Human papillomavirus genotype as a prognostic factor in carcinoma of the uterine cervix

2007 ◽  
Vol 17 (6) ◽  
pp. 1307-1313 ◽  
Author(s):  
S. Y. Tong ◽  
Y. S. Lee ◽  
J. S. Park ◽  
S. E. Namkoong
Keyword(s):  
Human Papillomavirus ◽  
Prognostic Significance ◽  
Rank Test ◽  
Lymph Node Status ◽  
Clinical Implications ◽  
Specific Sequence ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Cervical Carcinomas ◽  
Hpv 18

The clinical implications of specific human papillomavirus (HPV) types in invasive cervical carcinomas are only now beginning to be appreciated. The objective of this study was to determine the clinical implications and prognostic value of the HPV genotype in cervical carcinomas. In this study, we employed an HPV DNA chip to detect the type-specific sequence of HPV from cervical swabs taken from women with biopsy-proven neoplastic lesions of the cervix. We divided the patients into four groups: HPV-negative, HPV-16-related, HPV-18-related, and intermediate risk type–related. Associations with clinicopathologic data (stage, histologic type, lymph node status, parametrial invasion, lymphvascular space invasion, tumor size, vaginal involvement) and overall survival were assessed. HPV DNA was detected in 81.4% of the patients, and 19.0% harbored multiple HPV variants. HPV-16-related was the predominant type and was detected in 47.4% (46/97) of the patients. The HPV-16-related types were detected more frequently in patients with squamous cell carcinomas, whereas the HPV-18-related types were more prevalent in cases of adenocarcinomas and adenosquamous carcinomas (P< 0.05). Otherwise, no significant correlations were detected between the HPV genotype and any other clinicopathologic parameters. After a median follow-up of 30 months, the 5-year survival rate was lower in the HPV-18-related patients, but this difference was not found to be statistically significant, according to the results of the log-rank test. We conclude that neither the presence nor type of HPV DNA bears any prognostic significance in cases of cervical carcinoma.

scholarly journals Genotypes distribution of human papillomavirus in cervical samples of Ecuadorian women

2016 ◽  
Vol 19 (1) ◽  
pp. 160-166 ◽  
Author(s):  
Gustavo David García Muentes ◽  
Lindsay Karen García Rodríguez ◽  
Ramiro Israel Burgos Galarraga ◽  
Franklin Almeida Carpio ◽  
Juan Carlos Ruiz Cabezas
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Gynecological Cancer ◽  
Hpv Infection ◽  
Multiple Infections ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Hpv 18

ABSTRACT: Introduction: Human papillomavirus (HPV) is considered a necessary causative agent for developing oropharyngeal, anal and cervical cancer. Among women in Ecuadorian population, cervical cancer ranks as the second most common gynecological cancer. Not many studies about HPV burden have been published in Ecuador, and genotypes distribution has not been established yet. The little data available suggest the presence of other genotypes different than 16 and 18. Objectives: In the present study, we attempt to estimate the prevalence of HPV 16, HPV 18 and other 35 genotypes among Ecuadorian women undergoing cervical cancer screening. The overall prevalence of HPV infection was also estimated. Methods: Routine cervical samples were analyzed using Linear Array(r) HPV Genotyping test (Roche). Results: A total of 1,581 cervical samples obtained from Ecuadorian women undergoing cervical cancer screening were included in this study. HPV DNA was detected in 689 cervical samples (43.58%). Of these samples, 604 (38.20%) were positive for a single HPV genotype, while another 85 (5.37%) samples were positive for multiple HPV types. Genotype 16 (5.50%) resulted in the most frequently detected type in both single and multiple infections. HPV 33 (4.55%) and HPV 11 (3.80%) occupied the second and the third place in frequency among all detected genotypes. Conclusions: Viral genotypes different from HPV 16 and HPV 18 are frequently detected among Ecuadorian women. The overall prevalence of HPV resulted higher than the one reported in other South American countries with a greater burden in the second and third decades of life.

