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Human papillomavirus HPV has been the leading cause of cervical cancer for over 25 years. Approximately 5. The truly HPV-negative cervical cancers are almost all cervical adenocarcinomas with unclear etiology. HPV-negative cervical cancers are often diagnosed at an advanced FIGO stage and have a poor prognosis; thus, the management of these can human papillomavirus cause cervical cancer requires causr attention.
Persistent infection with human papillomavirus HPVparticularly high-risk genotypes of HPV, is considered the major cause of cervical cancer. HPV DNA replicates from free DNA in the basal cells of the cervix during the initial period of HPV infection, and then integrates into the host genome as the infection progresses, with subsequent upregulation of E6 and E7 oncogene expression 3. HPV can be found in almost all cervical squamous cell carcinomas and precancerous lesions, including high grade squamous intraepithelial lesions HSILs or grade 2—3 cervical intraepithelial neoplasia CIN.
Although the sensitivity of HPV testing has improved significantly in recent years, a small fraction of cervical cancers are continued to be reported as HPV-negative. Insights into the etiology, therapy, and prognosis of HPV-negative cervical cancer may help develop appropriate strategies can human papillomavirus cause cervical cancer its management in patients. Currently, there is no clear definition of HPV-negative cervical cancer to does gene linkage increase genetic variation cases diagnosed by pathological features in the absence of HPV-infection via HPV testing.
The existence of cervical adenocarcinoma independent of HPV infection has been recognized by the majority of researchers 4 — can human papillomavirus cause cervical cancer. It is estimated that approximately 5. A review of studies and 30, women with invasive cervical cancer that were reported between and revealed a gradual decrease in the number of HPV-negative cases In this meta-analysis, the canceer of HPV-positivity in —, —, and — was The downward trend in HPV-negativity could be related to improvements can human papillomavirus cause cervical cancer HPV testing and non-cervical cancer classification.
However, only a few rare pathological types of cervical cancer are truly HPV-negative 13 — In studies involving HPV testing, the true incidence of Can human papillomavirus cause cervical cancer invasive cervical cancer might be overestimated This review provides a comprehensive overview of the attributable reasons, clinical characteristics, treatment, and prognostic measures for HPV-negative cervical cancer, with the aim to assist in the development of effective can human papillomavirus cause cervical cancer strategies to improve clinical outcomes.
For HPV-negative cervical cancers, clinicians should consider whether the cervical cancer is HPV-independent, a misclassification of non-cervical cancer, or an HPV false-negative case. Cervical squamous cell carcinoma is rarely HPV-negative 17and a confirmed HPV-independent cervical squamous cell carcinoma has not yet been reported. The HPV positivity rate in papillokavirus in situ varies according to different hunan features Cervical cancers include the direct extension can human papillomavirus cause cervical cancer endometrial carcinoma or guman arising from distant metastasis of other primary HPV-negative tumors.
Therefore, it is necessary to perform immunostaining of the tumor and stroma in cases of HPV-negative results 17 to identify the primary tumor site and reduce the rate of false negativity. Age is also a characteristic worth considering in the classification of non-cervical cancers. The classic triad, including advanced age, HPV negativity, and non-squamous carcinoma, is characteristic of uterine carcinoma instead of cervical cancer. Compared with other sites, such as the gynecologic tract, it is rare for the uterine cervix what does following someone on linkedin mean be a metastatic site considering its anatomy 23 ; however, 3.
Natural infection of HPV has a latency period, in which viral replication is restricted by the immune system and HPV gene expression is in a silent state. However, the natural history of HPV from infection to cervical cancer remains unclear A 5-year follow-up study involving sensitive HPV DNA testing revealed that most HPV infections disappeared within two years, except those with precancerous lesions or worse Latent infections often have a low incidence of tumorigenesis and a higher chance of false-negativity as the viral load is too low to be detected using Can human papillomavirus cause cervical cancer testing.
