Comprehensive analysis of Human Papillomavirus and Chlamydia trachomatis in in-situ and invasive cervical adenocarcinoma.

OBJECTIVE

Chlamydia trachomatis (Ct) has been implicated as a co-factor in cervical carcinogenesis. The goal of the current study was to investigate if Ct may play a role in pathogenesis of cervical adenocarcinoma and, specifically, if there is a co-infection between Ct and Human Papillomavirus (HPV) in cervical adenocarcinomas. The second goal of the study was to determine the distribution of HPV genotypes in most recent cases of in-situ and invasive cervical adenocarcinomas.

METHODS

Biopsies of 71 cervical adenocarcinomas (31 in-situ and 40 invasive) were tested for the presence of Ct using two novel PCR assays. In addition, all cases were tested for HPV using SPF10-PCR assay and genotyped using LIPA(25) test.

RESULTS

None of the cases was found to be positive for Ct using two independent PCR assays. All lesions, however, were positive for HPV with the exception of a case of minimal deviation adenocarcinoma. Overall, 94.2% of cases were positive for either HPV16 (n=44, 62.8%) or HPV18 (n=20, 28.5%), or both (n=2, 2.8%). Other single HPV types included HPV45 (n=3, 4.2%) and HPV35 (n=1, 1.4%).

CONCLUSION

The study demonstrated lack of co-infection between Human Papillomavirus and C. trachomatis in in-situ and invasive adenocarcinoma of the uterine cervix. The role of Ct as a carcinogenetic co-factor may be restricted to cervical squamous cell carcinomas. Accounting for type cross-protection, currently available HPV vaccines are likely to prevent close to 100% of HPV-positive cervical adenocarcinomas.