Human papillomavirus genotyping by a polymerase chain reaction-based genechip method in cervical carcinoma treated with neoadjuvant chemotherapy plus radical surgery

2004 ◽  
Vol 14 (4) ◽  
pp. 639-649 ◽  
Author(s):  
H. J. Huang ◽  
S. L. Huang ◽  
C. Y. Lin ◽  
R. W. Lin ◽  
F. Y. Chao ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Human Papillomavirus ◽  
Cervical Carcinoma ◽  
Radical Surgery ◽  
Chain Reaction ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Hpv Genotyping ◽  
Polymerase Chain ◽  
Hpv 18

The aim of this study was to evaluate the accuracy of human papillomavirus (HPV) genotyping by a polymerase chain reaction (PCR)-based genechip method and to determine the prognostic value of HPV genotype in bulky stage IB or IIA cervical carcinoma treated with neoadjuvant chemotherapy (NAC) and radical surgery. A total of 149 patients had adequate tissue for the study. The SPF1/GP6+ primers were used to amplify a 184 bp fragment. The amplimers were submitted for direct sequencing and hybridization with a genechip using revert-blot detection of 39 types of HPV DNA in a single reaction. Two runs of PCR with respective hybridization were performed for each tumor. The complete concordance of HPV genotyping was 80.5% (120/149) of the paired genechip results. The kappa coefficient was 0.634 (P < 0.0001). HPV DNA sequences were detected in 100% of the specimens, among which 67.8% harbored single type and 32.2% contained multiple types. HPV-16 was detected in 98.7%, HPV-18 in 22.8%, HPV-31 in 0.7%, HPV-45 in 1.3%, HPV-52 in 2.0%, HPV-58 in 6.7%, HPV-59 in 4.7%, and HPV-67 in 0.7%. In multivariate analyses, the HPV genotype [HPV-18 or HPV-16 and HPV-18 only versus all others: relative risk (RR), 2.33; 95% CI, 1.17–4.64; P = 0.016] and pre-NAC tumor size (>5 versus ≤5 cm: RR, 2.25; 95% CI, 1.13–4.48; P = 0.021) were significantly related to overall survival. This PCR-based genechip method is sensitive and reproducible for HPV genotyping. The association of HPV-18 or HPV-16 and HPV-18 with poor outcome in cervical carcinoma treated with NAC plus radical surgery is confirmed.

scholarly journals Molecular Detection of Oncogenic Human Papillomavirus (HPV) Genotypes in Vulva Cancers, Penile Cancers and Anal Cancers in Myanmar

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 1s-1s
Author(s):  
Mu Mu Shwe ◽  
Hlaing Myat Thu ◽  
Khin Shwe Mar
Keyword(s):  
Human Papillomavirus ◽  
Conflicts Of Interest ◽  
Consensus Sequence ◽  
Restriction Enzymes ◽  
Cross Sectional ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Hpv Genotypes ◽  
Hpv 18 ◽  
Oncogenic Hpv

Abstract 12 A causal role for human papillomavirus (HPV) associated cancers of vulva, penile, and anus is supported by evidence from molecular and epidemiologic investigations. This study detected the oncogenic HPV genotypes in vulva cancers, penile cancers and anal cancers by a cross-sectional descriptive study in 2013. A total of 100 paraffin embedded biopsy tissues of histologically confirmed vulva cancers, penile cancers and anal cancers within past five years during 2008 and 2012 were studied. Those cases were 61 vulva cancers from Central Women Hospital, Yangon and 30 penile cancers and 9 anal cancers from Yangon General Hospital. HPV-DNA testing and genotyping were performed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Consensus sequence primer pairs within the E6 andE7 open reading were used to amplify oncogenic HPV genotypes (HPV-16,-18,-31,-33,-35,-52b,-58). Restriction enzymes were used for determination of specific HPV genotypes. HPV was identified in 36.1% of vulva cancers (22/61), 26.7% of penile cancers (8/30) and 44.4% of anal cancers (4/9). In vulva cancers, HPV-33 was the most common genotype (40.9%) followed by HPV-16 (31.8%), HPV-31 (22.7%), and HPV-18 (4.6%). In penile cancers, HPV-16 (62.5%) was the most common genotype followed by HPV-33 (25%) and HPV-18 (12.5%). Among anal cancers, the most frequent genotypes were HPV-16 (75%) and HPV-18 (25%). This study is the first report of evidence based oncogenic HPV genotypes in vulva cancers, penile cancers and anal cancers in Myanmar. This research provides the valuable information in understanding the burden of HPV associated cancers of the vulva, penile, and anus in Myanmar and the consideration of the effectiveness of prophylactic HPV vaccination in not only cervical cancer but also non-cervical cancers. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

scholarly journals Detection of High-Risk Human Papillomavirus in Cervix Sample in an 11.3-year Follow-Up after Vaccination against HPV 16/18

