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High-Risk Human Papillomavirus DNA in the Primary Tumor, Sentinel, and Nonsentinel Pelvic Lymph Nodes in Patients With Early-Stage Cervical Cancer: A Correlation With Histopathology
  1. Jiri Slama, MD*,,
  2. Marcela Drazdakova, MS*,,
  3. Pavel Dundr, MD*,§,
  4. Daniela Fischerova, MD, PhD*,,
  5. Michal Zikan, MD, PhD*,,
  6. Ivana Pinkavova, MD*,,
  7. Pavel Freitag, MD, PhD*,,
  8. David Pavlista, MD, PhD*,,
  9. Tomas Zima, MD, PhD*, and
  10. David Cibula, MD, PhD*,
  1. *General Teaching Hospital;
  2. Department of Oncogynecology;
  3. Institute of Clinical Biochemistry and Laboratory Diagnostics; and
  4. §Department of Pathology, 1st Medical School of Charles University, Prague 2, Czech Republic.
  1. Address correspondence and reprint requests to Jiri Slama, MD, Department of Oncogynecology, Apolinarska 18, General Teaching Hospital and 1st Medical School of Charles University, Prague 2, 128 51, Czech Republic. E-mail: slamajiri{at}


Introduction: Metastatic involvement of pelvic lymph nodes is the most important prognostic parameter in early-stage cervical cancer. Still, approximately 15% of patients with negative pelvic nodes experience recurrence, most of them in the pelvis. The presence of human papillomavirus (HPV) DNA in histologically negative pelvic nodes is considered a subclinical metastatic spread.

Methods: Patients with early-stage cervical cancer referred for surgical treatment were enrolled in the study. Cytobrush technique was used for sample collection from the fresh tissue to avoid any loss of material for histology.

Results: Altogether, 49 patients were enrolled in the study. High-risk (HR) HPV DNA was identified in the tumor in 91.8% patients and in the sentinel node or other pelvic nodes in 49.9% patients. Among the 10 HR HPV genotypes detected, HPV 16 was the most frequently represented in both the tumor and the lymph nodes (66.7% and 71.4%, respectively). All metastatic lymph nodes were HR HPV positive.

Conclusions: The presence of HR HPV DNA in a sentinel node had a 100% positive predictive value for metastatic involvement of pelvic lymph nodes in our study. This could be considered a sign of an early subclinical metastatic spread; however, the prognostic value has to be evaluated through a longer follow-up.

  • Cervical cancer
  • HPV
  • Lymph node
  • Sentinel lymph node
  • Recurrence

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  • This study was supported by the IGA MZ Czech Republic grant NS/10037-3.