Findings of multiple HPV genotypes in cervical carcinoma are associated with poor cancer-specific survival in a Swedish cohort of cervical cancer primarily treated with radiotherapy
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Malin Kaliff1, Bengt Sorbe2, Louise Bohr Mordhorst2, Gisela Helenius1, Mats G. Karlsson1 and Gabriella Lillsunde-Larsson1
1Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro SE 701 82, Sweden
2Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro SE 701 82, Sweden
Malin Kaliff, email: [email protected]
Keywords: cervical cancer; HPV; recurrences; survival
Received: December 04, 2017 Accepted: February 27, 2018 Published: April 10, 2018
Cervical cancer (CC) is one of the most common cancers in women and virtually all cases of CC are a result of a persistent infection of human papillomavirus (HPV). For disease detected in early stages there is curing treatment but when diagnosed late with recurring disease and metastasis there are limited possibilities. Here we evaluate HPV impact on treatment resistance and metastatic disease progression.
Prevalence and distribution of HPV genotypes and HPV16 variants in a Swedish CC patient cohort (n=209) was evaluated, as well as HPV influence on patient prognosis. Tumor samples suitable for analysis (n=204) were genotyped using two different real-time PCR methods. HPV16 variant analysis was made using pyrosequencing.
Results showed that HPV prevalence in the total series was 93%. Of the HPV-positive samples, 13% contained multiple infections, typically with two high-risk HPV together. Primary cure rate for the complete series was 95%. Recurrence rate of the complete series was 28% and distant recurrences were most frequent (20%). Patients with tumors containing multiple HPV-strains and particularly HPV genotypes belonging to the alpha 7 and 9 species together had a significantly higher rate of distant tumor recurrences and worse cancer-specific survival rate.
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