Human papillomavirus(HPV) has been implicated in the development of uterine cervical cancer. Detection of the small amounts of HPV DNA in cervical cells has been very difficult.
The polymerase chain reaction(PCR) is a new technique that can specifically amplify target DNA to facilitate its detection. PCR technique was used to detect HPV types 16 and 18 in cervical specimens obtained from normal cervix(20 cases),
dysplasia(25
cases), carcinoma in situ(21 cases), microinvasive cancer(11 cases), and invasive cancer(46 cases).
And then, cases of invasive carcinoma of the uterine cervix were analyzed to determine that the presence of specific human papillomavirus DNA in the neoplasm was a contributing factor to their outcome.
The detection rate of HPV 16 DNA in normal cervix, dysplasia, CIS, microinvasive cancer, and invasive squamous cell carcinoma were 50.0%, 36.0%, 31.0%, 45.5%, and 58.7%, respectively.
The detection rate of HPV 18 DNA in normal cervix, dysplasia, CIS, microinvasive cancer, and invasive squamous cell carcinoma were 8.0%, 4.8%, 0.0%, and 19.6%, respectively.
Of the factors evaluated in invasive cervical cancer, adenocarcinomatous component(p=0.004) and tumor grade(p=0.015) were found to be correlated with HPV 18 infection. 5 of 8 women whose tumors contained glandular elements had HPV 18 DNA, whereas
only 4
of 38 women whose tumors contained only squamous elements showed this infection. 6 of 9 women of HPV 18 infected tumors were grade 3 tumors as compared to only 7 of 28 of HPV 16 infected tumors.
Age at diagnosis and nodal status in relation to HPV type 18 exhibited a trend but were not statistically Significant.
These observations suggest that HPV type 18 may be associated with a more aggressive form of cervical cancer than HPV type 16.
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