The prevalence of human papillomavirus type 16 and 18 DNA in cervical cancer in different age groups: a study on the incidental cases of cervical cancer in Norway in 1983

N-Acetyl-L-Cysteine Reduces Cervical Carcinogenesis by Promoting Apoptosis

BACKGROUND AND OBJECTIVE

Cervical cancer is the fourth leading cause of cancer death in women, and is one of the most common malignant tumors of the reproductive system. However, more effective treatment for cervical cancer is needed. In this study, we aim to investigate whether N-acetyl-L-cysteine (NAC) could inhibit the proliferation of human papillomavirus (HPV)-positive cells, and reduce cervical carcinogenesis.

METHODS

The cervical cancer cell lines SiHa, HeLa, HPV-negative cell line C33A, and the immortalized human cervical keratinocyte cells S12 were used. The protein expression was determined using Western blot assay. mRNA expression was determined using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cell proliferation was determined by Cell Counting Kit-8 assay. Cell apoptosis was evaluated using Annexin V-FITC apoptosis kits. The numbers of colonies were measured using colony-forming assay. Xenograft tumor necrosis and HPV16 E7 expression were determined using hematoxylin and eosin (H&E) staining and immunohistochemistry.

RESULTS

Our results showed that NAC treatment at the concentration of 1.5 mM significantly promoted cell apoptosis and reduced cell growth by inhibiting HPV16 E7 expression. NAC inhibited HPV16-oncoprotein-induced hypoxia-inducible factor (HIF)-1α protein expression and Akt activation in vitro. Additionally, NAC suppressed tumor growth, as evidenced by the smaller tumor size in the xenograft mouse model and decreased HPV16 E7 expression in tumor tissues.

CONCLUSION

Our findings demonstrate that NAC exhibits the potential to promote HPV-positive cell apoptosis, and suppress the proliferation of HPV-positive cells by inhibiting cell inhibitor of apoptosis protein 2 and HIF-1α.

The inhibitory effects of bryostatin 1 administration on the growth of rabbit papillomas

Bryostatin 1 is a protein kinase C modulator that shows antineoplastic activity in a variety of tumor systems. This study examined the effects of bryostatin 1 administration on papilloma growth in rabbits. Investigations of optimal route, dose, and schedule were performed. Several groups of rabbits were inoculated with cottontail rabbit papillomavirus (CRPV) DNA. Bryostatin 1 was administered i.v., both daily and weekly, and intralesionally both weekly and bi-weekly. Intralesionally dosed papillomas were examined histologically for immune cell infiltration. In weekly and daily i.v. trials, 2.5 and 1.0 microg/kg, respectively, showed the greatest overall reduction in tumor size. Bryostatin 1 administered intralesionally also slowed papilloma growth. Treated lesions had significantly higher numbers of heterophils and eosinophils.

Human papillomavirus type 16 is detected in transitional cell carcinomas and squamotransitional cell carcinomas of the cervix and endometrium

BACKGROUND

The etiologic role of human papillomavirus (HPV) in a variety of squamous neoplasms, including malignant and premalignant lesions of the cervix, is well established. The presence of HPV, predominantly HPV types 16 and 18, in adenocarcinomas of the endometrium has also been reported, although less commonly. Although rare, transitional cell carcinoma (TCC) in the female genital tract, including such sites as the cervix, endometrium, and ovary, has been described. HPV, however, has not been previously studied in TCC of the female genital tract, the etiology of which is uncertain.

METHODS

Eight cases of primary TCC of the endometrium and six cases of primary TCC of the cervix were retrieved from the files of the Armed Forces Institute of Pathology and the University of Texas Southwestern Medical Center. Slides stained with hematoxylin and eosin were reviewed, and tumor tissue was obtained and analyzed for the presence of HPV types 6, 11, 16, 18, 31, and 33 by polymerase chain reaction (PCR).

RESULTS

HPV was detected by PCR in 4 of 6 TCCs of the cervix (67%) and in 2 of 8 TCCs of the endometrium (25%), using HPV general primers and specific primers to HPV type 16. PCR for HPV using specific primers to HPV types 6 and 11, 18, 31, and 33 were negative in all cases.

