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da Silva LL, Teles AM, Santos JMO, Souza de Andrade M, Medeiros R, Faustino-Rocha AI, Oliveira PA, dos Santos APA, Ferreira Lopes F, Braz G, Brito HO, da Costa RMG. Malignancy Associated with Low-Risk HPV6 and HPV11: A Systematic Review and Implications for Cancer Prevention. Cancers (Basel) 2023; 15:4068. [PMID: 37627099 PMCID: PMC10452364 DOI: 10.3390/cancers15164068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
High-risk human papillomavirus (HPV) is etiologically related to cervical cancer, other anogenital cancers and oropharyngeal carcinomas. Low-risk HPV, especially HPV6 and HPV11, cause genital warts and laryngeal papillomas. However, the accumulating data suggests that HPV6 and HPV11 may cause malignant lesions at non-cervical anatomic sites. This review aims to estimate the proportions of single and dual HPV6/11 infections in multiple cancers reported in the last 10 years in the Cochrane, Embasa and PubMed databases. Secondly, the genomes of HPV6/11 were compared with the most common high-risk genotype, HPV16, to determine the similarities and differences. A total of 11 articles were selected, including between one and 334 HPV+ cancer patients. The frequencies of single or dual HPV6/11 infections ranged between 0-5.5% for penile and 0-87.5% for laryngeal cancers and were null for vulvar, vaginal and oral cancers. The genomic similarities between HPV6/11 and HPV16 mainly involved the E7 gene, indicating a limited ability to block cell differentiation. The presence of single or dual HPV6/11 infections in variable proportions of penile and laryngeal cancers support the vaccination strategies that cover these genotypes, not only for preventing genital warts but also for cancer prevention. Other risk factors and co-carcinogens are likely to participate in epithelial carcinogenesis associated with low-risk HPV.
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Affiliation(s)
- Leandro Lima da Silva
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Amanda Mara Teles
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Animal Health, State University of Maranhão, São Luís 65099-110, MA, Brazil
| | - Joana M. O. Santos
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Marcelo Souza de Andrade
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Ana I. Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ana Paula Azevedo dos Santos
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Health Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil
| | - Fernanda Ferreira Lopes
- Post-Graduate Program in Odontology, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Geraldo Braz
- Post-Graduate Program in Computing Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Haissa O. Brito
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui M. Gil da Costa
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Associate Laboratory in Chemical Engineering (ALiCE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
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Nwachukwu CR, Harris JP, Chin A, Von Eyben R, Giaretta S, Shaffer JL, Hiniker SM, Kapp DS, Folkins AK, Kidd EA. Prognostic Significance of P16 Expression and P53 Expression in Primary Vaginal Cancer. Int J Gynecol Pathol 2019; 38:588-596. [PMID: 31593028 DOI: 10.1097/pgp.0000000000000568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To evaluate the correlation between p16 expression and clinical outcomes in patients with primary vaginal cancer treated with definitive radiotherapy. P16 immunohistochemical was performed on 25 patient samples and recorded from pathology reports in 7 patients. P53 immunohistochemical was performed on 3 p16-negative samples. Baseline characteristics were compared using the Fisher exact test. Outcomes were compared using log-rank tests, and cox proportional hazards models. Survival and recurrence analysis was performed with the Kaplan-Meier method and cumulative incidence estimates. P16 expression was positive in 29 patients and negative in 3 patients. Two of the p16-negative tumors showed positive expression of p53. The median overall survival, progression-free survival and 2-yr cumulative incidence of recurrence were 66 mo [95% confidence interval (CI), 31-96], 34 mo (95% CI, 21-86), and 19% (95% CI, 7%-34%), respectively. P16-positive tumors had higher median overall survival and progression-free survival compared with p16-negative tumors (82 vs. 31 mo, P=0.02 and 35 vs 16 mo, P=0.04, respectively). The 2-yr cumulative incidence of recurrence was 14% for p16-positive tumors compared with 67% for p16-negative tumors (P=0.07). On univariable analysis, p16-negative status, age older than 65, and advanced stage were associated with inferior overall survival. P16 negativity is an independent predictor of inferior overall survival. P16-positive vaginal cancers have a better prognosis and decreased incidence of recurrence compared with p16-negative tumors. These prognostic findings associated with p16-negative vaginal cancers will need to be confirmed in larger patient cohorts.