2017 ◽  
Vol 39 (08) ◽  
pp. 408-414
Author(s):  
Cirbia Teixeira ◽  
Julio Teixeira ◽  
Eliane Oliveira ◽  
Helymar Machado ◽  
Luiz Zeferino
Keyword(s):  
Placebo Group ◽  
Human Papillomavirus ◽  
High Risk ◽  
Persistent Infection ◽  
Hpv Vaccine ◽  
Vaccine Group ◽  
Rank Test ◽  
Hpv 16 ◽  
Post Vaccination ◽  
Hpv Dna

Purpose the aim of this study was to evaluate the pattern of human papillomavirus (HPV) detection in an 11.3-year post-vaccination period in a cohort of adolescent and young women vaccinated or not against HPV 16/18. Methods a subset of 91 women from a single center participating in a randomized clinical trial (2001–2010, NCT00689741/00120848/00518336) with HPV 16/18 AS04-adjuvanted vaccine was evaluated. All women received three doses of the HPV vaccine (n = 48) or a placebo (n = 43), and cervical samples were collected at 6-month intervals. Only in this center, one additional evaluation was performed in 2012. Up to 1,492 cervical samples were tested for HPV-DNA and genotyped with polymerase chain reaction (PCR). The vaccine group characteristics were compared by Chi-square or Fisher exact or Mann-Whitney test. The high-risk (HR)-HPV 6-month-persistent infection rate was calculated. The cumulative infection by HPV group was evaluated by the Kaplan-Meier method and the log-rank test. Results the cumulative infection with any type of HPV in an 11.3-year period was 67% in the HPV vaccine group and 72% in the placebo group (p = 0.408). The longitudinal analysis showed an increase of 4% per year at risk for detection of HR-HPV (non-HPV 16/18) over time (p = 0.015), unrelated to vaccination. The cumulative infection with HPV 16/18 was 4% for the HPV vaccine group and 29% for the placebo group (p = 0.003). There were 43 episodes of HR-HPV 6-month persistent infection, unrelated to vaccination. Conclusions this study showed the maintenance of viral detection rate accumulating HR-HPV (non-HPV-16–18) positive tests during a long period post-vaccination, regardless of prior vaccination. This signalizes that the high number of HPV-positive tests may be maintained after vaccination.

scholarly journals Ανίχνευση του ιού Human Papillomavirus (HPV) στον καρκίνο του πνεύμονα

2014 ◽  
Author(s):  
Εμμανουέλα Σαρχιανάκη
Keyword(s):  
Human Papillomavirus ◽  
Human Papilloma Virus ◽  
Real Time ◽  
Real Time Pcr ◽  
Hpv 16 ◽  
Papilloma Virus ◽  
Hpv Dna ◽  
Hpv 18