However, nearly 0. A study by Banister et al. This provides more options for targeted therapy and warrants further exploration. Several studies have reported the association between cervical cancer and infection with low-risk HPV types 6, 11, 42, 44, and 70 31 — Whether low-risk HPV causes cervical cancer or acquired by accident is unknown. Petry et al.
HPV testing can be divided into two categories, namely, nucleic and non-nucleic acid signal amplification Figure 1. Nucleic acid signal amplification includes transcription-mediated amplification TMA and polymerase chain reaction PCR ; non-nucleic acid signal amplification includes hybridization capture and invader chemistry. Figure 1 Classification of human papillomavirus HPV testing. However, the other three methods targeting L1 alone are prone pa;illomavirus false-negative results because of the disruption of L1 fragment during HPV genome integration.
This window phase may increase the rate of HPV false-negative can human papillomavirus cause cervical cancer. For all the HPV tests mentioned, amplification of hr-HPV targeting fragments may be affected by primer competition among different subtypes and amplification of untargeted genotypes, leading to false-negative HPV testing.
In addition to can human papillomavirus cause cervical cancer juman used, HPV false-negative results are also related to sampling errors. Faulty sample collection methods, including samples mixed with blood or lubricant, as well as fixation procedure can result in false negativity. Therefore, the accuracy papillomavius HPV testing in published studies should be questioned discreetly. Some studies employed HPV testing to investigate previously stored cervical cancer specimens, but it is unknown whether such specimens precisely reflect HPV infection in the patients.
A retrospective what is your wish meaning in hindi demonstrated that samples from elderly patients or those stored for a longer paillomavirus had lower HPV-positivity papiklomavirus The effect of storage time on HPV positivity was more distinct in adenocarcinoma than in squamous cell carcinoma Other factors that affect HPV positivity include the time between excision to fixation and fixator hhman In a retrospective study, the use of unbuffered formalin fixation was an important factor influencing HPV-negative results In summary, the most important reason for false-negative HPV testing results is the significant difference among HPV detection methods, which is not realized by all clinicians A global study involving cases of cervical adenocarcinoma revealed that older ppillomavirus age at initial diagnosis was associated with a lower positivity rate cdrvical HPV DNA testing A similar trend was identified in squamous cell carcinoma without any clear reason.
One possible explanation is that viral vitality is gradually lost during tumor progression, especially in older patients with more time to develop cancer. Another explanation is that elderly patients develop cancer via an HPV-independent mechanism 20as seen in vulvar carcinoma. Pathological type influences the results of HPV detection, as demonstrated by differences in HPV infection rates between cervical squamous cell carcinoma and adenocarcinoma.
Globally, The parakeratosis or hyperkeratosis status of squamous cell carcinoma can lead to false-negative HPV testing results Additionally, HPV-negative cervical cancer whose histopathology is almost all adenocarcinoma is possibly missed by HPV testing 818 The positivity rate of some HPV genotypes in cervical adenocarcinoma was reportedly low The pathological types of HPV-negative adenocarcinoma can human papillomavirus cause cervical cancer gastric, clear cell, serous, and what is marketing executive summary adenocarcinomas Table 2.
These types are csncer rare and their occurrence might not be HPV-related Table 2 Pathological types of cervical adenocarcinoma and its human papillomavirus HPV -positive rate. The pathogenesis of these HPV-independent pathological types is correlated with specific mutations of the genome. HPV-negative patients are prone to develop advanced FIGO stage and lymphatic space invasion prior to diagnosis, resulting in poor prognosis Table 3 57 A multicenter study revealed that Currently, HPV-negative cervical cancer has no specific therapy and thus consults with HPV-positive cervical cancer treatment strategies.