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Affiliation(s)
- Chika R Nwachukwu
- Departments of Radiation Oncology (C.R.N., J.P.H., A.C., R.V.E., S.G., J.I.S., S.M.H., D.S.K., E.A.K.) Pathology (A.K.F.), Stanford University School of Medicine, Stanford, California
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A report of human papilloma virus-16 associated vaginal carcinoma after thirty-two years of successful radiation therapy for cervical cancer. Virusdisease 2018; 29:537-539. [PMID: 30539058 DOI: 10.1007/s13337-018-0479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022] Open
Abstract
Once the recommended 5-year recurrence-free follow-up is achieved for cervical cancers regular annual pelvic examination is mandatory. The main aim of presenting this short report is to emphasize the difficulties in the collection and interpretation of cytology samples from stenosed cervix or vault after pelvic irradiation. Radiotherapy can induce changes in the cellular morphology which may persist for many years. A 64-year old post-menopausal lady who had received radiation therapy 32 years back for cervical carcinoma stage IIb presented to the Gynecology outpatient department with vaginal spotting. Even though the patient was under regular follow-up for the initial 2 years, she was lost to further follow-ups. The patient was symptom-free except for one episode of spotting in August 2016 and the histopathological examination of the vault smear had ruled out malignancy. However, 1 month later she again presented with spotting and pelvic examination revealed a warty growth at the lateral vaginal wall. The tissue excision biopsy was tested positive for HPV-16 DNA and the histopathology confirmed vaginal squamous cell carcinoma. The association of human papilloma virus (HPV) in cervical cancers was well established and these patients manifest a higher risk of HPV-induced vaginal cancers. HPV DNA testing during follow-up may facilitate early recognition of HPV-related lower genital tract cancers.
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Rüegsegger AB, Senn B, Spirig R. ["Alone with the taboo" - The social support experienced by women with vulvar neoplasia: a qualitative study]. Pflege 2018; 31:191-202. [PMID: 29592536 DOI: 10.1024/1012-5302/a000616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
"Alone with the taboo" - The social support experienced by women with vulvar neoplasia: a qualitative study Abstract. BACKGROUND Cancer of the vulva is a gynaecological disease often with relevant impact for these women's daily life. On top of the medical complications, psychological problems might arise as well, due to the impaired quality of life and the withdrawal from social life. We do not know whether and what type of support is given to these patients. AIM The qualitative study aimed at describing how the affected women experience the support they receive from their social environment from the time of the diagnosis to six months postoperatively. METHODS A qualitative design was used. In a secondary analysis, 20 transcribed interviews from the WOMN-PRO study were analysed by qualitative content analysis according to Mayring. RESULTS The findings from the study resulted in four main categories: having a serious disease shows how the patients experience the diagnosis as a shock and are confronted with questions of guilt and taboos. The category feel alone was strongly represented with features of not-speaking out, not looking at it and not-acting. Do it on your own features descriptions of the strategies the women use to get out of their loneliness. In experience help, it is shown that women who try to get in touch with their social environment usually receive support. CONCLUSIONS Patients have a high demand for information concerning the disease and its possible impacts on their daily life as well as emotional and practical support from their families / partners and especially from health professionals. We recommend designating someone who acts throughout the whole treatment process as a mediator and a person of trust.
