Correlation Between HPV Subtypes And Viral Load And Clinicopathological Features Of Cervical Adenocarcinoma

Objective: To investigate the correlation of human papilloma virus(HPV)infection subtypes and HPV viral load with clinicopathological features and survival prognosis of Endocervical adenocarcinoma(ECA).To provide more evidence for the prevention,screening,diagnosis and treatment of ECA.Methods: The clinicopathological data of 152 cases of ECA who underwent surgery and were pathologically confirmed from January 2017 to October 2021 at the Clinicopathological Center of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)were collected.Each case was reassessed histomorphologically according to the 2018 International Endocervical Adenocarcinoma Criteria and Classification(IECC),according to the evaluation classification results,the patients were divided into 3 groups: non-HPV-associated adenocarcinoma(NHPVA),HPV-associated adenocarcinoma(HPVA),endocervical adenocarcinoma not otherwisespecified(ECA-NOS).p16 immunohistochemical staining was performed in all cases,and HPV infection subtypes and viral loads were determined by real-time fluorescence quantitative Polymerase chain reaction(PCR).The relationship between IECC histological type,HPV infection subtype and viral load and ECA patients’ age of onset,nerve invasion,vascular tumor thrombus,lymph node metastasis,Silva infiltration pattern,International Federation of Gynecology and Obstetrics(FIGO)stage,maximum tumor diameter and other clinical and pathological data correlation.Results: There were significant differences between HPVA and NHPVA in lymph node metastasis,p16 immunohistochemical staining,FIGO stage and HPV viral load(P=0.048,P<0.001,P<0.001,P<0.001).2.There were significant differences in nerve invasion,vascular tumor thrombus,lymph node metastasis,FIGO stage and maximum tumor diameter between HPV16 and HPV18 subtypes(P=0.003,P=0.036,P=0.016,P=0.006,P=0.049).3.There was a significant difference in the viral load among the maximum diameters of tumors in the single HPV18 subtype group(P=0.011).4.Univariate analysis showed that tumor size,lymph node metastasis,vascular tumor thrombus,FIGO stage were significantly associated with the prognosis of patients(P=0.002,P<0.001,P=0.006,P=0.001).Multivariate analysis showed that lymph node metastasis was an independent risk factor for prognosis(P=0.005).There was a significant difference between the viral load and the survival prognosis in multiple infection cases(P=0.02).Conclusions: 1.NHPVA is more likely to have lymph node metastasis,higher FIGO stage,no viral infection or lower viral load than HPVA.2.The most common subtypes of ECA infection are HPV16 and HPV18,and HPV18 has a worse clinical prognosis than HPV16.3.The single HPV 18 subtype viral load was higher when the tumor diameter was larger in ECA.4.Lymph node metastasis is an independent risk factor for the prognosis of ECA.The viral load of multiple subtypes of HPV infection is a significant factor affecting the survival and prognosis of patients.