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Sayinzoga F, Tenet V, Heideman DAM, Sibomana H, Umulisa MC, Franceschi S, Hakizimana JDD, Clifford GM, Baussano I. Human papillomavirus vaccine effect against human papillomavirus infection in Rwanda: evidence from repeated cross-sectional cervical-cell-based surveys. Lancet Glob Health 2023; 11:e1096-e1104. [PMID: 37207683 PMCID: PMC10282073 DOI: 10.1016/s2214-109x(23)00193-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Rwanda was the first African country to implement national human papillomavirus (HPV) vaccination (against types HPV6, 11, 16, and 18). In 2011, a school-based catch-up programme was initiated to vaccinate girls aged younger than 15 years but it also reached older girls in schools. We aimed to estimate the population-level effect of HPV vaccination on HPV prevalence. METHODS Cross-sectional surveys were done between July, 2013, and April, 2014 (baseline), and between March, 2019, and December, 2020 (repeat), in sexually active women aged 17-29 years at health centres in the Nyarugenge District of Kigali, Rwanda. HPV prevalence was assessed in cervical cell samples collected by a health-care worker in PreservCyt solution (Cytyc, Boxbourough, MA, USA) and tested using a general primer (GP5+ or GP6+)-mediated PCR. Adjusted overall, total, and indirect (herd immunity) vaccine effectiveness was computed as the percentage of HPV detection among all women and among unvaccinated women. FINDINGS 1501 participants completed the baseline survey and 1639 completed the repeat survey. HPV vaccine-type prevalence in participants aged 17-29 years decreased from 12% (173 of 1501) in the baseline survey to 5% (89 of 1639) in the repeat survey, with an adjusted overall vaccine effectiveness of 47% (95% CI 31 to 60) and an adjusted indirect vaccine effectiveness of 32% (9 to 49). Among participants aged 17-23 years, who were eligible for catch-up vaccination, the adjusted overall vaccine effectiveness was 52% (35 to 65) and the adjusted indirect vaccine effectiveness was 36% (8 to 55), with important heterogeneity according to education (overall vaccine effectiveness was 68% [51 to 79] in participants with ≥6 years of school completed and 16% [-34 to 47] in those with <6 years) and HIV status (overall vaccine effectiveness was 55% [36 to 69] for HIV-negative participants and 24% [-62 to 64] for HIV-positive participants). INTERPRETATION In Rwanda, the prevalence of vaccine-targeted HPV types has been significantly decreased by the HPV vaccine programme, most notably in women who were attending school during the catch-up programme in 2011. HPV vaccine coverage and population-level impact is expected to increase in future cohorts who are eligible for routine HPV vaccination at age 12 years. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Felix Sayinzoga
- Ministry of Health, Rwanda Biomedical Center, Kigali, Rwanda; Susan Thompson Buffett Foundation, Kigali, Rwanda
| | - Vanessa Tenet
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Daniëlle A M Heideman
- Pathology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, Netherlands
| | - Hassan Sibomana
- Ministry of Health, Rwanda Biomedical Center, Kigali, Rwanda
| | - Marie-Chantal Umulisa
- Ministry of Health, Rwanda Biomedical Center, Kigali, Rwanda; Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | | | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Iacopo Baussano
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France.
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Duduyemi BM, Asante DB, Titiloye NA, Ohene-Nketia B, SA A. Molecular Analysis of HBV in Histologically Confirmed Hepatocellular Carcinoma in a Tertiary Hospital in Ghana. Niger Med J 2022; 63:147-154. [PMID: 38803700 PMCID: PMC11128152 DOI: 10.60787/nmj-63-2-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a leading cause of death in Africa. Viral hepatitis B is a leading cause of hepatocellular cancer in Ghana and most African countries except Egypt where hepatitis C virus is more prevalent. This study aims at reviewing the histopathological patterns of HCC and its association with hepatitis B virus in our environment. Methodology Demographics and histological diagnosis were retrieved from the surgical daybook and archival FFPE tissue samples with histopathologically confirmed HCC were used for this study. Sections (10μm) were taken from the tissues and digested to obtain DNA lysates. The DNA lysates were used in polymerase chain reaction (PCR) to determine the prevalence of HBV in the biopsies. Result Of the 24 confirmed cases of HCC seen in the 5-year period, there were 17 males and 7 females with M:F ratio of 2.4:1. The mean age of our patients was 39.92 ± 1.98 years with age range 13-85 years. 50% of the cases were moderately differentiated while 25% each were well and poorly differentiated. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Out of the 24 archival HCC biopsies screened, HBV DNA PCR amplification was achieved in 11 (45.83%) after the restriction fragment length polymorphism PCR reaction. Eight of the 11 cases were found in the male and 3 in females. Of the 11 (45.83%) samples that were positive for HBV DNA, 3 were above 40 years and 8 were 40 years and younger. Conclusion The overall prevalence of HBV DNA in our study was 45.83% and a greater proportion seen in ≤ 40 years. This suggests that most of our patients are infected with HBV early in life in our environment.
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Affiliation(s)
- Babatunde Moses Duduyemi
- Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Pathology, University of Sierra Leone Teaching Hospitals Complex & College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | - Du-Bois Asante
- Department of Biomedical Science, University of Cape Coast, Cape Coast, Ghana
| | - Nicholas Akinwale Titiloye
- Department of Pathology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Adams SA
- Department of Biomedical Science, University of Cape Coast, Cape Coast, Ghana
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Baussano I, Sayinzoga F, Tshomo U, Tenet V, Vorsters A, Heideman DAM, Gheit T, Tommasino M, Umulisa MC, Franceschi S, Clifford GM. Impact of Human Papillomavirus Vaccination, Rwanda and Bhutan. Emerg Infect Dis 2021; 27:1-9. [PMID: 33350922 PMCID: PMC7774553 DOI: 10.3201/eid2701.191364] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rwanda and Bhutan, 2 low- and middle-income countries, implemented primarily school-based national human papillomavirus (HPV) vaccination in 2011 (Rwanda) and 2010 (Bhutan). We estimated vaccination effectiveness through urine-based HPV prevalence surveys in schools in 2013–2014 and 2017. In Rwanda, 912 participants from baseline surveys and 1,087 from repeat surveys were included, and in Bhutan, 973 participants from baseline surveys and 909 from repeat surveys were included. The overall effectiveness against vaccine-targeted HPV types (i.e., HPV-6/11/16/18) was 78% (95% CI 51%–90%) in Rwanda, and 88% (6%–99%) in Bhutan and against other α-9 types was 58% (21–78) in Rwanda and 63% (27–82) in Bhutan. No effect against other HPV types was detectable. Prevalence of vaccine-targeted HPV types decreased significantly, as well as that of other α-9 types, suggesting cross-protection. These findings provide direct evidence from low- and middle-income countries of the marked effectiveness of high-coverage school-based, national HPV vaccination programs.