Παρά το ότι ο ρόλος του ιού των ανθρωπίνων θηλωμάτων ( Human Papilloma virus, HPV) στην εμφάνιση του καρκίνου του τραχήλου της μήτρας είναι καλά τεκμηριωμένος, ο ρόλος του HPV στην καρκινογένεση του πνεύμονα παραμένει αμφιλεγόμενος. Η συχνότητα ανίχνευσης του HPV DNA υπόκεινται σε ευρεία διακύμανση, από 0 έως 100 %. Αυτό εν μέρει οφείλεται στην τεχνική ανίχνευσης που χρησιμοποιήθηκε. Για να διευκρινίσουμε την επίδραση της HPV λοίμωξης στο πνευμονικό παρέγχυμα, αναλύσαμε 100 δείγματα από μη-μικροκυτταρικό καρκίνο πνεύμονα (39 πλακώδη καρκινώματα, 50 αδενοκαρκινώματα, 5 αδενοπλακώδη, 5 αδιαφοροποίητα και 1 μεγαλοκυτταρικό) από την περιοχή της Κρήτης στην Ελλάδα. Ως αρνητικός μάρτυρας χρησιμοποιήθηκαν 16 δείγματα υγειούς πνευμονικού ιστού. Έγινε εκχύλιση DNA από 100 τομές μονιμοποιημένες σε παραφίνη που πάρθηκαν από ασθενείς με μη-μικροκυτταρικό καρκίνο του πνεύμονα. Τα δείγματα εξετάσθηκαν για την παρουσία του HPV DNA με την τεχνική της Real Time PCR χρησιμοποιώντας τους γενικούς εκκινητές GP5+/GP6+. Επιπλέον, τα HPV θετικά δείγματα υπεβλήθησαν σε γονοτυπική ανάλυση. Σε αντιδιαστολή με την απουσία του ιϊκού γονιδιώματος στα δείγματα ελέγχου, HPV DNA ανιχνεύθηκε σε 19 από τα 100 εξετασθέντα δείγματα (19%). Συγκεκριμένα, 4 πλακώδη καρκινώματα, 12 αδενοκαρκινώματα, 1 αδενοπλακώδες και 2 αδιαφοροποίητα ήταν HPV θετικά. Η κατανομή των γονοτύπων του HPV ήταν η ακόλουθη : HPV 16 : 8 περιστατικά (42,1 %) , HPV 11 : 3 περιστατικά (15,8 %) , HPV 6 : 1 περιστατικό (5,2 %) , HPV 33 : 2 περιστατικά (10,5 %) , HPV 31 : 2 περιστατικά (10,5 %) και HPV 18 : 2 περιστατικά (10,5 %) . Η παρουσία του HPV στα δείγματα από καρκίνο παρέχει στοιχεία για τον πιθανό ρόλο του στο μη-μικροκυτταρικό καρκίνο του πνεύμονα και υποδεικνύει την ανάγκη για περαιτέρω έρευνα στο συγκεκριμένο πεδίο.

Role of Human Papillomavirus Genotype in Prognosis of Early-Stage Cervical Cancer Undergoing Primary Surgery

2007 ◽  
Vol 25 (24) ◽  
pp. 3628-3634 ◽  
Author(s):  
Chyong-Huey Lai ◽  
Chee-Jen Chang ◽  
Huei-Jean Huang ◽  
Swei Hsueh ◽  
Angel Chao ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Carcinoma ◽  
Dna Sequences ◽  
Early Stage ◽  
Prognostic Significance ◽  
Figo Stage ◽  
Stromal Invasion ◽  
Hpv Dna ◽  
Primary Surgery ◽  
Hpv 18

Purpose Our aim was to evaluate the prognostic significance of human papillomavirus (HPV) genotype in early-stage cervical carcinoma primarily treated with surgery in a large tertiary referral medical center. Patients and Methods Consecutive patients who underwent primary surgery for invasive cervical carcinoma of International Federation of Gynecology and Obstetrics (FIGO) stage I to IIA between 1993 and 2000 were retrospectively reviewed. Polymerase chain reaction (PCR) using a general primer set followed by reverse-blot detection of 38 types of HPV DNA in a single reaction was performed for genotyping. E6 type-specific PCR was performed to validate multiple types. Results A total of 1,067 eligible patients were analyzed. HPV DNA sequences were detected in 95.1% of the specimens, among which 9.6% contained multiple types. HPV 16 was detected in 63.8% of the samples, and HPV 18 was detected in 16.5% of the samples. The median follow-up time of surviving patients was 77 months. By multivariate analysis, FIGO stage, lymph node metastasis, depth of cervical stromal invasion, grade of differentiation, and HPV 18 positivity were significantly related to cancer relapse. FIGO stage II, deep stromal invasion, parametrial extension, HPV 18 positivity, and age older than 45 years were significant predictors for death. Using the seven selected variables from either recurrence-free or overall survival analysis, death-predicting (P < .0001) and relapse-predicting (P < .0001) models classifying three risk groups (low, intermediate, and high risk) were constructed and endorsed by internal validation. Conclusion The independent prognostic value of HPV genotype is confirmed in this study. The prognostic models could be useful in counseling patients and stratifying patients in future clinical trials.

