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Adrian G, Forslund O, Pedersen L, Sjövall J, Gebre-Medhin M. Circulating tumour HPV16 DNA quantification - A prognostic tool for progression-free survival in patients with HPV-related oropharyngeal carcinoma receiving curative chemoradiotherapy. Radiother Oncol 2023; 186:109773. [PMID: 37385383 DOI: 10.1016/j.radonc.2023.109773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Circulating tumour (ct) human papillomavirus (HPV) DNA is detectable in HPV-related oropharyngeal carcinoma (OPSCC) patients and has the potential to become an important clinical tool. This study aimed to evaluate the prognostic significance of ctHPV16-DNA kinetics during treatment with chemoradiotherapy in HPV-related OPSCC. Patients with p16-positive OPSCC recruited to the ARTSCAN III trial, comparing radiotherapy plus cisplatin with radiotherapy plus cetuximab, constituted the study cohort. MATERIALS AND METHODS Blood samples before start and at the end of treatment of 136 patients were analysed. ctHPV16-DNA was quantified by real-time (q)PCR. The correlation between ctHPV16-DNA levels and tumour burden was investigated with Pearson regression analysis. The prognostic value of ctHPV16-DNA levels at baseline and decline during treatment was evaluated by area-under-the-curve (AUC) calculations and analysed with univariable and multivariable Cox proportional hazards models. RESULTS ctHPV16-DNA was detectable with qPCR in 108/136 patients before start of treatment and cleared in 74% of these patients at the end of treatment. Disease burden was significantly correlated with baseline ctHPV16-DNA levels (R = 0.39, p=<0.001). Both lower baseline levels and AUC-ctHPV16DNA were associated with improved progression-free survival (p = 0.01 and p < 0.001), overall survival (p = 0.013 and p = 0.002), but not local tumour control (p = 0.12 and p = 0.2, respectively), with a stronger association for AUC-ctHPV16DNA (likelihood ratio test 10.5 vs 6.5 in Cox regression analyses of progression-free survival). In multivariable analysis including tumour volume (GTV-T) and treatment allocation (cisplatin vs cetuximab), AUC-ctHPV16DNA remained a significant prognostic marker of progression-free survival. CONCLUSION ctHPV16-DNA is an independent prognostic factor in HPV-related OPSCC.
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Affiliation(s)
- Gabriel Adrian
- Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden; Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden
| | - Ola Forslund
- Department of Laboratory Medicine, Medical Microbiology, Lund University, Lund, Sweden; Clinical Microbiology, Infection Prevention and Control, Office for Medical Services Region Skåne, Sweden
| | - Louise Pedersen
- Clinical Microbiology, Infection Prevention and Control, Office for Medical Services Region Skåne, Sweden
| | - Johanna Sjövall
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden; Department of Otorhinolaryngology - Head and Neck Surgery, Skåne University Hospital, Lund University, Lund, Sweden
| | - Maria Gebre-Medhin
- Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden; Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden.
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Kristiansen S, Bjartling C, Torbrand C, Grelaud D, Lindström M, Svensson Å, Forslund O. Increased prevalence of human papillomavirus in fresh tissue from penile cancers compared to non-malignant penile samples: a case-control study. BMC Cancer 2022; 22:1227. [PMID: 36443686 PMCID: PMC9703753 DOI: 10.1186/s12885-022-10324-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND HPV has been detected in approximately 50% of invasive penile cancers but with a large span between 24 and 89%, most likely due to different types of tumors and various methods for HPV analysis. Most studies of HPV in penile cancer have been performed using paraffin-embedded tissue, argued to be at risk for contaminated HPV analysis. Viral activity of HPV, by the use of HPV mRNA expression is well studied in cervical cancer, but seldom studied in penile cancer. The aim was to determine prevalence of HPV types in fresh tissue of penile cancers compared to non-malignant age-matched penile controls. Additional aims were to analyze the viral expression and copy numbers of HPV16-positive tumors and 10 mm adjacent to the tumor. METHODS Fresh tissue from penile cancer cases was biopsied inside the tumor and 10 mm outside the tumor. Controls were males circumcised for non-malignant reasons, biopsied at surgery. PCR and Luminex assays were used for identification of HPV types. HPV16-positive samples were investigated for copy numbers and expression of HPV16-mRNA. RESULTS Among tumors (n = 135) and age-matched controls (n = 105), HPV was detected in 38.5% (52/135) and 11.4% (12/105), respectively (p < 0.001), adjusted odds ratio 12.8 (95% confidence interval 4.9-33.6). High-risk HPV types were found in 35.6% (48/135) of tumors and 4.8% (5/105) of controls (p < 0.001). Among tumors and controls, HPV16 was present in 27.4% (37/135) and 1% (1/105), respectively (p < 0.001). Among HPV16-positive penile cancers, mean HPV16 viral copy/cell was 74.4 (range 0.00003-725.4) in the tumor and 1.6 (range 0.001-14.4) 10 mm adjacent from the tumor. HPV16-mRNA analysis of the tumors and 10 mm adjacent from the tumors demonstrated viral activity in 86.5% (32/37) and 21.7% (5/23), respectively. CONCLUSIONS The prevalence of HPV was significantly higher in penile cancer (38.5%) than among age-matched non-malignant penile samples (11.4%). HPV16 predominates (27.4%) in penile tumors. HPV16 expression was more common in penile cancer than in adjacent healthy tissue, strongly suggesting an etiological role for HPV16 in the development of penile cancer.
