to evaluate whether the detection of HPV DNA in postoperative lymphatic fluid might has a prognostic significance.

A total of 85 patients with cervical cancer (stage Ib-IIb), all underwent radical hysterectomy and pelvic lymphadenectomy at Pusan Paik hospital, between March 2002 and February 2004, were involved in this study. HPV subtyping was determined from preoperative cervical swab and postoperative lymphatic fluid through HPV DNA Chip(R) (Biomedlab Co., Seoul, Korea). Retrospectively, a clinical and pathological review was done from each patient's medical records. The relationship between HPV infection in lymphatic fluid and clinico-pathological parameters was analyzed.

HPV DNA in cervical cancer tissue was detected in 74 cases (87.1%). HPV 16 was the most common type (55.3%), followed by HPV 58 (9.4%) and HPV 18 (7.1%). HPV DNA in lymphatic fluids was detected in 5 cases (5.9%). The detected HPV subtype in lymphatic fluids was only HPV 16, and in these cases HPV 16 was also detected in cervical cancer tissue and in one case there was coinfection with HPV 59. In the presence of HPV in lymphatic fluids, the FIGO stage (p=0.0013) and resection margin positivity (p=0.0019) were significantly high. HPV-positive cases were found to have a 34.7-fold risk of advanced stage (95% CI=1.83-655.92) and a 38.5-fold risk of resection margin positivity (95% CI=4.58-323.57). SCC antigen and lymph node metastasis were also high but not statistically significant. The age at diagnosis, the age at marriage, the history of smoking, parity, the size of tumor, histopathological grade, and invasion depth were not associated with the presence of HPV in lymphatic fluids.

This study suggests that HPV in lymphatic fluid might be useful as a prognostic variable. Because the size of the study was small and the detection rate was also low, larger study was needed to confirm. The significance of HPV 16 in lymphatic fluid has to be defined in further study.