference was not statistically significant(P > 0.05).Comparison of genetic differences: There was no significant difference in the expression levels of P16 and KI-67 in cervical cancer patients of HPV negative group,HPV16(+)group and HPV18(+)group(P>0.05).Conclusion:(1).There were significant differences in pathological type,differentiation degree and incidence of nerve invasion between HPV negative group,HPV16(+)group and HPV18(+)group;(2).Compared with the HPV type 16(+)group,there were no significant differences in pathological type,differentiation degree and incidence of nerve invasion in the HPV negative group;(3).Compared with the type HPV18(+)group,the probability of nerve invasion in the HPV negative group was lower.However,there was no significant difference in pathological type and differentiation degree between the two groups;(4).There was no significant difference in overall survival time and overall survival rate between HPV negative group and HPV type 16(+)group and HPV type 18(+)group.There was no significant difference in the expression level of P16 and Ki-67 in HPV negative group,HPV16(+)group and HPV18(+)group.