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Affiliation(s)
| | - Beate Senn
- 2 Institut für Angewandte Pflegewissenschaft IPW-FHS, Fachhochschule St. Gallen
| | - Rebecca Spirig
- 3 Institut für Pflegewissenschaft, Universität Basel.,4 UniversitätsSpital Zürich
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Horn LC, Brambs CE, Handzel R, Mehlhorn G, Schmidt D, Schierle K. [Nomenclature of squamous cell precursor lesions of the lower female genital tract : Current aspects]. DER PATHOLOGE 2017; 37:526-533. [PMID: 27738814 DOI: 10.1007/s00292-016-0239-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The majority of precancerous lesions of the lower female genital tract (intraepithelial neoplasia, IN) are caused by human papillomavirus (HPV) infections resulting in cellular atypia and in turn an altered tissue architecture. Depending on the pathogenesis, a distinction is made between vulvar intraepithelial neoplasia (VIN) classified as classical VIN associated with high-risk HPV infections (u-VIN) and differentiated VIN (d-VIN), which is associated with lichen sclerosus et atrophicus and p53 alterations. In the current World Health Organization (WHO) classification a novel grading system for squamous cell precancerous lesions of the lower female genital tract has been proposed, differentiating low grade squamous intraepithelial lesions (L-SIL) including condyloma and HPV-associated alterations plus VIN 1, vaginal intraepithelial neoplasia (VaIN 1) and cervical intraepithelial neoplasia (CIN 1) from high grade squamous intraepithelial lesions (H-SIL) with VIN 2 and 3, VaIN 2 and 3 as well as CIN 2 and 3. The use of p16 immunohistochemistry can assist the differentiation. The new binary classification, however, contradicts the German cytological nomenclature (Munich nomenclature III), which differentiated three grades of dysplasia in order to avoid overtreatment of patients with moderate IN. The individual nomenclatures are compared to each other. It is recommended to report the grade of precancerous lesions in addition to the SIL classification of the WHO.
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Affiliation(s)
- L-C Horn
- Institut für Pathologie, Abteilung Mamma-, Gynäko- und Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland.
| | - C E Brambs
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München, Deutschland
| | - R Handzel
- Universitätsfrauenklinik Leipzig (Triersches Institut) im Zentrum für Frauen- und Kindermedizin, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland
| | - G Mehlhorn
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - D Schmidt
- Institut für Pathologie, Viersen, Deutschland
| | - K Schierle
- Institut für Pathologie, Abteilung Mamma-, Gynäko- und Perinatalpathologie, Universitätsklinikum Leipzig AöR, Liebigstraße 26, 04103, Leipzig, Deutschland
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Schnürch HG, Ackermann S, Alt CD, Barinoff J, Böing C, Dannecker C, Gieseking F, Günthert A, Hantschmann P, Horn LC, Kürzl R, Mallmann P, Marnitz S, Mehlhorn G, Hack CC, Koch MC, Torsten U, Weikel W, Wölber L, Hampl M. Diagnosis, Therapy and Follow-up Care of Vulvar Cancer and its Precursors. Guideline of the DGGG and DKG (S2k-Level, AWMF Registry Number 015/059, November 2015. Geburtshilfe Frauenheilkd 2016; 76:1035-1049. [PMID: 27765958 DOI: 10.1055/s-0042-103728] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required. This updated guideline aims to disseminate the most recent recommendations, which are much clearer and more individualized, and is intended to create a basis for the assessment and improvement of quality care in hospitals. Methods: This S2k guideline was drafted by members of the AGO Committee on Vulvar and Vaginal Tumors; it was developed and formally completed in accordance with the structured consensus process of the Association of Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). Recommendations: 1. The incidence of disease must be taken into consideration. 2. The diagnostic pathway, which is determined by the initial findings, must be followed. 3. The clinical and therapeutic management of vulvar cancer must be done on an individual basis and depends on the stage of disease. 4. The indications for sentinel lymph node biopsy must be evaluated very carefully. 5. Follow-up and treatment for recurrence must be adapted to the individual case.