CONCLUSIONS

The results of this study demonstrated that HPV type 16 was present in a proportion of primary TCCs of the cervix and endometrium. These findings support the hypothesis that these rare neoplasms are similar, with regard to risk factors, to the more commonly occurring squamous cell carcinomas of the cervix, and suggest that HPV may play an etiologic role in at least a proportion of these tumors.

HPV- and node status in cervical cancer long-term results

OBJECTIVE

To evaluate prognostic significance of HPV-status in cervical cancer and to compare that with the prognostic significance of lymph-node status.

METHODS

Cervical cancer biopsy specimens from primaries and, in surgical cases, from pelvic lymph-nodes too were analysed for the presence of human papillomavirus type 16 DNA-sequences using PCR technique. The management of surgical cases with two exceptions included Wertheim's hysterectomy predominantly with preoperative local radiotherapy and also with postoperative local and external beam radiotherapy depending on the histology. Non-surgical cases were treated with combined local and external radiotherapy to pelvic fields.

RESULTS

Patients have been followed up for an average of 37 months after treatment ranging between 0 and 102 months. The mean progression-free survival time of surgical and non-surgical cases were 43 and 28 months, respectively. Patients with HPV-16 positive biopsies from the cervical primary had an average progression-free survival of 37 months, the same as those with HPV-16 negative cervical biopsies. Those patients who were found to carry HPV-16 DNA in their surgically removed pelvic lymph-nodes had an average of 27 months progression-free survival. The mean progression-free survival among histologically node-positive and node-negative surgical cases were 23 and 42 months, respectively. The mean progression-free survival time of node-positive cases with HPV-16 positive cervical primary was 7.5 months while that of patients with HPV-16 negative cervical biopsy was 38 months. Among histologically node-negative patients, HPV-16 positive and negative cases had an average progression-free survival time of 38 and 46 months, respectively.

CONCLUSIONS

Among those under investigation the most important factors to predict progression-free survival were surgically amenable disease, histologically negative pelvic lymph-nodes and HPV-16 negative cervical biopsies, though this latter one proved significant only among surgical cases.

Younger age as a bad prognostic factor in patients with carcinoma of the cervix

OBJECTIVE

To verify the influence of age on the prognosis of cervix carcinoma.

STUDY DESIGN

Five hundred and sixty eight patients treated for a FIGO stage IB-IVA with radical irradiation in the Centre Hospitalier Universitaire Vaudois of Lausanne were subdivided according to the following age categories: < or = 45, 46-60, 61-69 and >70 years. Taking the 46-60 years age group as the reference, the hazard ratios (HR) of death and corresponding 95% confidence intervals (95% CI) were estimated by means of a Cox multivariate analysis.

RESULTS

The 5-year survival rates were, respectively, 57%, 67%, 60% and 45%. For the youngest women the risk of death was significantly increased (HR = 2.00, 95% CI [1.32-3.00]) and was even more accentuated in advanced stages.

CONCLUSION

Age under 45 years is a bad prognostic factor in carcinoma of the cervix.

Human papillomavirus infection in cervical biopsies from Norwegian gynecological in-patients

Polymerase chain reaction (PCR) and Southern blotting were used to assess the prevalence of HPV in cervical biopsies of 100 women who were treated at the gynecology department of Telemark Central Hospital for non-cancerous conditions. Nine (9%) of the biopsies were HPV positive. Four (4%) were of HPV type 18, one (1%) was HPV11 positive, and four contained different unrecognized HPV types (HPVX). HPV16 was not detected.

