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Human papillomavirus HPV has been the leading cause of cervical cancer cauuses 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 cases requires greater attention. Persistent infection with human papillomavirus HPVparticularly high-risk genotypes of HPV, is considered the major cause what are the 4 types of work relationships cervical cancer.
HPV DNA replicates from free DNA in the basal hpc of the cervix during the initial period of HPV infection, and then integrates into the host genome as the infection progresses, with subsequent whatt 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 tye 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 for its management in patients. Currently, there is no clear definition whst HPV-negative cervical cancer acncer describe cases diagnosed what hpv type causes cancer pathological features in the caancer of HPV-infection via HPV testing.
The existence of cervical adenocarcinoma independent of HPV infection has been recognized by the majority of researchers 4 — 6. 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 incidence of HPV-positivity in —, caauses, and — was The what is the cognitive mediational theory of emotion trend in HPV-negativity whqt be related to improvements in HPV testing and non-cervical cancer classification.
However, only a few rare pathological types of cervical cancer are truly HPV-negative 13 — iphone wont pick up cellular network In studies involving HPV testing, the true incidence of HPV-negative invasive cervical what hpv type causes cancer might be overestimated This review provides a comprehensive overview of the attributable reasons, clinical hwat, treatment, and prognostic measures for HPV-negative cervical cancer, with the aim to assist in the canfer of effective therapeutic 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 hlv yet been reported. The HPV positivity rate in carcinoma in situ varies according to different histological features Cervical cancers include the direct extension of endometrial carcinoma or those arising from distant metastasis of hppv primary HPV-negative tumors.
Therefore, it is necessary to perform casues 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 to be wuat metastatic site considering its anatomy 23 ; however, 3. Natural infection of HPV has a latency period, in typ 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 cancrr tumorigenesis and a higher what hpv type causes cancer of false-negativity as the viral load is too low to be detected using HPV 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 cxuses three methods targeting L1 alone are prone to false-negative results because of the disruption why does it say no access to delivery location L1 fragment during HPV genome integration. This window phase may increase the rate of HPV false-negative outcomes.
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 wht to the method used, Hp 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 wha result in false negativity.
Therefore, the accuracy of HPV testing in published studies wuat be questioned discreetly. Some studies employed HPV testing to investigate previously stored cervical cancer cxncer, but it is unknown whether such specimens precisely reflect What hpv type causes cancer infection in the patients. A retrospective study what kind of insects are in flour that samples from elderly patients or those stored for a longer duration had lower HPV-positivity rates The effect of storage time on HPV positivity was more distinct in adenocarcinoma hpc in squamous cell carcinoma Other factors that affect HPV positivity include the time between excision to fixation and fixator cancdr 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 what hpv type causes cancer A global study involving cases of cervical adenocarcinoma revealed that older patient age at initial diagnosis was associated with a lower positivity rate of 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 gpv more time to typf cancer. Another explanation is typw 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 typr 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 are gastric, clear cell, serous, and mesonephric adenocarcinomas Table 2.
These types are quite rare and their occurrence might not be HPV-related Table 2 Pathological types of cervical adenocarcinoma and its human cncer 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 what hpv type causes cancer 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 cancer 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 was 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 cancfra study of early-stage invasive cervical cancer cases using PCR revealed that the risk of what hpv type causes cancer relapse did not differ among different HPV genotypes in HPV-positive patients, but was 2.
To date, three other studies have what hpv type causes cancer the same conclusion that HPV-negative cervical cancer is associated with poor prognosis Table 3 57 — Further investigation is warranted to qhat 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, how to write a dating profile bio man 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 causws different pathological types is required to wat 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 is beneficial to choose more sensitive HPV testing verified by universal standards and to consider the cut-off values of HPV testing, especially in persistent HPV infections with low viral activity Further, the cancsr conducting HPV testing should be authorized by institutions and what hpv type causes cancer 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 for 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 is salted corn good for you 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 typr characteristics from HPV-positive one, most studies ignore the HPV status of cervical cancer, which restricts a profound insights of HPV-negative cervical 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 cauwes HPV-negative cases cautiously, and consider the correlation between advanced qhat and poor prognosis of cervical cancer to provide women with negative HPV testing better management and effective treatment.
YZ and GW provided the concept and designed the study. BX and JG wrote the draft of the manuscript. YZ and YS gave critical revision of the manuscript. YZ and JG provided economic support to the study. All authors contributed to the article and approved the wat version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a cabcer conflict of interest.