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Clinicopathological characteristics and survival outcomes in human papillomavirus independent cervical cancer: a propensity score matched analysis
  1. Danqing Li1,2,
  2. Shan Huang3,
  3. Ke Liu2,
  4. Yuankun Qin4,
  5. Ya Zhang2 and
  6. Yingjie Yang2,4
  1. 1 Department of Obstetrics and Gynecology, Soochow University Medical College, Suzhou, Jiangsu, China
  2. 2 Department of Surgical Gynecological Tumor, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, China
  3. 3 Department of Obstetrics and Gynecology, Guiqian International General Hospital, Guiyang, Guizhou, China
  4. 4 Department of Obstetrics and Gynecology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
  1. Correspondence to Dr Yingjie Yang, Department of Surgical Gynecological Tumor, The Affiliated Cancer Hospital of Guizhou Medical University, Guiyang 550000, China; yangyj166{at}aliyun.com

Abstract

Objective To investigate the clinicopathological characteristics and overall survival in high-risk human papillomavirus (HPV)-independent and HPV-associated cervical cancer.

Methods Patients with cervical cancer hospitalized between September 2015 and December 2019 from the Affiliated Cancer Hospital of Guizhou Medical University were enrolled. First, patients with negative results by HPV primary screening were excluded. Second, the paraffin-embedded tumor tissues from patients with negative results were used for extraction of deoxyribonucleic acid (DNA). The Hybribio K-37 test (PCR and flow-through hybridization for 37 types of HPV) was used to further identify HPV-negative infection status. Finally, 1:4 propensity score matching between high-risk HPV-independent and HPV-associated groups was performed, and the clinicopathological characteristics and overall survival were compared between the two groups.

Results Forty cervical HPV primary screening negative patients were screened of 729 patients (5.5%). Among them, 13 (1.8%) patients who were identified with high-risk HPV-independent cervical cancer after the K-37 test were selected as the study group. There were significant intergroup differences in the distribution of International Federation of Gynecology and Obstetrics (FIGO, 2018) stage (χ2=5.825, p=0.016), pathological types (χ2=6.910, p=0.009), lymph node metastasis (χ2=6.168, p=0.013), and tumor size (χ2=5.319, p=0.021). After propensity score matching, 52 patients from the HPV-associated group were selected as the control group. Patients with high-risk HPV-independent cervical cancer had poorer prognosis than those with HPV-associated cervical cancer (median overall survival: 27 vs 29 months, p=0.03; median disease-free survival: 27 vs 29 months, p=0.021).

Conclusion Patients with high-risk HPV-independent cervical cancer more frequently had advanced stage disease, nodal metastasis, larger tumor, and a higher proportion of adenocarcinoma. The prognosis of patients with high-risk HPV-independent cervical cancer was poorer than those with HPV-associated cervical cancer.

  • uterine cervical neoplasms

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors Study design and responsible for the overall content as guarantor: YY. Manuscript writing: DL. Data collection: SH. Statistical calculations: KL. Molecular biology experiment: YQ. Manuscript editing and reviewing: YZ.

  • Funding This work was funded by the Scientific and Technological Activities Project of the Affiliated Cancer Hospital of Guizhou Medical University (grant number YJ2019034).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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