scholarly journals Molecular detection of oncogenic subtypes of human papillomavirus (HPV) in a group of women in the Amazon region of Brazil

2020 ◽  
Vol 42 ◽  
pp. e50005
Author(s):  
Alessandra Silva e Silva ◽  
Cláudia Giuliano Bica ◽  
Aniúsca Vieira ◽  
Cleiton Fantin
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Genetic Material ◽  
Hpv Infection ◽  
Cervical Cancer Prevention ◽  
Eligibility Criteria ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Human Papillomavirus 16 ◽  
Hpv 18

The natural history of cervical cancer is strongly related to the presence of human papillomavirus (HPV) infection, with its relationship with cervical cancer being a matter of concern. It is estimated that 70% of all cervical cancers worldwide are caused by HPV 16 and 18. Accordingly, the present study aimed to contribute to the identification of HPV subtypes circulating in a group of women of Manaus-Brazil.  Cervical samples were collected from 49 women, following the eligibility criteria of the study, and DNA was then extracted from the samples, which were analyzed for the presence of the virus in the genetic material through the polymerase chain reaction (PCR) using generic primers (GP05/06). Finally, identification of the viral subtypes was performed using specific primers for the detection of the main subtypes already examined (16 and 18). Positive HPV DNA was detected in 100% of the samples included in the study. Human papillomavirus 16 was the most prevalent subtype in the majority of lesions, accounting for 29 (59.2%) of the positive cases, and HPV 18 was detected in four (8.2%) women. In these 4 cases there was co-infection, with the presence of both HPV 18 and HPV 16. Therefore, 40.8% (20 cases) in which HPV DNA was detected presented infection with other subtypes of HPV not included in the study. This data has clinical implications related to cervical cancer prevention, as the current prophylactic HPV vaccines are only effective against high-risk HPV 16 and 18 subtypes.

scholarly journals Detection of Immunoglobulin G against E7 of Human Papillomavirus in Non-Small-Cell Lung Cancer

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Raul Storey ◽  
Joongho Joh ◽  
Amy Kwon ◽  
A. Bennett Jenson ◽  
Shin-je Ghim ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Small Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Small Cell Lung ◽  
Hpv 16 ◽  
Lung Cancers ◽  
Hpv Dna ◽  
The One ◽  
Nsclc Patients ◽  
Hpv 18

Background. A significant number of non-small-cell lung cancers (NSCLC) have human papillomavirus (HPV) DNA integrated in their genome. This study sought to further establish HPV’s possible etiologic link to NSCLC by evaluating an immune response to HPV’s oncogene, E7, in patients with NSCLC.Patients and Methods. Antibodies (IgG) in serum against E7 for HPV 16 and 18 in 100 patients with NSCLC were examined by enzyme-linked immunosorbent assay (ELISA).Results. Sixteen NSCLC patients were found to have a high titration of IgG for HPV oncogenic E7 protein. 23.5% of adenocarcinomas (AC,) and 15.4% of squamous cell carcinomas (SCC) were positive for IgG against HPV E7. HPV-18 (11%) had a slightly higher frequency than HPV-16 (6%). Of the six positive cases for HPV-16, 3 were AC, 2 SCC, and 1 NOS (not otherwise specified). For the 11 HPV-18 positives, 7 were AC, and 4 SCC. The one case with IgG against HPV 16 and 18 was AC. One case had high cross-reactive levels against E7 of HPV 16 and 18. Two (28%) of 7 patients who reported never smoking were positive for HPV, and 12 (13.6%) of 88 smokers were HPV positive.Conclusions. The study detected high levels of IgG against E7 in 16% of NSCLC patients. This adds evidence to a potential role of HPV in the pathogenesis of NSCLC.

scholarly journals High-Risk Human Papillomavirus (HR-HPV) Genotypes Among Women With Cervical Precancer and Cancer in Myanmar

