Detection of human papillomavirus DNA in primary and metastatic lesions of carcinoma of the cervix in women from Okinawa, Japan.

Of 351 patients with invasive cervical cancer treated at Ryukyu University Hospital, Okinawa, 293 who were tested for human papilloma virus (HPV) DNA of the primary cervical lesion before the initiation of treatment were considered for the study. The polymerase chain reaction (PCR) was performed using fresh specimens, immediately after sampling. In 250 of 293 patients (85.3%), HPV DNA was detected in cervical tumor by PCR using L1 consensus primer. The positive rate by histology was 89.9% in squamous cell carcinoma, 93.8% in adenosquamous carcinoma, and 51.4% in adenocarcinoma. The former two figures were significantly higher than the latter (p < 0.001 and p = 0.002). Concerning identification of HPV types, HPV 16 was most predominant in squamous cell carcinoma, whereas type 18 was relatively high in adenocarcinoma. However, the type distribution of HPV was different to some extent from those in other countries. During treatment, 489 nodal and other tissue samples were obtained from 113 of 250 HPV DNA-positive patients, and were submitted to an assay of HPV DNA. HPV DNA was amplified in all 55 metastatic samples and also in 12 of 434 nonmetastatic tissues (2.8%). HPV types specified in these samples were always identical with the HPV types determined in their primary tumors. In 154 samples from 29 of 43 HPV DNA-negative patients, HPV DNA was not detected, either in 14 metastatic samples or in 140 histologically benign samples. Cancer-free, but HPV DNA-positive nodal, liver, and pulmonary tissues could be interpreted to be already involved at the time of examination, by observing the clinical course of the disease over time.