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Hoelzle CR, Arnoult S, Borém CRM, Ottone M, de Magalhães KCSF, da Silva IL, Simões RT. microRNA Levels in Cervical Cancer Samples and Relationship with Lesion Grade and HPV Infection. Microrna 2021; 10:139-145. [PMID: 34086555 DOI: 10.2174/2211536610666210604123534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/12/2020] [Accepted: 03/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND miR-21, miR-214, and miR-let-7a are three validated and well-known miRNAs. miR-21 is described as an "oncomir," while miR-214 and miR-let-7a are described mainly as tumor suppressors. The role of these miRNAs remains unclear in cervical cancer, an important malignancy among women worldwide and responsible for many deaths every year. OBJECTIVE The objective of this study was to describe the expression profile of miR-21, miR-214, and miR-let-7a in plasma and cervical scraping from a control group and patients with different grades of cervical lesions and invasive cervical cancer, and then correlate with HPV infection groups. METHODS Plasma and cervical scraping were submitted to DNA and RNA extraction. HPV detection and typing were performed by conventional PCR followed by PAGE to amplicons interpretation. The miRNA relative expression in plasma and cervical scraping samples was performed by real-time PCR using specific TaqMan probes. RESULTS miR-21 (p=0.0277) and miR-214 (p=0.0151) were up-regulated in cervical scraping samples of the invasive cervical cancer (ICC) group. However, miR-214 was also up-regulated in the LSIL group (p=0.0062). Both miRNAs were not related to HPV infection. However, miR-let-7a was higher in HPV positive plasma samples (p=0.0433) than in HPV negative plasma samples, and the correlation analysis confirmed the association between the levels of this miRNA with the presence of HPV (p=0.0407; r=0.3029), but not with lesion grade (p>0.05). CONCLUSION Our results suggest that miR-21 is related to cervical cancer progression and miR-214 appears to have an ambiguous role in cervical lesions. miR-let-7a may be upregulated at the systemic level in patients with HPV infection.
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Affiliation(s)
- Carolina R Hoelzle
- Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH. Molecular Biology and Biomarkers Laboratory. Belo Horizonte, Minas Gerais, Brazil
| | - Solène Arnoult
- Polytech Marseille. Aix-Marseille Université. Marseille, France
| | - Cinthya R M Borém
- Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH. Molecular Biology and Biomarkers Laboratory. Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Ottone
- Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH. Molecular Biology and Biomarkers Laboratory. Belo Horizonte, Minas Gerais, Brazil
| | - Kênia C S F de Magalhães
- Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH. Molecular Biology and Biomarkers Laboratory. Belo Horizonte, Minas Gerais, Brazil
| | - Istéfani L da Silva
- Center for Biological and Health Sciences. Federal University of West of Bahia (UFOB), Bahia, Brazil
| | - Renata T Simões
- Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH. Molecular Biology and Biomarkers Laboratory. Belo Horizonte, Minas Gerais, Brazil
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Baussano I, Tshomo U, Tenet V, Heideman DAM, Wangden T, Franceschi S, Clifford GM. Prevalence of Human Papillomavirus and Estimation of Human Papillomavirus Vaccine Effectiveness in Thimphu, Bhutan, in 2011-2012 and 2018 : A Cross-sectional Study. Ann Intern Med 2020; 173:888-894. [PMID: 32956600 DOI: 10.7326/m20-2849] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bhutan implemented a national program for human papillomavirus (HPV) vaccination in 2010 involving girls aged 12 to 18 years and achieving nearly 90% coverage. OBJECTIVE To estimate HPV vaccine effectiveness in a city in Bhutan. DESIGN 2 cross-sectional surveys, 2011-2012 and 2018. SETTING 2 hospitals in Thimphu, capital of Bhutan. PARTICIPANTS Sexually active women aged 17 to 29 years: 1445 participants from the baseline survey and 1595 from the repeated survey. INTERVENTION National HPV vaccination program. MEASUREMENTS HPV was assessed in cervical cell samples by using general primer GP5+/GP6+-mediated polymerase chain reaction. Human papillomavirus types were stratified as vaccine types (HPV6/11/16/18) and nonvaccine types. Age- and sexual behavior-adjusted overall, total, and indirect (herd immunity) vaccine effectiveness (VE) was computed as (1 - HPV prevalence ratio) for HPV among all women and among unvaccinated women. RESULTS Between the 2 surveys, the prevalence of HPV vaccine types decreased from 8.3% to 1.4%, whereas the prevalence of nonvaccine types increased from 25.8% to 31.4%. The overall and indirect adjusted VE against vaccine-targeted HPV types was 88% (95% CI, 80% to 92%) and 78% (CI, 61% to 88%), respectively. Among women younger than 27 years, who were targeted by the vaccination program, the overall and indirect adjusted VE was 93% (CI, 87% to 97%) and 88% (CI, 69% to 95%), respectively. No impact on nonvaccine HPV types was detectable. LIMITATION Hospital-based recruitment; self-reported vaccination status. CONCLUSION In Bhutan, the prevalence of vaccine-targeted HPV types has decreased sharply, providing the first evidence of the effectiveness of a high-coverage national HPV vaccination program in a lower-middle-income country. PRIMARY FUNDING SOURCE Bill & Melinda Gates Foundation.
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Affiliation(s)
- Iacopo Baussano
- International Agency for Research on Cancer, Lyon, France (I.B., V.T., G.M.C.)
| | - Ugyen Tshomo
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan (U.T., T.W.)
| | - Vanessa Tenet
- International Agency for Research on Cancer, Lyon, France (I.B., V.T., G.M.C.)
| | - Daniëlle A M Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands (D.A.H.)
| | - Tshering Wangden
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan (U.T., T.W.)
| | | | - Gary M Clifford
- International Agency for Research on Cancer, Lyon, France (I.B., V.T., G.M.C.)
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Petrini CG, Bastos LB, Duarte G, Dos Santos Melli PP, Alves-Filho JC, Quintana SM. Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study. Acta Cytol 2020; 64:442-451. [PMID: 32599588 DOI: 10.1159/000508015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/15/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. OBJECTIVE This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). METHODS A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. RESULTS The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). CONCLUSIONS Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.
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Affiliation(s)
- Caetano Galvão Petrini
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Larissa Brito Bastos
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Geraldo Duarte
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - José Carlos Alves-Filho
- Pharmacology Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Silvana Maria Quintana
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil,
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Mpunga T, Chantal Umulisa M, Tenet V, Rugwizangoga B, Milner Jr DA, Munyanshongore C, Heideman DA, Bleeker MC, Tommasino M, Franceschi S, Baussano I, Gheit T, Sayinzoga F, Clifford GM. Human papillomavirus genotypes in cervical and other HPV-related anogenital cancer in Rwanda, according to HIV status. Int J Cancer 2020; 146:1514-1522. [PMID: 31173641 PMCID: PMC7003740 DOI: 10.1002/ijc.32491] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022]
Abstract
The study aim was to describe human papillomavirus (HPV)-attributable cancer burden in Rwanda, according to anogenital cancer site, HPV type, age and HIV status. Tissue specimens of cervical, vulvar, vaginal, penile and anal cancer diagnosed in 2012-2018 were retrieved from three cancer referral hospitals and tested for high-risk (HR) HPV DNA. Cervical cancer represented the majority of cases (598 of 738), of which 96.0% were HR-HPV positive. HPV-attributable fractions in other cancer sites varied from 53.1% in 81 penile, through 76.7% in 30 vulvar, 83.3% in 24 vaginal, up to 100% in 5 anal cases. HPV16 was the predominant HR-HPV type in cervical cancer (55.0%), followed by HPV18 (16.6%) and HPV45 (13.4%). HPV16 also predominated in other cancer sites (60-80% of HR-HPV-attributable fraction). For cervical cancer, type-specific prevalence varied significantly by histology (higher alpha-9 type prevalence in 509 squamous cell carcinoma vs. higher alpha-7 type prevalence in 80 adenocarcinoma), but not between 501 HIV-negative and 97 HIV-positive cases. With respect to types targeted, and/or cross-protected, by HPV vaccines, HPV16/18 accounted for 73%, HPV31/33/45/52/58 for an additional 22% and other HR-HPV types for 5%, of HPV-attributable cancer burden, with no significant difference by HIV status nor age. These data highlight the preventive potential of the ongoing national HPV vaccination program in Rwanda, and in sub-Saharan Africa as a whole. Importantly for this region, the impact of HIV on the distribution of causal HPV types was relatively minor, confirming type-specific relevance of HPV vaccines, irrespective of HIV status.
