A perspective study on correlation between HPV DNA and lymph nodes in surgically treated cervical carcinoma patients. Preliminary data

• Published in: European journal of gynaecological oncology Vol. 30; no. 5; p. 557
• Main Authors: Rolla, M, Berretta, R, Patrelli, T S, Merisio, C, Gramellini, D, Fadda, G M, Bacchi Modena, A, Nardelli, G B
• Format: Journal Article
• Language: English
• Published: Italy 2009
• Subjects: Adenocarcinoma - surgery; Adenocarcinoma - virology; Adult; Aged; Alphapapillomavirus - genetics; Alphapapillomavirus - isolation & purification; Biomarkers; Carcinoma, Squamous Cell - surgery; Carcinoma, Squamous Cell - virology; Disease Progression; DNA, Viral - isolation & purification; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Pelvis; Prospective Studies; Sentinel Lymph Node Biopsy; Uterine Cervical Neoplasms - surgery; Uterine Cervical Neoplasms - virology
• ISSN: 0392-2936

The purpose of this study was to analyze the presence of HPV DNA in lymph nodes in patients with cervical cancer. A prespective study was performed on a total of 18 patients with cervical cancer in FIGO Stage I-II. The surgical procedure consisted of systematic pelvic lymphadenectomy with removal of the common/external/internal (obturator) iliac lymph node chains, followed by radical hysterectomy depending on the clinical stage, or by Piver's type II radical laparohysterectomy for Stage IA2 carcinoma and Piver's type-III laparohysterectomy for Stage IB or Stage II carcinoma. After removal by a technique not yet described in the literature, the lymph nodes were processed directly in the operating room. HPV DNA testing was done using a cytobrush device. At the end of this operation, the lymph nodes were sent to the hospital's pathologist for metastasis detection. The correlation between a positive HPV DNA test in the cervix and lymph node metastasis was non significant (p < 0.63). By contrast, the correlation between a positive HPV DNA test in the lymph nodes and lymph node metastasis was highly significant (p < 0.005), as was the correlation between positive HPV DNA tests in the cervix and lymph nodes (p < 0.005). Finally, the correlation between disease stage and positive HPV DNA testing in the lymph nodes was also significant (p < 0.05). In conclusion, the technique that we used for HPV DNA extraction appears safe and reproducible. The results are comparable with, if not better, than those obtained with other techniques reported in the literature. The presence of HPV DNA in the lymph nodes is probably an early indicator of metastasis and as such it could be used as a predictor of relapse. Normally untreated patients who have this marker could then receive adjuvant therapy.