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Affiliation(s)
| | | | - C D Alt
- Institut für Diagnostische und Interventionelle Radiologie, Universität Düsseldorf, Düsseldorf
| | - J Barinoff
- Klinik für Gynäkologie und Geburtshilfe, Markus Krankenhaus, Frankfurt am Main
| | - C Böing
- Katholisches Klinikum Oberhausen, Frauenklinik St. Clemens-Hospital, Oberhausen
| | - C Dannecker
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Universität München, Campus Großhadern, München, Munich
| | - F Gieseking
- Dysplasiezentrum in der Frauenarztpraxis Heussweg, Hamburg
| | - A Günthert
- Frauenklinik Luzerner Kantonsspital, Lucerne, Switzerland
| | - P Hantschmann
- Abteilung Gynäkologie und Geburtshilfe, Kreiskliniken Altötting - Burghausen, Altötting
| | - L C Horn
- Institut für Pathologie des Universitätsklinikums Leipzig, Leipzig
| | - R Kürzl
- ehem. Universitätsfrauenklinik Maistraße, Munich
| | - P Mallmann
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der Universität Köln, Cologne
| | - S Marnitz
- Klinik und Poliklinik für Radioonkologie und Strahlentherapie der Universität Köln, Cologne
| | - G Mehlhorn
- Universitätsfrauenklinik Erlangen, Erlangen
| | - C C Hack
- Universitätsfrauenklinik Erlangen, Erlangen
| | - M C Koch
- Universitätsfrauenklinik Erlangen, Erlangen
| | - U Torsten
- Klinik für Gynäkologie und Zentrum für Beckenbodenerkrankungen, Vivantes Klinikum Neukölln, Berlin
| | - W Weikel
- Klinik für Gynäkologie und gynäkologische Onkologie, Universitätsfrauenklinik Mainz, Mainz
| | - L Wölber
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M Hampl
- Klinik für Frauenheilkunde und Geburtshilfe des Universitätsklinikums Düsseldorf, Düsseldorf
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Germann D, Catarino R, Saiji E, Daikeler T, Petignat P, Vassilakos P. Vulvar intraepithelial neoplasia grade 3 associated with Behçet's disease. BMC Res Notes 2016; 9:172. [PMID: 26983442 PMCID: PMC4794835 DOI: 10.1186/s13104-016-1985-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little information is available regarding the association between vulvar intraepithelial neoplasia grade 3 (VIN3) and Behçet's disease (BD). We report here concomitant VIN3 and genital ulcers in a patient with BD. CASE A 44-year-old Caucasian woman with a history of BD, which had been evolving for 6 years, presented with ulcerated and papillomatous lesions on the vulva. Biopsies revealed a multifocal VIN3 positive for high-risk human papillomavirus (HPV) 33. Multiple biopsies were performed to exclude invasive cancer and VIN3 was treated with laser vaporization. CONCLUSION We report clinical and anatomopathological features of a rare case of multifocal, high-risk, HPV-related VIN3. We also discuss the possible pathogenesis in the context of BD, featuring chronic ulceration and intrinsic or treatment-induced immunosuppression.
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Affiliation(s)
- Daphné Germann
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Rosa Catarino
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Essia Saiji
- Department of Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Thomas Daikeler
- Department of Rheumatology, Basel University Hospitals, Basel, Switzerland
| | - Patrick Petignat
- Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Vassilakos
- Geneva Foundation for Medical Education and Research, Geneva, Switzerland
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Alkatout I, Schubert M, Garbrecht N, Weigel MT, Jonat W, Mundhenke C, Günther V. Vulvar cancer: epidemiology, clinical presentation, and management options. Int J Womens Health 2015; 7:305-13. [PMID: 25848321 PMCID: PMC4374790 DOI: 10.2147/ijwh.s68979] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
EPIDEMIOLOGY Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. HISTOLOGY Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%). CLINICAL FEATURES Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain. THERAPY The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema. PROGNOSIS The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival.
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Affiliation(s)
- Ibrahim Alkatout
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Melanie Schubert
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Nele Garbrecht
- Institute for Pathology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marion Tina Weigel
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Walter Jonat
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Christoph Mundhenke
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Veronika Günther
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Beltrão M, Wanderley MSO, de Santana NA, Bruneska D, de Lima Filho JL. Site of infections associated with human papillomavirus. Arch Gynecol Obstet 2014; 291:481-91. [PMID: 25245668 DOI: 10.1007/s00404-014-3480-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/12/2014] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV) is the most clinically common sexually transmitted infection due to its carcinogenic power and the high number of lesions that it causes at different sites of the human body. MATERIAL AND METHODS Genital tract organs are the most common sites where the virus can be found, but by increasing the sensitivity of diagnostic technique, it is possible to identify viral presence in different regions of the body such as the stomach, the lung, and the urinary tract. These findings break with the traditional HPV skin/genital tropic profile and demonstrate that the virus is capable of infecting a wide variety of cells, tissues, and organs or can, at least, survive in these areas. The widespread presence of the HPV in the human body, often in latent form, led us to consider the hypothesis that HPV latency may be associated with no disease. CONCLUSION This observation raises further questions about the possibility of the virus not causing disease in specific sites of the human body, but rather, behaving like a commensal/opportunistic microorganism.