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Affiliation(s)
- Tharcisse Mpunga
- Butaro Cancer Centre of ExcellenceMinistry of HealthButaroRwanda
| | - Marie Chantal Umulisa
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
- International Agency for Research on CancerLyonFrance
| | - Vanessa Tenet
- International Agency for Research on CancerLyonFrance
| | - Belson Rugwizangoga
- Department of PathologyUniversity Teaching Hospital of KigaliKigaliRwanda
- University of Rwanda School of Medicine and PharmacyKigaliRwanda
| | | | | | - Daniëlle A.M. Heideman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | - Maaike C.G. Bleeker
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pathology, Cancer Center AmsterdamAmsterdamThe Netherlands
| | | | | | | | - Tarik Gheit
- International Agency for Research on CancerLyonFrance
| | - Felix Sayinzoga
- Rwanda Biomedical CentreMinistry of Health of RwandaKigaliRwanda
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Umulisa MC, Franceschi S, Baussano I, Tenet V, Uwimbabazi M, Rugwizangoga B, Heideman DAM, Uyterlinde AM, Darragh TM, Snijders PJF, Sayinzoga F, Clifford GM. Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda. BMC Womens Health 2018; 18:59. [PMID: 29699549 PMCID: PMC5921370 DOI: 10.1186/s12905-018-0549-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/09/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A pilot screening campaign in Rwanda, based on careHPV-testing followed by visual inspection with acetic acid triage (careHPV+VIA triage), was evaluated against other WHO-recommended screening options, namely HPV screen-and-treat and VIA screen-and-treat. METHODS 764 women aged 30-69 underwent at visit 1: i) VIA, and cervical cell collection for ii) careHPV in Rwanda, and iii) liquid-based cytology and GP5+/6+ HR-HPV PCR in The Netherlands. All 177 women positive by VIA, careHPV and/or PCR were recalled, of whom 84% attended. At visit 2, VIA was again used to triage screen-positive women for treatment and to obtain biopsies from all women either from visible lesions or at 12 o'clock of the squamocolumnar junction. Cross-sectional screening indices were estimated primarily against histological high-grade squamous intraepithelial lesions or worse (hHSIL+), after imputation of missing histology data, based on 1-visit or 2-visit approaches. RESULTS In a 1-visit screen-and-treat approach, VIA had sensitivity and specificity of 41% and 96%, respectively, versus 71% and 88% for careHPV, and 88% and 86% for PCR. In a 2-visit approach (in which hHSIL+ imputed among women without visit 2 were considered untreated) careHPV sensitivity dropped to 59% due to loss of 13% of hHSIL+. For careHPV+VIA triage, sensitivity dropped further to 35%, as another 24% of hHSIL+ were triaged to no treatment. CONCLUSIONS CareHPV was not as sensitive as gold-standard PCR, but detected considerably more hHSIL+ than VIA. However, due to careHPV-positive hHSIL+ women being lost to follow-up and/or triaged to no treatment, 2-visit careHPV+VIA triage did not perform better than VIA screen-and-treat.
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Affiliation(s)
| | - Silvia Franceschi
- Cancer Epidemiology Unit, Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | | | - Belson Rugwizangoga
- Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda
- University of Rwanda School of Medicine and Pharmacy, Kigali, Rwanda
| | | | - Anne M. Uyterlinde
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Peter J. F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Gary M. Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
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de Abreu PM, Có ACG, Azevedo PL, do Valle IB, de Oliveira KG, Gouvea SA, Cordeiro-Silva MF, Louro ID, de Podestá JRV, Lenzi J, Sena A, Mendonça EF, von Zeidler SLV. Frequency of HPV in oral cavity squamous cell carcinoma. BMC Cancer 2018; 18:324. [PMID: 29580212 PMCID: PMC5870524 DOI: 10.1186/s12885-018-4247-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/19/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The prevalence of high-risk human papillomavirus (HPV) DNA in cases of oral cavity squamous cell carcinoma (SCC) varies widely. The aim of this study is to investigate the frequency of high-risk HPV DNA in a large Brazilian cohort of patients with oral cavity SCC. METHODS Biopsy and resected frozen and formalin-fixed paraffin-embedded specimens of oral cavity SCC were available from 101 patients who were recruited at two Brazilian centres. Stringent measures with respect to case selection and prevention of sample contamination were adopted to ensure reliability of the data. Nested PCR using MY09/MY11 and GP5+/GP6+ as well as PGMY09/11 L1 consensus primers were performed to investigate the presence of HPV DNA in the tumours. HPV-positive cases were subjected to direct sequencing. Shapiro-Wilk and Student t test were used to evaluate data normality and to compare the means, respectively. Qualitative variables were analysed by logistic regression. RESULTS Our results demonstrate that the frequency of high-risk HPV types in oral cavity SCC is very low and is less than 4%. All HPV-positive cases were HPV16. In addition, our results do not show a significant association between the tumour clinical features and the risk factors (tobacco, alcohol and HPV) for oral cavity SCC. CONCLUSION In the current study, we observed an overlapping pattern of risk factors that are related to tumour development. This, along with a low frequency of high-risk HPV DNA, supports the findings that HPV is not involved in the genesis of oral cavity SCC in Brazilian population.
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Affiliation(s)
- Priscila Marinho de Abreu
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Anna Clara Gregório Có
- Departamento de Patologia, Programa de Pós-graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Av. Marechal Campos, 1468 Maruípe, Vitória, ES, 29.040-090, Brazil
| | - Pedro Leite Azevedo
- Departamento de Patologia, Programa de Pós-graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Av. Marechal Campos, 1468 Maruípe, Vitória, ES, 29.040-090, Brazil
| | - Isabella Bittencourt do Valle
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Karine Gadioli de Oliveira
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Sônia Alves Gouvea
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | | | - Iúri Drummond Louro
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - José Roberto Vasconcelos de Podestá
- Programa de Prevenção e Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brazil
| | - Jeferson Lenzi
- Programa de Prevenção e Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brazil
| | - Agenor Sena
- Programa de Prevenção e Detecção Precoce do Câncer Bucal, Setor de Cirurgia de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brazil
| | | | - Sandra Lúcia Ventorin von Zeidler
- Programa de Pós-Graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil. .,Departamento de Patologia, Programa de Pós-graduação em Biotecnologia, Centro de Ciências da Saúde, Universidade Federal do Espirito Santo, Av. Marechal Campos, 1468 Maruípe, Vitória, ES, 29.040-090, Brazil.
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10
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Tshomo U, Franceschi S, Tshokey T, Tobgay T, Baussano I, Tenet V, Heideman DA, Snijders PJ, Clifford GM. Evaluation of cytology versus human papillomavirus-based cervical cancer screening algorithms in Bhutan. Oncotarget 2017; 8:72438-72446. [PMID: 29069800 PMCID: PMC5641143 DOI: 10.18632/oncotarget.19783] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 06/26/2017] [Indexed: 12/22/2022] Open
Abstract
To evaluate the performance of existing versus alternative cervical cancer screening protocols in Bhutan, cervical exfoliated cells were collected for cytology and high-risk human papillomavirus (HR-HPV) testing among 1,048 women aged 30-69 years. Conventional smears were prepared and read locally. HR-HPV was tested by GP5+/6+ polymerase chain reaction, followed by genotyping and human DNA methylation analysis among HR-HPV-positives, in Europe. Test positivity was 7.5% for ASCUS or worse (ASCUS+) cytology and 14.0% for HR-HPV. All women with ASCUS+ and/or HR-HPV positivity (n=192) were recalled for colposcopy, among whom a total of 29 cases of histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were identified. An additional 7 CIN2+ cases were imputed among women without colposcopy. Corrected sensitivities for CIN2+ and CIN3+ were 61% and 74% for ASCUS+, 86% and 96% for HR-HPV, and 47% and 70% for ASCUS+ triage of HR-HPV. Specificity varied from 88% for HR-HPV up to 98% for ASCUS+ triage of HR-HPV, similarly for CIN2+ and CIN3+. Among HR-HPV-positive women with biopsies, methylation analysis offered similar discrimination of CIN2/3 and cervical cancer as ASCUS+, and better than HPV16/18 genotyping alone, but sample sizes were limited. In conclusion, the performance of cytology in Bhutan is in the mid-range of that reported in other screening settings. HR-HPV testing has the potential to improve detection of CIN2+, albeit with a higher referral rate for colposcopy. Cytological triage of HR-HPV-positives (performed in the absence of knowledge of HR-HPV status) reduced referral but missed more than one third of CIN2+.
