The overall goal of this proposal is to relate the presence of human papillomavirus (HPV) to the outcome of disease - recurrence and survival - in women with invasive anogenital cancer. The study group will include women with invasive cervical or anal carcinomas of any histologic type and women with invasive squamous cell carcinoma of the vulva. This study will focus on cervical cancer as these tumors constitute the largest number of cases in this population and have the most significant world-wide public health impact. The presence of HPV DNA (or a specific genotype of HPV) will be studied in relation to the risk of death or tumor recurrence in women with cervical cancer and the risk of death in women with vulvar or anal cancer. HPV genomes will be detected and typed by polymerase chain reaction (PCR) amplification. Secondarily, the same risks will be studied in relation to seroreactivity to specific HPV antigens. The occurrence and persistence of HPV DNA in regional node metastases of cervical, vulvar and anal cancers will be studied to determine if detection of HPV DNA in nodal tissues is a marker for early metastases. All lymph nodes removed at surgery (both histologically affected and unaffected) from women with HPV DNA-positive and DNA-negative tumors will be examined using PCR amplification for detection of HPV sequences.
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