Carcinoma of the uterine cervix is the most frequent neoplasm among women in Korea. A number of factors have been linked to the progression of this disease. Strong epidemiologic evidence suggests that the human papillomaviruses(HPV), especially
type 16
and 18, are the most likely candidate agents in the development of cervical cancer. And certain oncogenes have also been implicated in the progression of the disease. Some authours show that HPV DNA cooperates with activated ras in transforming
primary
cells. Although commonly categorized as belonging to either the low risk or high risk groups, the prognostic value of HPV types in cervical cancer has been studied only recently, and the results are controversial. The patients with H-ras gene
alteration
had been suggested to have poorer prognosis. Seventy women treated for an invasive squamous cell carcinoma of the uterine cervix and forty-two normal controls during the period from January, 1985 to December, 1985 were studied to investigate the
correlation between HPV positivity and ras gene expression in cervical cancer and to determine the prognostic value of HPV postivity and ras gene expression, analyzed using HPV amplification by polymerase chain reaction(PCR) and
immunohistochemistry,
respectively. The prevalence of HPV 16/or 18 in cervical cancer patients was 80.7(27/33)% while for the control group it was 18. 2(6/33)%(p<0.001). The detection rate of HPV 16 DNA was significantly higher in cervical cancer than in control
tissues(75.4% vs 12.1%; p<0.01), and there was no significant difference between the two groups in the detection rate of HPV 18 DNA(17.5% vs 9.1%; p<0.1). Our results did not reveal any statistically significant correlations between HPV
positivity
and
the age, stage, histologic types and lymph node metastases, but statistically significant correlations in tumor size and the invasion depth of cervical wall.
The ras gene expression was positive in 33.3% of cervical cancer while in only 3.0% of control tissues(p<0.001). The expression of ras gene was not significantly associated with age, clinical stage, tumor size, the invasion depth of cervical wall
and
the lymph node metastasis. The association between HPV positively and ras gene expression was not statistically significant.
The 5-year disease free survival(DFS) rates were not significantly different between the cancer patients with positive and negative HPV detection(38.5% vs 34.8%; p<0.1) and between with and without ras gene expression(33.3% vs 42.9%; >0.1).
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