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Affiliation(s)
- Monique Beltrão
- Laboratory of Imunopathology Keizo Asami (LIKA), Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235 Cidade Universitária, Recife, PE, CEP 50670-901, Brazil,
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Simbiri KO, Jha HC, Kayembe MK, Kovarik C, Robertson ES. Oncogenic viruses associated with vulva cancer in HIV-1 patients in Botswana. Infect Agent Cancer 2014; 9:28. [PMID: 25225572 PMCID: PMC4164322 DOI: 10.1186/1750-9378-9-28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 07/04/2014] [Indexed: 12/15/2022] Open
Abstract
Background Oncoviruses such as HPV, KSHV, and EBV have been reported in patients with HIV infection and AIDS. How oncovirus-associated cancers rise in AIDS patients has not been fully established. The purpose of our study was to identify the viral agents in vulvar cancer and to assess their contribution to pathogenesis. Method We retrospectively identified a total of 13 vulva tissue samples from HIV-1 positive and 9 vulvar samples from HIV-1 negative patients from the Botswana National Health Laboratory in Gaborone, Botswana, a Southern African country with a high incidence of HIV. We utilized PCR and IHC to identify HPV, EBV, KSHV, and JC virus in FFPE preserved tissue samples. Results Using the GP5+/GP6+ primer set we detected several HPV types in tissue samples. EBV was detected in all of the positive cases (100%) and in most of the negative cases (89%). KSHV was detected in 39% of the HIV-1 positive samples and in 11% of the negative samples, and no JC virus was detected in any of the samples. Using IHC we demonstrated that LANA was expressed in 61% of the positive samples and in 44% of the negative samples. The ubiquitous EBV was more consistently expressed in negative cases (100%) than in positive cases (69%). Interestingly, the HPV-16 E6 transcript was detected in 56% of the negative samples compared to 31% of the positive samples. However, the cell cycle protein P21 used as a surrogate marker for HPV was detected in 77% of the positive samples and in 44% of the negative samples, while VEGF signals were similar in both positive (92%) and negative samples (89%). Conclusion Our study, suggests that in Botswana, vulvar squamous cell carcinoma (VSCC) is associated with oncogenic viruses present in the niche but the contribution and progression may be regulated by HPV and other immunosuppressive infections that include HIV-1.
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Affiliation(s)
- Kenneth O Simbiri
- Department of Microbiology and Immunology, Upstate Medical University, R2120A, Weiskotten Hall, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Hem C Jha
- Department of Microbiology, Abramson Cancer Center, Tumor Virology Program, Perelman School of Medicine at the University of Pennsylvania, 202A Johnson Pavilion, 3610 Hamilton Walk, Philadelphia, PA 19104-6076, USA
| | | | - Carrie Kovarik
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana ; Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Erle S Robertson
- Department of Microbiology, Abramson Cancer Center, Tumor Virology Program, Perelman School of Medicine at the University of Pennsylvania, 202A Johnson Pavilion, 3610 Hamilton Walk, Philadelphia, PA 19104-6076, USA
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[Update on gynecopathology]. DER PATHOLOGE 2012; 34:25-33. [PMID: 23263439 DOI: 10.1007/s00292-012-1705-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Recent years have witnessed significant achievements in light microscopic, immunohistochemical and molecular diagnostics in gynecopathology. In this article four topics will be discussed as examples. The squamous precancerous and carcinomatous lesions of the female anogenital tract and the cervix are caused by a transforming high risk human papillomavirus (HPV) infection. No differences in morphological findings can be found between the different locations. In contrast to the current WHO classification a new categorization into low grade and high grade precancerous lesions is suggested. Only some cervical adenocarcinomas are related to high risk HPV infection. Nevertheless, some of these unusual variants demonstrate p16 overexpression. Uterine leiomyosarcomas are clinically aggressive neoplasms independent of the histological grade and in most cases curative treatment is not feasible. It is most important to distinguish leiomyosarcoma from those leiomyoma variants which mimic uterine leiomyosarcoma. Pelvic and ovarian serous carcinomas can be separated into low grade and high grade types which differ significantly in formal pathogenesis, molecular features and pathomorphological findings. Significant differences are also obvious in clinical behavior and response to chemotherapy regimens.
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