CLINICAL RESEARCH
Warty carcinoma of the uterine cervix: a virus-induced disease?
 
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1
Department of Gynaecological Oncology, Medical University Pleven, Pleven, Bulgaria
2
Department of General and Clinical Pathology, Medical University Pleven, Pleven, Bulgaria
3
Scientific Laboratory, Department of Epidemiology, Medical University Pleven, Pleven, Bulgaria
4
Department of Gynaecology, Medical University Varna, Varna, Bulgaria
5
Department of Plastic and Reconstructive Surgery, MU-Pleven, Pleven, Bulgaria
6
Complex Oncological Centre Burgas, Burgas, Bulgaria
Submission date: 2020-05-20
Final revision date: 2020-06-15
Acceptance date: 2020-07-04
Online publication date: 2020-08-06
 
Arch Med Sci 2022;18(5)
 
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ABSTRACT
Introduction:
Warty carcinoma (WC) of the uterine cervix is a rare subtype of squamous-cell carcinoma (SCC), and its frequency, clinical behaviour, and aetiology are obscure. It originates from condylomas, and a viral carcinogenesis seems logical.

Material and methods:
Retrospective analysis was performed of all cervical carcinomas (CC), diagnosed at a single institution for a 10-year period. Analysed patients had stage I carcinoma. Patients with WC were identified, and their tumour samples were tested for high-risk HPV (hr-HPV) and EBV, using PCR and ISH. Clinical characteristics and WC rates across all stage I CC patients were assessed. All patients had minimum 3-year follow-up, and overall survival (OS) and 5-year survival rates were calculated.

Results:
WC comprised 2.2% of all stage I CC (n = 630). The mean age of the patients was 48 years (range: 29–72). The primary tumour size was 2 cm in 4 (28.6%) patients, 2–4 cm in 2 (14.3%) patients, and 4 cm in 8 (57.1%) patients. Lymph node metastasis was found in 1 (7.1%) patient. EBV or hr-HPV were detected in 2 (18.2%) patients using ISH, with no coinfection reported. Hr-HPV was detected in 2 (18.2%) patients; EBV in 4 (36.4%) cases, and in 2 of them (18.2%) there was a co-infection. Thirteen patients had a follow-up of ≥ 5 years and their 5-year OS was 100%.

Conclusions:
WC is a rare subtype of SCC with good prognosis, regardless of viral status. In contrast to SCC, its aetiology is not related to hr-HPV. The role of EBV remains unclear and cannot currently be denied.

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