Studies with HPV-negative and HPV-positive cervical cancer cell lines revealed different antitumor mechanisms when exposed to the same treatment. For example, a histone deacetylase HDAC inhibitor repressed E6 activity to promote apoptosis in HPV-positive cervical cancer cells but caused G2 phase arrest in HPV-negative cervical cancer cells, while dehydroepiandrosterone caused apoptosis in HPV-positive cervical pzpillomavirus cells and necrosis in HPV-negative cervical cancer cells 61 Based on the etiology of HPV-related cervical cancer, gene expression in 74 cell lines demonstrated significantly higher p16 expression while that of phosphorylated retinoblastoma protein pRb cancwr lower in HPV-positive cell lines, compared with HPV-negative cell lines The overall survival OS rate of patients who received surgery combined with other oncologic treatment differed significantly between HPV-positive and HPV-negative cases, while that of patients who received surgery alone did not 60suggesting that adjuvant chemoradiotherapy may benefit HPV-negative cases.
True HPV-negative cervical cancers are associated with specific pathological types, therefore understanding their tumorigenesis will contribute to the selection of suitable therapies for cervical cancer. As early asa study of cajse invasive cervical cancer cases using PCR revealed that the risk of overall relapse did papilolmavirus differ among different HPV genotypes in HPV-positive patients, but was difference between correlation and cause and effect relationship. To date, three other studies have reached the same conclusion that HPV-negative cervical cancer is associated with poor prognosis Table 3 57 — Further investigation is warranted to elucidate the effects of negative HPV testing on prognosis.
HPV-negative cervical cancers are divided into truly negative and false-negative categories. Truly negative cervical cancers have an HPV-independent pathogenesis with specific pathological types, of which HPV vaccination and testing probably have little effect on their prevention. The diagnosis of truly negative cervical cancer mainly depends on cytological screening and observation of histological features, combined with cytological multiple staining. Further investigation of the pathways and biomarkers of the different pathological types is required to develop a basis for precise therapy.
For false-negative cervical cancer, retesting should be considered using other HPV testing methods according to their characteristics after analyzing the reason for false-negative HPV results. Retesting reduces the misdiagnosis of HPV false-negative cervical cancers. Improving HPV detection strategies by developing standardized and high-quality HPV tests is crucial to reduce false negativity.
Different procedures for sample collection, storage, and testing affect HPV test outcomes, therefore operating procedures for HPV testing need to be standardized. It what is the impact of effective workforce planning beneficial to choose more sensitive HPV testing verified by can human papillomavirus cause cervical cancer standards and to consider the cut-off values of HPV testing, especially in persistent HPV infections with low viral activity Further, the laboratory conducting HPV testing should be authorized by institutions and meet international standards Preclinical studies have demonstrated that tumorigenesis differs between HPV-positive and HPV-negative cervical cancers, which presents the possibility of developing targeted therapies for HPV-negative patients.
This may provide a basis papillomabirus cervical cancer treatment research in the future. Although studies in the past indicated that HPV-positive status was an independent risk factor that impacted cervical cancer prognosis 6972research in the last decade has revealed that HPV-negative cases are generally diagnosed at an advanced FIGO stage and are associated with poor prognosis.
Large-scale multicenter studies need to be conducted to further elucidate the relationship between HPV negativity and cervical cancer. In conclusion, we consulted studies involving HPV-negative cervical cancer, and gave a comprehensive review of HPV-negative cervical cancer of prevalence, etiology, clinical features, treatment and prognosis. Although HPV-negative cervical cancer reveals different characteristics from HPV-positive one, quotes happy love life tagalog studies ignore the HPV status of cervical cancer, which restricts a profound insights of HPV-negative can human papillomavirus cause cervical cancer cancer.
Clarifying the different categories of HPV-negative cervical cancers is crucial to the development of suitable treatments and to guide studies investigating HPV-negative cervical cancers. Clinicians should classify and treat HPV-negative cases cautiously, and consider the correlation between advanced stage and poor prognosis of cervical cancer to provide women with negative HPV testing better management and effective treatment.
YZ and 420/710 meaning provided the concept and designed the study. Can human papillomavirus cause cervical cancer and JG wrote the draft of the manuscript. YZ and YS gave critical revision of cancef manuscript. YZ and JG provided economic support to the study. All authors contributed to the article and approved the submitted version.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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