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HPV-DNA, vascular space invasion, and their impact on the clinical outcome in early-stage cervical carcinomas
  1. M. Graflund*,
  2. B. Sorbe*,
  3. S. Sigurdardóttir and
  4. M. Karlsson
  1. * Department of Gynecological Oncology, Örebro University Hospital, Örebro, Sweden
  2. Department of Pathology, Örebro University Hospital, Örebro, Sweden
  1. Address correspondence and reprint requests to: M. Graflund, MD, PhD, Department of Gynecological Oncology, Örebro University Hospital, SE-701 85 Örebro, Sweden. Email: marianne.graflund{at}


The present study was designed to analyze the relationship of human papillomavirus (HPV)-DNA, microvessel density, and their impact on clinical outcome in early cervical carcinoma. HPV-DNA was evaluated in 171 cases of cervical carcinoma treated from 1965 to 1990. In 110 cases, the analyses could be performed. A polymerase chain reaction technique was used on paraffin-embedded specimens obtained before the start of therapy. HPV-DNA of any type was detected in 78% (86/110) of all evaluable tumors. HPV16 was the predominant type and was detected in 56% (62/110), HPV18 in 8% (9/110), and HPV35 in 21% (23/110). Patients with tumors containing HPV16 or HPV18 were significantly (P = 0.011) younger than patients with tumors not containing either of these two subtypes. Vascular space invasion and lymph node metastases were observed more frequently in tumors expressing HPV16 and HPV18 (P = 0.002, P = 0.047) than in tumors negative for these HPV strains. Tumors containing HPV16 and HPV18 were significantly (P = 0.012) larger and more frequently (P = 0.005) associated with higher FIGO stages. The cancer-specific survival rate was lower for patients with HPV16- and HPV18-positive tumors, but the difference was not statistically significant. The microvessel density was a non-significant prognostic factor. The overall 5-year survival rate of the complete series was 91%. It was concluded that HPV-DNA was a prognostic factor in early-stage cervical cancer and was associated with the age of the patient, vascular space invasion, lymph node metastases, tumor size, and FIGO stage.

  • cervical cancer
  • HPV
  • prognostic factors
  • vascular space invasion

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