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Marcela Lizano, Jaime Berumen, Miriam C. Guido, Leonora Casas, Alejandro García-Carrancá, Association Between Human Papillomavirus Type 18 Variants and Histopathology of Cervical Cancer, JNCI: Journal of the National Cancer Institute, Volume 89, Issue 16, 20 August 1997, Pages 1227–1231, https://doi.org/10.1093/jnci/89.16.1227
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Adenocarcinoma, adenosquamous carcinoma, and small-cell carcinoma of the uterine cervix are reported to be low in incidence but clinically important. They usually exhibit a more aggressive biologic behavior and have a poorer prognosis than squamous cell carcinomas at similar stages (1–3). Although human papillomavirus type 16 (HPV16) is associated predominantly with squamous cell carcinomas and HPV18 is associated predominantly with adenocarcinomas and adenosquamous carcinomas (4), differences in prognosis among these groups of cancers are largely still not understood. On the other hand, few reports have evaluated the role of HPV type in the development of small-cell carcinomas [e.g., (5)]. DNA sequence variations among different isolates of HPV16 and HPV18 have been found in various geographic locations and ethnic groups (6–11). To date, these variations have not been shown to correlate with pathologic features (12), and it is not clear whether HPV genetic-intratype variability could account for the wide spectrum of pathology found in the associated lesions.