Human papilloma virus status in cervical cancer predictive and prognostic significance for chemo radiation treatment

Abstract

Aim: To find out the prevalence of HPV infection and genotypes in invasive cervical cancer patients.To know the predictive and prognostic significance of HPV infection to chemo radiation. Materials and Methods: This study was conducted in the department of radiation oncology in Patients attending to O.P.D during the period of one year are included in this study. A total of 145 women age of 30-70 years who were histopathologically proven for cervical cancer. All the patients were given radiotherapy. Results: For HPV detection exfoliated cells were taken by direct scrapings with cervix brush from the cervical tumour before treatment and preserved in preservCyt bottles. The DNP was extracted and was subjected to PCR by using established primers. HPV DNA was detected in 143 (98.6%) of the patients. Median age of the patients was 50 years. Most of the cases were in stage II disease (65.5%). Around 28 different HPV genotypes were found.HPV 16 is the most common genotype (77.6%).34.2% of patients were having multiple genotypes.HPV 33, 35, 52, and 58 were found as multiple genotypes and were not found in singles. Patients were followed up after chemo radiation. Mean follow up was 9.6 months and median follow up was 12 months. Only 82 patients remained for follow up at 12 months and the remaining patients did not turn up for follow up. At the end of 12 months, 57 (69.7%) patients were disease free, 11 (13.4 %) were with residual disease, and 14 (17.7%) were having recurrences. 20 patients were tested for HPV DNA post treatment; HPV DNA was cleared in 20% of patients, and was prevalent in 80% of patients in the study.20% of patients were having persistent HPV 16 genotype. All the patients with multiple genotypes prior treatment were found with single genotype post treatment.20% of patients were found to have different genotypes post treatment when compared to pretreatment.Conclusion: HPV 16 did not show any significance in disease response. 80% of patients had persistent HPV DNA post treatment.