HPV RNA analyses in sentinel and peripheral lymph nodes as potential diagnostic tool for metastatic cervical cancer

Introduction Cervical cancer is the fourth-most common type of cancer death in women worldwide. Thereby, human papillomavirus infection (HPV) is associated with more than 90% of cervical cancer cases. Consequently, HPV screening in lymph nodes may be supportive for early detection of metastatic spreading and subsequent therapeutic interventions.

Material and methods Tumor tissues samples and lymph node cytobrush smears were taken during cervical cancer surgery. Besides routine histopathological screening tissue aliquots were subjected to the Hologic Panther System for Aptima assay. This assay represents an in vitro nucleic acid amplification test for qualitative detection of E6/E7 viral messenger RNA (mRNA) from 14 high-risk HPV types in cervical specimens. In parallel, further aliquots of the lysed tissues were analyzed for HPV-specific DNA using the Abbott RealTime HighRisk HPV test system.

Results As potential prognostic marker for metastasized cervical carcinoma 510 tissue samples from 27 patients including primary tumor, adjacent normal tissue, and corresponding sentinel and peripheral lymph nodes were analyzed for HPV RNAs and DNAs. This molecular co-testing revealed an overall higher sensitivity as compared to the routine histological analysis. A direct comparison of the nucleic acid methods revealed 51 HPV RNA-positive tissues versus 22 DNA-positive tissues that, in addition, could discriminate appropriate HPV subtypes, particularly HPV-16, HPV-18, and other high-risk subtypes.

Summary The increased sensitivity of HPV RNA detection in lymph nodes may contribute to early identification of metastatic spreading and underscores the importance of further translational studies in the context of sentinel randomized controlled trials such as e.g. Senticol-3.

Publication History

Article published online:
11 October 2022