The Use of Polymerase Chain Reaction to Detect Metastatic Cancer Cells Within Lymph Nodes in Stage I Cervical Carcinoma

The aim of the study was to determine whether human papillomavirus (HPV) in lymph nodes is a useful marker for the risk of recurrence in patients with HPV-related cervical cancer. The polymerase chain reaction and DNA-DNA hybridization techniques were used to examine 149 formalin-fixed, paraffin-embedded lymph nodes that had been resected from 24 patients undergoing radical hysterectomy for stage IB cervical carcinoma. The lymph nodes were examined for the HPV type, which in each case was found in the cervical tumor. Of 18 patients with histologically negative nodes, HPV DNA was found in a lymph node in two of 10 patients who later experienced a recurrence and in three of eight patients who were alive and well for > or = 5 years after surgery. In addition, HPV was detected in the lymph nodes of two of four patients with nodal metastases at the primary surgery; four of nine histologically positive lymph nodes in these patients contained HPV. It is concluded that detection of HPV in resected lymph nodes is probably not a useful means of identifying the cervical cancer patients who might benefit from adjuvant postoperative therapy.