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Affiliation(s)
- Ugyen Tshomo
- Department of Obstetrics & Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | | - Tshokey Tshokey
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Tobgay
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | | - Vanessa Tenet
- International Agency for Research on Cancer, Lyon, France
| | | | - Peter J.F. Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
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11
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Tshomo U, Franceschi S, Tshokey T, Tobgay T, Baussano I, Tenet V, Snijders PJF, Gheit T, Tommasino M, Vorsters A, Clifford GM. Evaluation of the performance of Human Papillomavirus testing in paired urine and clinician-collected cervical samples among women aged over 30 years in Bhutan. Virol J 2017; 14:74. [PMID: 28390433 PMCID: PMC5385028 DOI: 10.1186/s12985-017-0744-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/29/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Urine sampling may offer a less invasive solution than cervical sampling to test for human papillomavirus (HPV) for HPV vaccine impact monitoring. METHODS Paired samples of urine and exfoliated cervical cells were obtained for 89 women with history of high-risk (HR) HPV-positive normal cytology in Bhutan. Urine sampling protocol included self-collection of first-void urine immediately into a conservation medium and procedures to optimize DNA yield. Colposcopical abnormalities were biopsied. Two HPV assays were used: a multiplex type-specific PCR (E7-MPG) and a less analytically sensitive GP5+/6+ PCR followed by reverse line blot. RESULTS HPV positivity for 21 types common to both assays was similar in urine and cells by E7-MPG (62.9% and 57.3%, respectively, p = 0.32) but lower in urine by GP5+/6+ (30.3% and 40.4%, p = 0.05). HPV6/11/16/18 positivity did not significantly differ between urine and cells by either assay. Sensitivity of urine (using cells as gold standard) to detect 21 HPV types was 80% and 58% for E7-MPG and GP5+/6+, respectively, with specificity 61% and 89%. HPV type distribution in urine and cells was similar, regardless of assay. The 5 detected CIN3+ were HR-HPV positive in cells by both assays, compared to 4 and 3 by E7-MPG and GP5+/6+, respectively, in urine samples. CONCLUSION For the monitoring of vaccine impact, we demonstrate validity of a urine sampling protocol to obtain HPV prevalence data that are broadly comparable to that from cervical cells. However, detection of HPV in urine varies according to assay sensitivity, presumably because low level infections are frequent.
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Affiliation(s)
- Ugyen Tshomo
- Department of Obstetrics & Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Tshokey Tshokey
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tashi Tobgay
- Department of Pathology & Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Peter J. F. Snijders
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Tarik Gheit
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Massimo Tommasino
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Gary M. Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
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12
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Asante DB, Asmah RH, Adjei AA, Kyei F, Simpong DL, Brown CA, Gyasi RK. Detection of Human Papillomavirus Genotypes and Epstein-Barr Virus in Nasopharyngeal Carcinomas at the Korle-Bu Teaching Hospital, Ghana. ScientificWorldJournal 2017; 2017:2721367. [PMID: 28421207 PMCID: PMC5379089 DOI: 10.1155/2017/2721367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/28/2017] [Accepted: 03/08/2017] [Indexed: 11/18/2022] Open
Abstract
Nasopharyngeal carcinomas (NPC) are endemic in Far East Asia and commonly harbour Epstein-Barr virus (EBV) which is known to serve as a key oncogenic promoter. Human papillomavirus (HPV) is known to contribute to the pathogenesis of NPC. However, in Ghana these two viruses have not been linked to NPC prevalence. This study was designed to determine the HPV genotypes and EBV involved in NPC tissue biopsies. A retrospective study design involving 72 formalin-fixed paraffin-embedded tissue (FFPET) samples of NPC from 2006 to 2012 were retrieved from the Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences. Sections were taken for histological analysis and for DNA lysate preparation. The DNA lysates were subjected to polymerase chain reaction (PCR) analysis to determine the presence of HPV genotypes and EBV. HPV specific primers were used to type for fourteen HPV genotypes (HPV-16, 18, 6/11, 31, 33, 35, 44, 42, 43, 45, 56, 52, 58, and 59). Out of the 72 NPC biopsies analyzed by PCR, EBV DNA was present in 18 (25%) cases and HPV DNA in 14 (19.23%). High risk HPV (HR-HPV) genotypes 18 and 31 were associated with the NPC. There were 3 (4.2%) cases of coinfection by both viruses. The EBV DNA present in the undifferentiated variant of the NPC and the histopathology of the NPC in Ghana is similar to the type described in endemic areas.
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Affiliation(s)
- Du-Bois Asante
- Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 4236, Korle-Bu, Accra, Ghana
- Biomedical and Forensic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Richard Harry Asmah
- Medical Laboratory Sciences, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Andrew Anthony Adjei
- Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 4236, Korle-Bu, Accra, Ghana
| | - Foster Kyei
- Molecular Biology and Biotechnology, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - David Larbi Simpong
- Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 4236, Korle-Bu, Accra, Ghana
| | - Charles Addoquaye Brown
- Medical Laboratory Sciences, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Richard Kwasi Gyasi
- Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, College of Health Sciences, P.O. Box KB 4236, Korle-Bu, Accra, Ghana
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13
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Prevalence and risk factors for human papillomavirus infection among Chinese ethnic women in southern of Yunnan, China. Braz J Infect Dis 2017; 21:325-332. [PMID: 28284657 PMCID: PMC9427817 DOI: 10.1016/j.bjid.2017.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 11/22/2022] Open
Abstract
Background Dai is a major Chinese ethnic minority group residing in rural areas of the southern part of Yunnan. However, no data exist on the Human Papillomavirus (HPV) prevalence and genotype distribution among Dai women. Method A total of 793 participants (Dai = 324, Han = 251, other ethnic = 218) were included in this study. PCR was performed to detect the HPV-positive samples, and genotyping was performed with an HPV Geno-Array. Result The overall HPV prevalence was very low among Dai women compared to the others. The prevalence of high-risk-HPV infections was significantly higher (p = 0.001) among other ethnic women (22.0%) than that among Han (13.1%) and Dai women (7.1%). The overall HPV, high-risk-HPV, single and multiple infection prevalence among rural women were 12.9%, 12.1%, 12.3%, and 0.5%, respectively. HPV-16 (5.5%) was shown to be the most prevalent genotype, followed by HPV-52 (2.6%) and HPV-58 (2.4%). Urban women had relatively higher rates of overall HPV (16.0%), high-risk-HPV (14.1%), single genotype (11.9%), and multiple genotype (4.1%) infections. In urban women, HPV-52 (3.6%) was the most prevalent genotype, followed by HPV-39 (2.7%) and HPV-16 (1.2%). In the urban area, HPV prevalence was highest in women aged <29 years, but declined with increasing age. However, in rural women, the highest HPV prevalence was observed among women at older age (>50 years). Education and smoking habit were significantly associated with HPV infection among both rural and urban area women (p < 0.001). Conclusion The prevalence and genotype distribution of HPV varied among ethnic women in urban and rural area of Yunnan Province.
