The incidence of anal cancer is increasing worldwide, but limited information is available about the prognosis of these tumors. Human papillomavirus (HPV) DNA have been investigated as a prognostic factor in anal cancer. The objective of this study was to retrospectively investigante HPV DNA and clinical data in a series of consecutive cases of invasive anal carcinomas treated in a single institutional service in Brazil. HPV DNA prevalence and genotype distribution were investigated in association with clinicopathological characteristics.
A group of 81 patients with invasive anal carcinomas was retrospective analyzed for a period of 10 years. Formalin fixed paraffin- embedded samples were tested for HPV detection and genotype distribution by using a SPF-10 Inno Lipa assay. Prevalence ratios were estimated by logistic regression and survival was analyzed by Kaplan Meier and log-rank.
The prevalence of HPV DNA for the whole group was 69%, and it was significantly higher in squamous cell carcinomas (SCC) (88.1%) (OR 9.51 IC 95% 2.96-30.50) and in female patients (78.4%) (OR 3.18 IC 95% 1.19-8.48). Multiple infection was detected in 14.3% of cases and HPV 16, 18 and 33 were the most prevalent genotypes. Overall survival for the group was 44.3%. Survival was significantly higher for men (p = 0.008) and for SCC patients (p = 0.01), and was reduced for patients with distant metastasis (p = 0.01). HPV positive tumors presented with a higher survival, although the difference was not significant (p > 0.05).
The high prevalence of HPV DNA in anal carcinomas was confirmed in this study, however, the presence of HPV DNA did not significantly affect the prognosis of the patients. Prognosis was affected by gender, histological type and distant metastasis.
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