A Study Of HPV DNA In Detecting Lymph Nodes Micrometastasis Of Cervical Cancer

Objective To explore the clinical significance of the detection of high risk human papillomavirus 16/18(HPV 16/18) DNA and cytokeratin(CK) and analyze the feasibility of HPV as a maker to detect pelvic lymph nodes micrometastasis of early-stage cervical cancer.And also to determine the association among viral load of HPV16 DNA in primary focus,HPV16 DNA in pelvic lymph nodes and the clinical and pathological features of cervical cancer.Methods①HPV16/18 DNA was detected by polymerase chain reaction(PCR) in 27 primary tumors and 477 local lymph nodes.②CK was detected by immunohistochemical analysis(IHC) in these lymph nodes.③Viral load of HPV16 DNA was measured by fluorescent quantitation PCR(FQ-PCR) in 19 primary focus.Results①Among 477 lymph nodes,the positive rates of HPV16/18 DNA and CK were 86.96%(20/23) and 100%(23/23) respectively in 23 metastasis lymph nodes.The positive rate of HPV16/18 DNA and CK were 6.63%(31/454) and 4.85%(22/454) respectively in 454 non-metastasis lymph nodes.②The positive rates of all lymph nodes detected by HPV16/18 and CK as makers were 10.69%(51/477) and 9.43%(45/477),respectively. There was no significant difference in detecting lymph nodes micrometastasis rate between HPV and CK.(P＞0.05).③The positive rate of HPV in lymph nodes correlated with patients'age,tumor diameter,tumor differentiation,histological type,depth of myometrial infiltration,whether cervical cancer has metastasis lymph nodes or not and different numbers of excision lymph nodes,respectively(P＜0.05).④Viral loads of HPV16 DNA(log^copies) in 9 primary focus which had HPV16 lymph nodes and 10 primary focus which didn't have ones were 5.53±1.25 and 5.52±0.26 respectively,and there was no significant difference between them(P＞0.05).Viral loads of HPV16DNA(log^copies) between tumor diameter＜4cm and≥4cm were 5.13±1.00 and 6.09±0.68 respectively and there was significant difference between them(P＜0.05).Conclusion HPV can be used as a maker to detecte micrometastasis.Detection of HPV DNA may help to find the early metastases that can't be histopathologically examined. Detection of HPV in lymph nodes can increase the micrometasiasis rate in cervical caner more accurately.Viral load of HPV16 DNA in primary focus might correlate with the quantity of carcinoma cells in primarily focus,but not with HPV DNA in pelvic lymph nodes.