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Affiliation(s)
- Sinja Kristiansen
- grid.4514.40000 0001 0930 2361Department of Dermatology and Venereology, Lund University, Skane University Hospital, Jan Waldenströmsgata 16, 214 28 Malmö, Sweden
| | - Carina Bjartling
- grid.4514.40000 0001 0930 2361Department of Obstetrics and Gynecology, Lund University, Skane University Hospital, Malmö, Sweden
| | - Christian Torbrand
- grid.413823.f0000 0004 0624 046XLund University, Department of Urology, Helsingborg Hospital, Helsingborg, Sweden ,grid.4514.40000 0001 0930 2361Lund University, Institution of Translational Medicine, Malmö, Sweden
| | - Diane Grelaud
- grid.411843.b0000 0004 0623 9987Department of Pathology, Skane University Hospital and Regional Laboratories, Malmö, Sweden
| | - Martin Lindström
- grid.411843.b0000 0004 0623 9987Department of Pathology, Skane University Hospital and Regional Laboratories, Malmö, Sweden
| | - Åke Svensson
- grid.4514.40000 0001 0930 2361Department of Dermatology and Venereology, Lund University, Skane University Hospital, Jan Waldenströmsgata 16, 214 28 Malmö, Sweden
| | - Ola Forslund
- grid.4514.40000 0001 0930 2361Lund University, Department of Medical Microbiology, Laboratory Medicine, Lund, Sweden ,grid.426217.40000 0004 0624 3273Clinical Microbiology, Infection Prevention and Control, Office for Medical Services Region Skane, Kristianstad, Sweden
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Jimenez DG, Sobti A, Askmyr D, Sakellariou C, Santos SC, Swoboda S, Forslund O, Greiff L, Lindstedt M. Tonsillar Cancer with High CD8 + T-Cell Infiltration Features Increased Levels of Dendritic Cells and Transcriptional Regulation Associated with an Inflamed Tumor Microenvironment. Cancers (Basel) 2021; 13:5341. [PMID: 34771506 PMCID: PMC8582523 DOI: 10.3390/cancers13215341] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Human papillomavirus (HPV) is the main causal agent of tonsillar cancer (TC) and HPV+ TC has a favorable prognosis compared to HPV- disease. In this study, we examined aspects of the tumor microenvironment of TC, focusing on T-cells, dendritic cells (DC), and macrophages. Fresh biopsies of TC and the contralateral healthy tonsil (HT) were obtained from 20 patients, analyzed by multiparameter flow cytometry, and assessed against a detailed HPV-status. Additionally, RNA-sequencing data from 38 TC samples available in the public database, The Cancer Genome Atlas (TCGA), were explored, focusing on the same leukocyte populations. HPV+ TC featured increased levels of CD8+ T-cells and antigen-presenting cells (cf. HPV- TC and HT, respectively). In HPV+ TC, CD8+ T-cell frequencies correlated to DC levels independently of tumor stage, HPV 16 copy number, and E7 oncogene expression as well as frequencies of other leukocytes. Similarly, RNA sequencing data were explored by dividing the HPV+ TCs according to predefined CD8+ T-cell scores in silico. Higher levels of genes expressed by antigen-presenting cells and effector T-cells, such as immune checkpoints and cytokines, were detected in the CD8HIGH HPV+ TC samples (cf. CD8LOW HPV+ TC). In conclusion, CD8HIGH HPV+ TC displays a unique inflammatory profile associated with increased effector T-cell functions and the presence of antigen-presenting cells in the tumor microenvironment. Further studies are warranted to assess if this information can be used on an individual basis to aid in prognosis and treatment decisions.