The incidental finding of abnormal cervical histology in postmenopausal patients

A report is supplied on 216 samples of cervical tissue incidentally found in 684 endometrial specimens collected during hysteroscopic examination of postmenopausal women with uterine bleeding and a recent negative Pap smear. We found 43 (19.9%) specimens including cervical tissue with some histologic sign of pathology. Twenty-five (11.6%) had histologic features suggestive for human papillomavirus (HPV) infection, while 18 (8.3%) had cervical intraepithelial neoplasia (CIN). Of the 18 CIN cases, 9 were CIN I, 6 CIN II and 3 CIN III. Altogether, the prevalence of dysplasia in postmenopausal women with recently referred normal cervical cytology was impressive. A significant number of dysplastic lesions (14 out of 18, 77.7%) did not present any histologic sign of HPV. Also, none of the histologic diagnoses of sub-clinical HPV infection was confirmed by the in situ hybridization. Considering the significant prevalence of high grade lesions (9 CIN II and III, 4.2% of the analysed samples) found in this randomly selected patient population, our data strongly suggest the need for a regular follow-up of the transformation zone in all postmenopausal women. Although in women of postmenopausal age some low grade lesions seem to have only a reactive-reparative significance, a more accurate screening procedure, taking into account the peculiar modifications of the menopausal uterine cervix, is advisable.

Human papillomavirus DNA in cervical carcinoma--correlation with clinical data and influence on prognosis

Human papillomavirus (HPV) is a main factor in cervical carcinogenesis. However, data on the correlation of HPV with clinical features and the prognosis of cervical carcinoma remain controversial. The HPV status (positivity, type, copy number) in unfixed tissue specimens of 205 primary invasive cervical carcinomas was determined by Southern blot hybridization. A correlation with comprehensive clinical and histopathologic data and long-time survival was evaluated. HPV DNA was detected in 73% of the cases; 83% of the HPV-positive tumors contained HPV 16. HPV 16 was predominant among squamous-cell carcinomas (SCC) (p = 0.05). HPV 16 copy number was higher in keratinizing tumors (p < 0.05), and elevated levels of the SCC antigen were more common in patients positive for HPV 16 (p < 0.03). No association was found between the HPV status and 8 other clinical and histopathologic variables. Multivariate analysis after a median follow-up of 73 months demonstrated longer survival for patients with lower clinical stage (p = 0.001) and keratinizing SCC (p = 0.005). Women with HPV-negative tumors had a higher risk of death (RR 1.51; p = 0.07). HPV analysis does not clearly define biologically distinct sub-sets of cervical carcinoma. This underlines the importance of additional factors in cervical carcinogenesis.

Human papillomavirus infection in Norwegian women with cervical cancer

The objective of the present study was to determine the prevalence of human papillomavirus (HPV) infections in Norwegian women with cervical cancer. We used the polymerase chain reaction (PCR) and Southern blot techniques to assess the prevalence of HPV in cervical biopsies of 133 women admitted to the Norwegian Radium Hospital for treatment of cervical cancer. At the time of sampling (from February 1988 to April 1989) about 85% of Norwegian women with cervical cancer were treated at the Norwegian Radium Hospital. HPV was found in biopsies of 91 (68%) of women with cancer; 70 (53%) biopsies contained HPV type 16, 19 (14%) HPV type 18, 4 (3%) HPV type 33, 2 (1.5%) HPV type 11, and 3 (2%) HPV DNA of unknown type (HPVX). Five percent of biopsies were doubly infected, chiefly with HPV 16 + 18. We found a significant association between HPV 18 and low age, poorly differentiated tumors and adenocarcinomas. Our results show that there is an association between HPV types 16 and 18 and cervical cancer also in a Norwegian setting. PCR was more sensitive than Southern blotting for detection of HPV. Thirty-six (27.5%) of cancer biopsies were positive by PCR but negative by Southern blotting, as against 49 (73.5%) positive by both methods; we also encountered 4 samples positive by Southern blotting and negative by PCR. In 23/53 cancer biopsies positive by Southern blotting we found evidence for integrated or rearranged HPV genomes.

The prevalence of human papillomavirus in cervical lesions with koilocytosis and/or CIN I

Thirty-one patients with koilocytosis and/or concomitant CIN I were analysed for the presence of HPV types 11, 16 and 18 by in situ hybridization and Southern blot analysis. The prevalence of HPV was 48% and 55%, respectively, when measured by the two methods and among the HPV positive, HPV 11 and 16 were present in 47% and 60%, respectively, whereas HPV 18 was not found.