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Clifford GM, Vaccarella S, Franceschi S, Tenet V, Umulisa MC, Tshomo U, Dondog B, Vorsters A, Tommasino M, Heideman DAM, Snijders PJF, Gheit T. Comparison of Two Widely Used Human Papillomavirus Detection and Genotyping Methods, GP5+/6+-Based PCR Followed by Reverse Line Blot Hybridization and Multiplex Type-Specific E7-Based PCR. J Clin Microbiol 2016; 54:2031-8. [PMID: 27225411 PMCID: PMC4963525 DOI: 10.1128/jcm.00618-16] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/12/2016] [Indexed: 11/20/2022] Open
Abstract
GP5+/6+-based PCR followed by reverse line blot hybridization (GP5+/6+RLB) and multiplex type-specific PCR (E7-MPG) are two human papillomavirus (HPV) genotyping methodologies widely applied in epidemiological research. We investigated their relative analytical performance in 4,662 samples derived from five studies in Bhutan, Rwanda, and Mongolia coordinated by the International Agency for Research on Cancer (IARC). A total of 630 samples were positive by E7-MPG only (13.5%), 24 were positive by GP5+/6+RLB only (0.5%), and 1,014 were positive (21.8%) by both methods. Ratios of HPV type-specific positivity of the two tests (E7-MPG:GP5+/6+RLB ratio) were calculated among 1,668 samples that were HPV positive by one or both tests. E7-MPG:GP5+/6+RLB ratios were >1 for all types and highly reproducible across populations and sample types. E7-MPG:GP5+/6+RLB ratios were highest for HPV53 (7.5) and HPV68 (7.1). HPV16 (1.6) and HPV18 (1.7) had lower than average E7-MPG:GP5+/6+RLB ratios. Among E7-MPG positive infections, median mean fluorescence intensity (MFI; a semiquantitative measure of viral load) tended to be higher among samples positive for the same virus type by GP5+/6+RLB than for those negative for the same type by GP5+/6+RLB. Exceptions, however, included HPV53, -59, and -82, for which the chances of being undetected by GP5+/6+RLB appeared to be MFI independent. Furthermore, the probability of detecting an additional type by E7-MPG was higher when another type was already detected by GP5+/6+RLB, suggesting the existence of masking effects due to competition for GP5+/6+ PCR primers. In conclusion, this analysis is not an evaluation of clinical performance but may inform choices for HPV genotyping methods in epidemiological studies, when the relative merits and dangers of sensitivity versus specificity for individual types should be considered, as well as the potential to unmask nonvaccine types following HPV vaccination.
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Affiliation(s)
| | | | | | - Vanessa Tenet
- International Agency for Research on Cancer, Lyon, France
| | | | - Ugyen Tshomo
- Department of Obstetrics and Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Bolormaa Dondog
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | | | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Tarik Gheit
- International Agency for Research on Cancer, Lyon, France
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15
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Franceschi S, Chantal Umulisa M, Tshomo U, Gheit T, Baussano I, Tenet V, Tshokey T, Gatera M, Ngabo F, Van Damme P, Snijders PJF, Tommasino M, Vorsters A, Clifford GM. Urine testing to monitor the impact of HPV vaccination in Bhutan and Rwanda. Int J Cancer 2016; 139:518-26. [PMID: 26991686 DOI: 10.1002/ijc.30092] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/18/2016] [Accepted: 02/17/2016] [Indexed: 01/08/2023]
Abstract
Bhutan (2010) and Rwanda (2011) were the first countries in Asia and Africa to introduce national, primarily school-based, human papillomavirus (HPV) vaccination programmes. These target 12 year-old girls and initially included catch-up campaigns (13-18 year-olds in Bhutan and ninth school grade in Rwanda). In 2013, to obtain the earliest indicators of vaccine effectiveness, we performed two school-based HPV urine surveys; 973 female students (median age: 19 years, 5th-95th percentile: 18-22) were recruited in Bhutan and 912 (19 years, 17-20) in Rwanda. Participants self-collected a first-void urine sample using a validated protocol. HPV prevalence was obtained using two PCR assays that differ in sensitivity and type spectrum, namely GP5+/GP6+ and E7-MPG. 92% students in Bhutan and 43% in Rwanda reported to have been vaccinated (median vaccination age = 16, 5th-95th: 14-18). HPV positivity in urine was significantly associated with sexual activity measures. In Rwanda, HPV6/11/16/18 prevalence was lower in vaccinated than in unvaccinated students (prevalence ratio, PR = 0.12, 95% confidence interval, CI: 0.03-0.51 by GP5+/GP6+, and 0.45, CI: 0.23-0.90 by E7-MPG). For E7-MPG, cross-protection against 10 high-risk types phylogenetically related to HPV16 or 18 was of borderline significance (PR = 0.68; 95% CI: 0.45-1.01). In Bhutan, HPV6/11/16/18 prevalence by GP5+/GP6+ was lower in vaccinated than in unvaccinated students but CIs were broad. In conclusion, our study supports the feasibility of urine surveys to monitor HPV vaccination and quantifies the effectiveness of the quadrivalent vaccine in women vaccinated after pre-adolescence. Future similar surveys should detect increases in vaccine effectiveness if vaccination of 12 year-olds continues.
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Affiliation(s)
- Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | | | - Ugyen Tshomo
- Department of Obstetrics & Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Tarik Gheit
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Tshokey Tshokey
- Department of Laboratory Services, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | | | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 Amsterdam, HV, The Netherlands
| | - Massimo Tommasino
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - Gary M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France
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16
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Baloch Z, Yuan T, Yindi S, Feng Y, Tai W, Liu Y, Liu L, Zhang A, Wang B, Wu X, Xia X. Prevalence of genital human papillomavirus among rural and urban populations in southern Yunnan province, China. ACTA ACUST UNITED AC 2016; 49:e5254. [PMID: 27254662 PMCID: PMC4932820 DOI: 10.1590/1414-431x20165254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/11/2016] [Indexed: 11/22/2022]
Abstract
This study was designed to investigate and compare the HPV prevalence, genotypes distribution and associated risk factors in rural and urban women living in Xishuang Banna district, in the province of Yunnan. A total of 177 and 190 women from rural and urban areas were engaged, respectively. HPV DNA was amplified using the L1 consensus primers system (MY09/11 and GP5/6) and HPV GenoArray test was conducted for genotyping. Proportions were compared by chi-square test, and logistic regression was used to evaluate risk factors. A total of 54 women were positive for HPV DNA. Among rural women, 23 women were positive for HPV infection, of which 21 showed a single infection and 2 had a multiple infection. HPV-16 (10/23) was the most prevalent genotype followed by HPV-52 (5/23), and HPV-58 (5/23). Urban women had a higher infection rate for overall HPV (31/54) and for multiple genotype infection (8/31). HPV-52 (9/31) was the most prevalent genotype followed by HPV-39 (7/31) and HPV-68 (5/31). The age-specific HPV prevalence was also different between rural and urban women. In urban area, women with age <35 years had the highest HPV prevalence, which declined thereafter as age advanced. However, in rural women the highest HPV prevalence was observed in an older age group (>56 years). Ethnicity, smoking and parity were significantly associated with HPV infection among urban women. Our study demonstrates that HPV prevalence and genotype distribution varies among women from rural and urban areas in the south of Yunnan.
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Affiliation(s)
- Z Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - T Yuan
- Yunnan Province, Kunming, China
| | - S Yindi
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Y Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - W Tai
- The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Y Liu
- Yunnan Province, Kunming, China
| | - L Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - A Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - B Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - X Wu
- Yunnan Province, Kunming, China
| | - X Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
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17
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Ngabo F, Franceschi S, Baussano I, Umulisa MC, Snijders PJF, Uyterlinde AM, Lazzarato F, Tenet V, Gatera M, Binagwaho A, Clifford GM. Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme. BMC Infect Dis 2016; 16:225. [PMID: 27221238 PMCID: PMC4877733 DOI: 10.1186/s12879-016-1539-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 05/05/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). METHODS To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18-69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR. RESULTS HPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women. CONCLUSIONS This study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.
