| Autor: |
da Mata S; Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal.; Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal., Ferreira J; Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal.; Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal., Nicolás I; Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain., Esteves S; Clinical Investigation Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal., Esteves G; Department of Pathology, Centro Hospitalar e Universitário de Lisboa Central, 1150-199 Lisboa, Portugal., Lérias S; Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal., Silva F; Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal., Saco A; Department of Pathology, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain., Cochicho D; Department of Virology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal., Cunha M; Department of Virology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal., Del Pino M; Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain., Ordi J; Department of Pathology, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain.; Institut de Salut Global de Barcelona (ISGlobal), 08036 Barcelona, Spain., Félix A; Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, 1099-023 Lisbon, Portugal.; Nova Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal. |
| Abstrakt: |
The expression of p16 is a good surrogate of human papillomavirus (HPV) infection in HPV-associated cancers. The significance of p16 expression, HPV genotype and genera in the outcome of patients with HPV-associated cervical cancer (CC) is unclear. Our aim is to ascertain the prognostic significance of these factors. Data from 348 patients (median age: 47.5 years old) with CC, diagnosed in two referral centers, were retrospectively collected. Advanced disease (FIGO2018 IB2-IV) was present in 68% of patients. A single HPV genotype was identified in 82.8% of patients. The most common HPVs were HPV16 (69%) and HPV18 (14%). HPV genera reflected this distribution. HPV16 tumors presented at an earlier stage. P16 was negative in 18 cases (5.2%), 83.3% of which were squamous cell carcinomas. These cases occurred in older patients who tended to have advanced disease. In the univariate analysis, HPV16 (HR: 0.58; p = 0.0198), α-9 genera (HR: 0.37; p = 0.0106) and p16 overexpression (HR: 0.54; p = 0.032) were associated with better survival. HPV16 (HR: 0.63; p = 0.0174) and α-9 genera (HR: 0.57; p = 0.0286) were associated with less relapse. In the multivariate analysis, only the International Federation of Gynecology and Obstetrics (FIGO) stage retained an independent prognostic value. HPV16, α-9 genera and p16 overexpression were associated with better survival, although not as independent prognostic factors. Patients with p16-negative HPV-associated CC were older, presented with advanced disease and had worse prognosis. |