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Affiliation(s)
- David Gomez Jimenez
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (D.G.J.); (A.S.); (C.S.); (S.C.S.)
| | - Aastha Sobti
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (D.G.J.); (A.S.); (C.S.); (S.C.S.)
| | - David Askmyr
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (D.A.); (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
| | - Christina Sakellariou
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (D.G.J.); (A.S.); (C.S.); (S.C.S.)
| | - Sofia Carreira Santos
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (D.G.J.); (A.S.); (C.S.); (S.C.S.)
| | - Sabine Swoboda
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (D.A.); (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
| | - Ola Forslund
- Department of Microbiology, Lund University, 221 85 Lund, Sweden;
| | - Lennart Greiff
- Department of ORL, Head & Neck Surgery, Skåne University Hospital, 221 85 Lund, Sweden; (D.A.); (S.S.); (L.G.)
- Department of Clinical Sciences, Lund University, 221 85 Lund, Sweden
| | - Malin Lindstedt
- Department of Immunotechnology, Lund University, 223 81 Lund, Sweden; (D.G.J.); (A.S.); (C.S.); (S.C.S.)
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Yang J, Chen Y, Luo H, Cai H. The Landscape of Somatic Copy Number Alterations in Head and Neck Squamous Cell Carcinoma. Front Oncol 2020; 10:321. [PMID: 32226775 PMCID: PMC7080958 DOI: 10.3389/fonc.2020.00321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 02/24/2020] [Indexed: 02/05/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Somatic copy number alterations (CNAs) play a significant role in the development of this lethal cancer. In this study, we present a meta-analysis of CNAs for a total of 1,395 HNSCC samples. Publicly available R packages and in-house scripts were used for genomic array data processing, including normalization, segmentation and CNA calling. We detected 125 regions of significant gains or losses using GISTIC algorithm and found several potential driver genes in these regions. The incidence of chromothripsis in HNSCC was estimated to be 6%, and the chromosome pulverization hotspot regions were detected. We determined 323 genomic locations significantly enriched for breakpoints, which indicate HNSCC-specific genomic instability regions. Unsupervised clustering of genome-wide CNA data revealed a sub-cluster predominantly composed of nasopharynx tumors and presented a large proportion of HPV-positive samples. These results will facilitate the discovery of therapeutic candidates and extend our molecular understanding of HNSCC.
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Affiliation(s)
- Jian Yang
- Center of Growth, Metabolism, and Aging, Key Laboratory of Bio-Resources and Eco-Environment, College of Life Sciences, Sichuan University, Chengdu, China
| | - Yi Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Luo
- Center of Growth, Metabolism, and Aging, Key Laboratory of Bio-Resources and Eco-Environment, College of Life Sciences, Sichuan University, Chengdu, China
| | - Haoyang Cai
- Center of Growth, Metabolism, and Aging, Key Laboratory of Bio-Resources and Eco-Environment, College of Life Sciences, Sichuan University, Chengdu, China
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Forslund O, Sugiyama N, Wu C, Ravi N, Jin Y, Swoboda S, Andersson F, Bzhalava D, Hultin E, Paulsson K, Dillner J, Schwartz S, Wennerberg J, Ekblad L. A novel human in vitro papillomavirus type 16 positive tonsil cancer cell line with high sensitivity to radiation and cisplatin. BMC Cancer 2019; 19:265. [PMID: 30909875 PMCID: PMC6434888 DOI: 10.1186/s12885-019-5469-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 03/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Human papillomavirus (HPV) is an established risk factor for oropharyngeal squamous cell carcinoma (OSCC). The aim was to establish cell lines from HPV-positive tonsil carcinomas to be used for treatment development. Methods Fresh samples from 23 HPV-positive tonsil carcinomas were cultivated in vitro. The established cell line was analyzed for viral characteristics, cell karyotype, TP53 status, and growth capabilities in nude mice. In vitro studies of sensitivities to radiation, cisplatin and cetuximab were