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Affiliation(s)
- Fidele Ngabo
- Ministry of Health of Rwanda, Kigali, Rwanda
- Université Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | | | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Anne M Uyterlinde
- Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Fulvio Lazzarato
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
| | | | - Agnes Binagwaho
- Ministry of Health of Rwanda, Kigali, Rwanda
- Harvard Medical School, Boston, MA, USA
- Geisel School of Medicine, Dartmouth, Hanover, USA
| | - Gary M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France.
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18
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Distribution of Carcinogenic Human Papillomavirus Genotypes and Association to Cervical Lesions among Women in Fez (Morocco). PLoS One 2016; 11:e0146246. [PMID: 26731415 PMCID: PMC4711798 DOI: 10.1371/journal.pone.0146246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/15/2015] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To determine the distribution of cervical high-risk human papillomavirus genotypes and their association to cellular abnormalities in women from Fez and its neighborhood. METHODS Women attending the Hassan II University Hospital for cervical pap smears were recruited after an informed consent. Interviews and two cervical samples were performed for each woman. Cervical samples were used for cytological analysis and HPV DNA detection. HPV was typed using a method based on multiplex PCR with fluorescently labeled specific primers followed by capillary electrophoresis. The study was approved by the ethics committee of the Faculty of Medicine and Pharmacy of Fez. RESULTS The HPV prevalence in the studied population was 43.1% and the most prevalent types were HPV 53 (23 cases); HPV 16 (20 cases); HPV 35 (18 cases); HPV 51 (10 cases) and HPV 56 (7 cases). From the 619 confirmed pap smears, 20% were abnormal. The cytological abnormalities were significantly associated to HPV infection, women age, number of pregnancies and parity (p < 0.05). CONCLUSION More attention should be given to HPV in Morocco because it represents an important public health concern. The distribution of carcinogenic HPV types in the studied population is different from the data in other regions but epidemiological studies in other Moroccan regions are required.
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Iaconelli M, Petricca S, Libera SD, Di Bonito P, La Rosa G. First Detection of Human Papillomaviruses and Human Polyomaviruses in River Waters in Italy. FOOD AND ENVIRONMENTAL VIROLOGY 2015; 7:309-15. [PMID: 26049729 DOI: 10.1007/s12560-015-9203-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/03/2015] [Indexed: 05/07/2023]
Abstract
Waterborne exposure to human viruses is possible through contact with contaminated water environments and can result in infections associated with a wide range of illnesses, including gastrointestinal, respiratory, ear, ocular, and skin infections. Recently, the occurrence in water environments of two groups of human viruses-both known with oncogenic potential, human polyomaviruses (HPyVs) and papillomaviruses (HPVs)-has been reported worldwide. These viruses, responsible for highly prevalent infections worldwide, have recently been proposed as potentially emerging waterborne pathogens. The objective of the present study was to examine the occurrence of HPyVs and HPVs in surface waters, by monitoring two rivers in Northwestern Italy, by nested PCR assays and sequencing. HPyVs (JC, BK, and Merkel cell polyomavirus) were detected in 10/25 (40%) samples. HPVs (HPV8, 17, 21, 25, 32, 80, 99, 105, and putative new HPVs) were identified in 14/25 (56%) river samples. The number of HPV DNA copies in waters was measured by quantitative real-time PCR. To our knowledge, this is the first detection and quantification of HPVs in surface waters. The possibility that HPyVs and HPVs can be transmitted by the waterborne route deserves to be explored in future studies.
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Affiliation(s)
- M Iaconelli
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - S Petricca
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - S Della Libera
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - P Di Bonito
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - G La Rosa
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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20
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La Rosa G, Della Libera S, Petricca S, Iaconelli M, Briancesco R, Paradiso R, Semproni M, Di Bonito P, Bonadonna L. First detection of papillomaviruses and polyomaviruses in swimming pool waters: unrecognized recreational water-related pathogens? J Appl Microbiol 2015; 119:1683-91. [PMID: 26249276 DOI: 10.1111/jam.12925] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/30/2015] [Accepted: 07/31/2015] [Indexed: 01/20/2023]
Abstract
AIMS Viral outbreaks associated with swimming pools have been described worldwide. The objective of this study was to examine the extent of viral contamination in indoor and outdoor swimming pools. METHODS AND RESULTS Pools were examined for the presence of human enteric viruses (adenovirus, norovirus and enterovirus) and nonenteric viruses (papillomavirus and polyomavirus-BK, JC, KI, WU and Merkel cell). Bacteriological parameters were also evaluated. The analysed pool waters met microbiological quality standards. Enteric viruses were not detected. On the other hand, papillomaviruses (HPV8, 12, 23, 25, 120 and unclassified HPVs) and polyomaviruses (JC and Merkel cell polyomaviruses) were detected in 9/14 samples (64%). The number of HPV DNA copies in pool waters, measured by quantitative Real-time PCR, ranged from 1.27E+04 to 1.13E+05/10L. CONCLUSION Results show that a variety of nonenteric viruses may be discharged in pool waters by various secretions and excretions from infected individuals or asymptomatic carriers. SIGNIFICANCE AND IMPACT OF THE STUDY To the best of our knowledge, this is the first report on human papillomaviruses and polyomaviruses in swimming pools. The likelihood that these viruses can be transmitted by recreational activities deserves to be explored in future studies.
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Affiliation(s)
- G La Rosa
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - S Della Libera
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - S Petricca
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - M Iaconelli
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - R Briancesco
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - R Paradiso
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - M Semproni
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
| | - P Di Bonito
- Department of Infectious Parasitic Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - L Bonadonna
- Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy
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21
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Baloch Z, Yuan T, Wang B, Tai W, Feng Y, Liu Y, Li X, Feng Y, Liu L, Zhang AM, Wu X, Xia X. Ethnic and geographic variations in HPV prevalence and genotype distribution in north-western Yunnan, China. J Med Virol 2015; 88:532-40. [PMID: 26266484 DOI: 10.1002/jmv.24352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 11/09/2022]
Abstract
The prevalence and genotype distribution of human papillomavirus (HPV) vary throughout the world. To assess the prevalence and genotype distribution of HPV among three ethnic groups in two geographic locations in north-western Yunnan, we recruited 522 women in Shangri-le (n = 255) and Lijiang (n = 267). PCR amplification of HPV DNA was performed on cervical cells from these women using two consensus primer systems (MY09/11 and GP5/6). Amplified-HPV DNA was genotyped using the HPV GenoArray test. Geographically, the HPV prevalence was significantly higher (P = 0.002) among Shangri-le women than among Lijiang women. Infections with high-risk (HR)-HPV and with multiple HPV genotypes were also significantly more common (P = 0.001) among women in Shangri-le than women in Lijiang. Additionally, the prevalence of overall, HR-HPV, and single genotype HPV infections was significantly higher (P = 0.001) among Tibetan women than among Naxi and Han women. HPV-16 and HPV-33 were significantly more frequent in Shangri-le women compared with Lijiang (P = 0.006) women. In addition, HPV-16 (9.81%) and HPV-33 (5.88%) were significantly more prevalent in Tibetan women than in Naxi and Han women. Here, for the first time, we highlight the significant variation in the prevalence and genotype distribution of HPV in various populations in the north-western region of Yunnan Province.
