Distribution Of Human Papillomavirus Genotypes In Early-stage Cervical Adenocarcinoma And Its Clinical Significance

Background:Cervical carcinoma is one of the most common cancers in women, and cervical carcinoma is the only one cancer with the clear etiology, which is high-risk Human papillomavirus (HPV) infection. HPV16、18are the most common types in HPVs. Most of all is squamous cervical carcinoma, but in recent years, the trend of the proportion of adenocarcinoma in cervical cancer has been rising. The reasons of rising trend are not only because of the popularity of cervical cancer screening of cervical squamous cell carcinoma the incidence rate decreased, but also because of the incidence of adenocarcinoma of the uterine cervix to the absolute value of the increase. Compared with squamous cell carcinoma, prognosis of cervical adenocarcinoma is worse, soadenocarcinoma should arouse our attention. But so far, only a few studies focus on the relationship between the distribution of HPV genotypes and the prognosis of adenocarcinoma, and the results across studies are inconsistent. Objective:This study aimed to analyze the distribution of HPV genotype in early cervical adenocarcinoma, and explore the association of HPV genotype with survival duration of cervical adenocarcinoma.Materials and methods:During the period from June2000to May2010, a total of101patients with cervical adenocarcinoma who received surgery in Women’s Hospital School Of Medicine Zhejiang University were enrolled. The paraffin specimen of cervical adenocarcinoma were used extract DNA, and then HPV genotype were detected by nested polymerase chain reaction (Nested PCR). The associations of HPV18with clinicopathological parameters and survival duration were analyzed in the cervical adenocarcinoma patients.Results:DNA of96samples was successfully extracted. The HPV-positive rate in the early-stage cervical adenocarcinoma cases was95.8%(92/96). The two most commonly HPV types were HPV16(59.4%) and HPV18(60.4%). The proportions of single, double, and multiple HPV infections were22.9%,32.3%, and40.6%, respectively. The HPV18-positive and HPV18-negative rate of lymph node metastasis and vascular involvement were27.6%Vs.7.9%and22.4%Vs.7.9%; their difference reached statistical significantly. Univariate analysis showed that positive surgical margin, uterine corpus invasion, lymph node metastasis, and HPV18infection were the predictive factors for poor prognosis of patients with cervical adenocarcinoma. Multivariate analysis revealed that lymph node metastasis was an independent prognostic factor for both disease-free survival and overall survival duration, and uterine corpus invasion was the independent prognostic factor of overall survival in the early-stage cervical adenocarcinoma patients.Conclusions:HPV16and HPV18are the major genotypes of HPV in the early-stage cervical adenocarcinoma. Infection with HPV18was prove to develop lymph node metastasis and vascular involvement, but not significantly correlated with disease-free survival and overall survival duration.