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 18s-19s
Author(s):  
Mu Mu Shwe ◽  
Kyi Kyi Nyunt ◽  
Khin Saw Aye ◽  
Hlaing Myat Thu ◽  
Hla Myat Mo Mo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Conflicts Of Interest ◽  
Hpv Vaccination ◽  
Vaccination Program ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Incidence And Mortality ◽  
Hpv Genotypes ◽  
Hpv 18

Abstract 11 In Myanmar, cervical cancer ranks as the first most frequent cancer among women aged between 15 to 44 years and Human Papillomavirus (HPV) vaccination program is not established yet. Information on HPV genotypes distribution in cervical cancer is crucial to predict the future impact of HPV vaccines. This study aimed to determine the HPV-DNA and genotypes among women with cervical pre-cancer and cancer in Myanmar. A cross-sectional descriptive study was performed in 169 women with cervical neoplasia during 2012 to 2014. After obtaining informed consent, cervical cells were collected from 134 women with cervical intraepithelial neoplasia (CIN) and 35 with squamous cell carcinoma (SCC) of the cervix attending Sanpya General Hospital, Yangon, and Central Women Hospital, Mandalay. HPV-DNA testing and genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). HR-HPV was identified in CINI (39.3%), CINII (58.6%), CINIII (66.7%), and SCC (77.1%). Overall, the most common genotypes were HPV-16 (68.1%), followed by HPV-31 (16.5%), HPV-18 (7.7%), HPV-58 (6.6%), and HPV-35 (1.1%). Among SCC, HPV-16 was the most common genotype (66.7%) followed by HPV-18 (14.8%), HPV-31 (11.1%), HPV-35 (3.7%), and HPV-58 (3.7%). In CINI, the most common genotype were HPV-16 (69.7%) followed by HPV-31 (21.2%), HPV-18 (6.1%) and HPV-58 (3.0%). In CINII, HPV-16 was most commonly determined (52.9%) followed by HPV-31 (23.5%), HPV-58 (17.6%), and HPV-18 (5.9%). In CINIII, HPV-16 was also the most common genotype (85.7%) followed by HPV-31 (7.1%) and HPV-58 (7.1%). Vaccine preventable genotype, HPV-16 was the most common genotype in Myanmar. This study highlighted that the establishment of National HPV vaccination program is needed to reduce the incidence and mortality of cervical cancer in Myanmar.[Table: see text][Table: see text] AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

Human papillomavirus prevalence in postradiotherapy uterine cervical carcinoma patients: correlation with recurrence of the disease

2006 ◽  
Vol 16 (3) ◽  
pp. 1048-1054 ◽  
Author(s):  
R. K. Singh ◽  
S. Maulik ◽  
S. Mitra ◽  
R. K. Mondal ◽  
P. S. Basu ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Viral Load ◽  
Predictive Value ◽  
High Viral Load ◽  
Hpv 16 ◽  
Hpv Dna ◽  
Hpv Prevalence ◽  
Exfoliated Cells ◽  
Increased Risk ◽  
Hpv 18

To understand the role of human papillomavirus (HPV) in recurrence of uterine cervical cancer (CA-CX) after radiotherapy, we have analyzed the HPV prevalence in the exfoliated cells of 56 patients and their corresponding plasma. HPV DNA was detected in exfoliated cells of 78% (44/56) patients (HPV-16, 68%; HPV-18, 14%; HPV-X [other than 16, 18], 11%; and mixed infection of HPV-16 and HPV-18 in three cases). HPV DNA in plasma was present in only 25% (11/44) of the HPV-positive exfoliated cells (positive predictive value, 100%; negative predictive value, 27%) with concordance in HPV types. The recurrence of the disease was significantly associated with the presence of HPV in the exfoliated cell (P = 0.01) and plasma (P = 0.007) as well as high viral load in the exfoliated cell (P = 0.0002). Kaplan–Meier disease-free estimates have also shown the significant association between HPV prevalence in plasma and recurrence of the disease (P = 0.045). Thus, it indicates that in postradiotherapy CA-CX patients, the high viral load in the exfoliated cell as well as HPV presence in the plasma samples could be used in early detection of the patients at increased risk for disease recurrence and progression.

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