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Affiliation(s)
- Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - Tao Yuan
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Binghui Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - Wenlin Tai
- Second Affiliated Hospital, Kunming Medical University, Kunming, 650101, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - Yanqing Liu
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Xiao Li
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Yue Feng
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - Li Liu
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - A-mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
| | - Xiaomei Wu
- First Hospital, Yunnan Province, Kunming, 650034, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China.,Research Center for Molecular Medicine, Kunming, 650500, China
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22
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Human papillomavirus type distribution in invasive cervical cancers from Madhya Pradesh: implications for vaccination programs in central India. Int J Gynecol Pathol 2015; 33:531-6. [PMID: 25083972 DOI: 10.1097/pgp.0000000000000083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Invasive cervical carcinoma (ICC) remains a leading cause of female mortality in India. There is a paucity of data about human papillomavirus (HPV) type distribution among ICCs from Central India. Formalin-fixed, paraffin-embedded ICC specimens (n=270 patients) from Madhya Pradesh state were screened for HPV by GP5/6 primer-based polymerase chain reaction followed by cycle sequencing and NCBI BLAST search. HPV was detected in 93.3% of the tumors. Thirteen types were detected: HPV16 (73.7%), HPV18 (11.9%), HPV45 (2.2%), HPV66 (1.5%), HPV35 (1.1%), and HPV56 (0.7%). HPV31, 51, 58, 59, 67, 82 and JEB2 were each seen in 1 case (0.4%). HPV16 was more common among women less than 40 yr than 40 yr or older (P=0.006), and HPV18 was more common in women aged 40 yr or older (P=0.013). Squamous cell carcinomas were more frequently HPV-positive than adenocarcinomas (P=0.01). HPV18 was more common in adenocarcinoma than in squamous cell carcinoma (P=0.02). These data contribute to the pan-India profile of HPV-type relationship to ICC and show the potential of current vaccines to greatly relieve (by up to 85.6%) the ICC burden in Central India. The findings are also suggestive that next-generation HPV vaccines might be designed on a regional basis rather than from compounded global data.
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23
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Alvarez-Aldana A, Martínez JW, Sepúlveda-Arias JC. Comparison of five protocols to extract DNA from paraffin-embedded tissues for the detection of human papillomavirus. Pathol Res Pract 2014; 211:150-5. [PMID: 25444238 DOI: 10.1016/j.prp.2014.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 10/14/2014] [Accepted: 10/23/2014] [Indexed: 12/22/2022]
Abstract
Formalin-fixed paraffin-embedded (FFPE) tissues are a valuable source of DNA with which to perform large retrospective studies on the epidemiology of HPV infection. Five different DNA extraction protocols were carried out to evaluate the DNA obtained from FFPE samples with polymerase chain reaction (PCR) using two primer sets to amplify a constitutive human gene, β-globin, and two primer sets to detect the L1 and E6 HPV genes. From the five DNA extraction protocols evaluated, the best results were obtained with protocol A, corresponding to a crude extract from the sample. With the procedures described herein, we were able to amplify DNA extracted from archival paraffin blocks stored for six years. However, the amplification products were more efficiently obtained with primers that amplified shorter fragments. This result indicates that a major factor limiting the extraction process in these samples is DNA fragmentation, a factor that will naturally vary between the different specimens evaluated. Also, depending upon the extraction method, PCR amplification of a human gene does not necessarily guarantee the successful extraction of viral DNA. In conclusion, different DNA and HPV detection methods can significantly influence the results. Therefore, the DNA extraction methods and primers used for DNA amplification in fixed tissues need to be chosen carefully, depending on the specific requirements of the study being carried out.
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Affiliation(s)
- Adalucy Alvarez-Aldana
- Facultad de Ciencias de la Salud, Departamento de Ciencias Básicas, Grupo Infección e Inmunidad, Universidad Tecnológica de Pereira, Pereira, Colombia.
| | - José William Martínez
- Facultad de Ciencias de la Salud, Departamento de Medicina Comunitaria, Grupo Epidemiología, Salud y Violencia, Universidad Tecnológica de Pereira, Pereira, Colombia.
| | - Juan C Sepúlveda-Arias
- Facultad de Ciencias de la Salud, Departamento de Ciencias Básicas, Grupo Infección e Inmunidad, Universidad Tecnológica de Pereira, Pereira, Colombia.
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24
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Lopera EA, Baena A, Florez V, Montiel J, Duque C, Ramirez T, Borrero M, Cordoba CM, Rojas F, Pareja R, Bedoya AM, Bedoya G, Sanchez GI. Unexpected inverse correlation between Native American ancestry and Asian American variants of HPV16 in admixed Colombian cervical cancer cases. INFECTION GENETICS AND EVOLUTION 2014; 28:339-48. [PMID: 25446942 DOI: 10.1016/j.meegid.2014.10.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 09/18/2014] [Accepted: 10/16/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-European variants such as European-Asian (EAs), Asian American (AA) and African (Af) are mostly confined to Eastern Asia, The Americas and African regions respectively. Several studies have shown that genetic variation of HPV 16 is associated with the risk of cervical cancer, which also seems to be dependent on the population. This relationship between ethnicity and variants have led to the suggestion that there is co-evolution of variants with humankind. Our aim was to evaluate the relationship between the individual ancestry proportion and infection with HPV 16 variants in cervical cancer. METHODS We examined the association between ancestry and HPV 16 variants in samples of 82 cervical cancer cases from different regions of Colombia. Individual ancestry proportions (European, African and Native American) were estimated by genotyping 106 ancestry informative markers. Variants were identified by PCR amplification of the E6 gene, followed by reverse line blot hybridization (RLB) with variants specific probes. RESULTS Overall European (E) and Asian American (AA) variants frequency was 66.5% and 33.5% respectively. Similar distribution was observed in cases with higher proportions of European or African ancestry. A higher Native American ancestry was significantly associated with higher frequency of E variants (median ancestry>23.6%, Age and place of birth adjusted OR: 3.55, 95% CI: 1.26-10.03, p=0.01). Even further, an inverse geographic correlation between Native American ancestry and frequency of infections with AA variants was observed (ρ=-0.825, p=0.008). Regions with higher proportion of Native American ancestry had a lower frequency of AA variants of HPV 16. CONCLUSIONS This study suggests replacement of AA variants by E variants of human papillomavirus 16 in cervical cancer cases with high Native American ancestry.
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Affiliation(s)
- Esteban A Lopera
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Armando Baena
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Victor Florez
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Jehidys Montiel
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Constanza Duque
- Genética Molecular, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia; Universidad Cooperativa de Colombia, Carrera 42 No 49-95, Medellín, Colombia
| | - Tatiana Ramirez
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Mauricio Borrero
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia; Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia; Department of Gynecology and Obstetrics, School of Medicine, Universidad de Antioquia, UdeA, Calle 70 No 52-52, Medellín, Colombia
| | - Carlos M Cordoba
- Department of Gynecology and Obstetrics, School of Medicine, Universidad de Antioquia, UdeA, Calle 70 No 52-52, Medellín, Colombia
| | - Fredy Rojas
- Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia
| | - Rene Pareja
- Instituto de Cancerología Las Américas, Carrera 70 No 1-35, Torre 5, Medellín, Colombia
| | - Astrid M Bedoya
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia; Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Gabriel Bedoya
- Genética Molecular, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Gloria I Sanchez
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, UdeA, Calle 70 No 52-21, Medellín, Colombia.