performed. Results After 19 months (eight passages), one cell line, LU-HNSCC-26, was established in vitro and also grew as xenografts. The tumor was from a 48 year old non-smoking man with non-keratinizing, p16 positive tonsil OSCC, stage T2N0M0 with HPV16. It contained 19.5 (CV% 3.7) HPV16 copies/cell (passage 8). The complete HPV16 genome sequence was obtained. Episomal HPV16 was present with an E2/E7 ratio of 1.1 (CV% 2.6). In addition, HPV16 mRNA specific for the intact E2 gene was detected. The viral expression manifested 1.0 (CV% 0.1) E7 mRNA copies per HPV16 genome. The karyotype was determined and the cell line demonstrated wild type TP53. The ID50 for radiation was 0.90 Gy and the IC50 for cisplatin was 0.99 μmol/L. The cell line was inhibited to a maximum of 18% by cetuximab. Conclusions We established an in vitro tonsil carcinoma cell line containing episomal HPV16. This is an important step towards efficient treatment development. Electronic supplementary material The online version of this article (10.1186/s12885-019-5469-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ola Forslund
- Department of Laboratory Medicine, Division of Medical Microbiology, Skane Laboratory Medicine, Lund University, Lund, Sweden
| | - Natsuki Sugiyama
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Skane University Hospital, Barngatan 4, SE-222 25, Lund, Sweden
| | - Chengjun Wu
- Department of Laboratory Medicine, Division of Medical Microbiology, Skane Laboratory Medicine, Lund University, Lund, Sweden
| | - Naveen Ravi
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Yuesheng Jin
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Sabine Swoboda
- Department of Clinical Sciences Lund, Oto-rhino-laryngology, Head and Neck Surgery, Lund University, Skane University Hospital, Lund, Sweden
| | - Fredrik Andersson
- Department of Pathology, Regional Laboratories Region Skane, Skane University Hospital, Lund, Sweden
| | - Davit Bzhalava
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Emilie Hultin
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Kajsa Paulsson
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Joakim Dillner
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Schwartz
- Department of Laboratory Medicine, Division of Medical Microbiology, Skane Laboratory Medicine, Lund University, Lund, Sweden
| | - Johan Wennerberg
- Department of Clinical Sciences Lund, Oto-rhino-laryngology, Head and Neck Surgery, Lund University, Skane University Hospital, Lund, Sweden
| | - Lars Ekblad
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Skane University Hospital, Barngatan 4, SE-222 25, Lund, Sweden.
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Wu C, Nilsson K, Zheng Y, Ekenstierna C, Sugiyama N, Forslund O, Kajitani N, Yu H, Wennerberg J, Ekblad L, Schwartz S. Short half-life of HPV16 E6 and E7 mRNAs sensitizes HPV16-positive tonsillar cancer cell line HN26 to DNA-damaging drugs. Int J Cancer 2019; 144:297-310. [PMID: 30303514 PMCID: PMC6587446 DOI: 10.1002/ijc.31918] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
Abstract
Here we show that treatment of the HPV16-positive tonsillar cancer cell line HN26 with DNA alkylating cancer drug melphalan-induced p53 and activated apoptosis. Melphalan reduced the levels of RNA polymerase II and cellular transcription factor Sp1 that were associated with HPV16 DNA. The resulting inhibition of transcription caused a rapid loss of the HPV16 early mRNAs encoding E6 and E7 as a result of their inherent instability. As a consequence of HPV16 E6 and E7 down-regulation, the DNA damage inflicted on the cells by melphalan caused induction of p53 and activation of apoptosis in the HN26 cells. The BARD1-negative phenotype of the HN26 cells may have contributed to the failure to repair DNA damage caused by melphalan, as well as to the efficient apoptosis induction. Finally, nude mice carrying the HPV16 positive tonsillar cancer cells responded better to melphalan than to cisplatin, the chemotherapeutic drug of choice for tonsillar cancer. We concluded that the short half-life of the HPV16 E6 and E7 mRNAs renders HPV16-driven tonsillar cancer cells particularly sensitive to DNA damaging agents such as melphalan since melphalan both inhibits transcription and causes DNA damage.
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Affiliation(s)
- Chengjun Wu
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kersti Nilsson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Yunji Zheng
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Camilla Ekenstierna
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Skane University Hospital, Lund, Sweden
| | - Natsuki Sugiyama
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Skane University Hospital, Lund, Sweden
| | - Ola Forslund
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Naoko Kajitani
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Haoran Yu
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Johan Wennerberg
- Department of Clinical Sciences Lund, Oto-rhino-laryngology, Head and Neck Surgery, Lund University, Skane University Hospital, Lund, Sweden
| | - Lars Ekblad
- Department of Clinical Sciences Lund, Oncology and Pathology, Lund University, Skane University Hospital, Lund, Sweden
| | - Stefan Schwartz
- Department of Laboratory Medicine, Lund University, Lund, Sweden
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Faust H, Eldenhed Alwan E, Roslin A, Wennerberg J, Forslund O. Prevalence of human papillomavirus types, viral load and physical status of HPV16 in head and neck squamous cell carcinoma from the South Swedish Health Care Region. J Gen Virol 2016; 97:2949-2956. [DOI: 10.1099/jgv.0.000611] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Helena Faust
- Division of Medical Microbiology, Department of Laboratory Medicine, Lund University, Skane Laboratory Medicine, Sölvegatan 23, 221 85 Lund, Sweden
| | - Erika Eldenhed Alwan
- Division of Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skane University Hospital, Lasarettsgatan 21, 221 85 Lund, Sweden
| | - Alexander Roslin
- Division of Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skane University Hospital, Lasarettsgatan 21, 221 85 Lund, Sweden
| | - Johan Wennerberg
- Division of Otorhinolaryngology, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skane University Hospital, Lasarettsgatan 21, 221 85 Lund, Sweden
| | - Ola Forslund
- Division of Medical Microbiology, Department of Laboratory Medicine, Lund University, Skane Laboratory Medicine, Sölvegatan 23, 221 85 Lund, Sweden
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Forslund O, Schwartz S, Olofsson K, Rydell R. Viral load and mRNA expression of HPV type 6 among cases with recurrent respiratory papillomatosis. Laryngoscope 2015; 126:122-7. [PMID: 26010342 DOI: 10.1002/lary.25357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2015] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine viral load of human papillomavirus type 6 (HPV6), physical state of HPV6-DNA, and transcription level of HPV6 E7-mRNA in laryngeal papilloma and in adjacent healthy mucosa. STUDY DESIGN Case series. METHODS A papilloma biopsy was collected from each of 25 adult patients with respiratory recurrent papillomatosis. From 14 of the 25 patients, we first collected a biopsy from healthy mucosa of the false vocal fold and another from the papilloma. Quantity of HPV6 and E7-mRNA was measured by polymerase chain reaction. RESULTS For the papilloma, the median load of HPV6 was 41 copies/cell, and the lowest amount was 5.4 copies/cell. Human papillomavirus type 6 was detected in 50% (7/14) of the healthy mucosa, with a median of 1.1 copies/cell, and the highest amount was 6.6 copies/cell. Overall, viral load was higher in papilloma than in healthy mucosa (P < 0.05). The average HPV6 E2/E7-DNA ratio was 1.3, indicating an episomal state. Human papillomavirus type 6-mRNA was detected in all HPV6-DNA-positive samples. The transcription median ratio of HPV6-mRNA/HPV6-DNA was 1.5 in papilloma and 3.8 in healthy mucosa. CONCLUSION The amount of HPV6-DNA was consistently higher in the papilloma than in healthy mucosa. The transcription level of HPV6 E7 mRNA was similar in the papilloma and in normal mucosa. We suggest that interfering with replication of HPV6 and suppression of HPV6 to fewer than five copies/cell may be curative.
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Affiliation(s)
- Ola Forslund
- Department of Laboratory Medicine, Medical Microbiology, Lund University, Malmö
| | | | - Katarina Olofsson
- Department of Clinical Sciences, Division of Otorhinolaryngology, Umeå University, Umeå
| | - Roland Rydell
- Department of Clinical Sciences, Division of Otorhinolaryngology, Head and Neck Surgery, Scania University Hospital, Lund University, Scania, Sweden
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