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25
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Tshomo U, Franceschi S, Dorji D, Baussano I, Tenet V, Snijders PJF, Meijer CJLM, Bleeker MCG, Gheit T, Tommasino M, Clifford GM. Human papillomavirus infection in Bhutan at the moment of implementation of a national HPV vaccination programme. BMC Infect Dis 2014; 14:408. [PMID: 25047665 PMCID: PMC4223630 DOI: 10.1186/1471-2334-14-408] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 07/12/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical cancer is the most common female cancer in Bhutan, the first low/middle-income country to implement a national human papillomavirus (HPV) vaccination programme. METHODS To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2,505 women aged 18-69 years from the general population, and biopsies from 211 cervical intraepithelial neoplasia grade 3 (CIN3) and 112 invasive cervical cancer (ICC) cases. Samples were tested for HPV using GP5+/6+ PCR. RESULTS Among the general population, HPV prevalence was 26%, being highest (33%) in women ≤24 years, but remaining above 15% in all age-groups. Determinants of HPV included age, marital status, and number of sexual partners. Among the eight percent with cytological abnormalities, 24 CIN3 and 4 ICC were histologically confirmed. Even after additional testing with a sensitive E7 PCR, no infections with vaccine-targeted HPV types were detected in the few vaccinated women (n = 34) compared to 6% prevalence in unvaccinated women of similar age (p = 0 · 215). CONCLUSION Based upon type-specific prevalence among biopsies, at least 70% of ICC in Bhutan are theoretically preventable by HPV16/18 vaccination, but screening programmes should be expanded among older women, who have an important underlying burden of CIN3 and ICC.
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Affiliation(s)
- Ugyen Tshomo
- Department of Obstetrics & Gynaecology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
| | - Dorji Dorji
- Department of Laboratory Services, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Iacopo Baussano
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
| | - Vanessa Tenet
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
| | - Peter JF Snijders
- VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - Chris JLM Meijer
- VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - Maaike CG Bleeker
- VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands
| | - Tarik Gheit
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
| | - Massimo Tommasino
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
| | - Gary M Clifford
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, cedex 08, France
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26
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Bosgraaf RP, Verhoef VMJ, Massuger LFAG, Siebers AG, Bulten J, de Kuyper-de Ridder GM, Meijer CJM, Snijders PJF, Heideman DAM, IntHout J, van Kemenade FJ, Melchers WJG, Bekkers RLM. Comparative performance of novel self-sampling methods in detecting high-risk human papillomavirus in 30,130 women not attending cervical screening. Int J Cancer 2014; 136:646-55. [PMID: 24923998 DOI: 10.1002/ijc.29026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 05/27/2014] [Indexed: 01/22/2023]
Abstract
We determined whether the participation rate for a brush-based cervicovaginal self-sampling device is noninferior to the participation rate for a lavage-based one for testing for hrHPV (high-risk human papillomavirus). Additionally, positivity rates for hrHPV, the detection rates for cervical intraepithelial neoplasia grades 2 and 3 or worse (CIN2+/3+), and user comfort were compared. A total of 35,477 non-responders of the regular cervical screening program aged 33-63 years were invited to participate. Eligible women (n = 30,130) were randomly assigned to receive either a brush-based or a lavage-based device, and a questionnaire for reporting user convenience. Self-sampling responders testing hrHPV-positive were invited for a physician-taken sample for cytology; triage-positive women were referred for colposcopy. A total of 5,218 women participated in the brush-based sampling group (34.6%) and 4809 women in the lavage-based group (31.9%), i.e. an absolute difference of 2.7% (95%CI 1.8-4.2). The hrHPV-positivity rates in the two groups were identical (8.3%, relative risk (RR) 0.99, 95%CI 0.87-1.13). The detection of CIN2+ and CIN3+ in the brush group (2.0% for CIN2+; 1.3% for CIN3+) was similar to that in the lavage group (1.9% for CIN2+; 1.0% for CIN3+) with a cumulative RR of 1.01, 95%CI 0.83-1.24 for CIN2+ and 1.25, 95%CI 0.92-1.70 for CIN3+. The two self-sampling devices performed similarly in user comfort. In conclusion, offering a brush-based device to non-responders is noninferior to offering a lavage-based device in terms of participation. The two self-sampling methods are equally effective in detecting hrHPV, CIN2+/CIN3+ and are both well accepted.
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Affiliation(s)
- Remko P Bosgraaf
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
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27
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Foliaki S, Brewer N, Pearce N, Snijders PJF, Meijer CJLM, Waqatakirewa L, Clifford GM, Franceschi S. Prevalence of HPV infection and other risk factors in a Fijian population. Infect Agent Cancer 2014; 9:14. [PMID: 24891876 PMCID: PMC4040509 DOI: 10.1186/1750-9378-9-14] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 03/20/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cancer is among the leading contributors to morbidity and mortality in the Pacific, but the magnitude of the problem and the potential for prevention have not been comprehensively studied. Over the past decade, cervical cancer has been the most common cancer among women in Fiji with an age standardised cervical cancer incidence rate of 51 per 100,000. This rate is among the highest in the South Pacific region and in the world. This high cervical cancer incidence rate is likely linked to the low cervical screening rate, but it points also to the possibility of a high burden of human papillomavirus (HPV) infection. METHODS We conducted a population-based survey in Fiji to provide information on human papillomavirus (HPV) prevalence, and the distribution of individual HPV types in a Fijian health-sub-district. We included 1,261 women aged between 16 and 64 years. A general primer GP5+/6+ mediatedpolymerase chain reaction (PCR) assay was used for HPV testing of 44 HPV types. RESULTS The crude HPV prevalence in 1,244 women with an adequate HPV sample was 24.0% (95% confidence interval (CI), 21.7-26.4%) and the corresponding age standardised prevalence was 25.5% (95% CI, 23.1-28.1%). The prevalence of high-risk HPV types was 13.6% (95% CI, 11.8-15.6%). Among 1,192 women with adequate cytological results, 13 (1.1%) showed cervical abnormalities, the majority of which were high-grade intraepithelial lesions or worse. HPV prevalence declined from 35.8% in women aged <25 years to 18.6% in those aged 55-64 years of age. After adjustment, the only variables significantly associated with HPV-positivity were age (ranging from odds ratio (OR) 0.57 (95% CI, 0.36-0.89) for 25-34 year-old-women to OR 0.43 (95% CI, 0.20-0.89) for 55-64 year-old-women) and 'husband's extramarital sexual relationships' (OR 1.69; 95% CI, 1.17-2.34). CONCLUSION These findings on HPV provide key information for future policy decisions on the most appropriate methods of cervical cancer prevention in Fiji and in the Pacific region.
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Affiliation(s)
- Sunia Foliaki
- Centre for Public Health Research, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Naomi Brewer
- Centre for Public Health Research, Massey University, PO Box 756, Wellington 6140, New Zealand
| | - Neil Pearce
- Centre for Public Health Research, Massey University, PO Box 756, Wellington 6140, New Zealand
- London School of Hygiene & Tropical Medicine, London, UK
| | - Peter JF Snijders
- Vrije Universiteit Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - Chris JLM Meijer
- Vrije Universiteit Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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28
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Palmer E, Newcombe RG, Green AC, Kelly C, Noel Gill O, Hall G, Fiander AN, Pirotte E, Hibbitts SJ, Homer J, Powell NG. Human papillomavirus infection is rare in nonmalignant tonsil tissue in the UK: implications for tonsil cancer precursor lesions. Int J Cancer 2014; 135:2437-43. [PMID: 24723209 DOI: 10.1002/ijc.28886] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 03/11/2014] [Indexed: 01/23/2023]
Abstract
The incidence of human papillomavirus (HPV)-associated tonsil cancer is increasing but the prevalence of HPV, and of premalignant precursors, in tonsil tissue is unknown. We aimed to assess prevalence of HPV infection in nonmalignant tonsillar crypt epithelia and to histopathologically characterise positive samples. Formalin-fixed paraffin-embedded (FFPE) tonsil tissue specimens were obtained from an age- and sex-stratified random sample of patients aged 0-69 years whose paired tonsils were archived following elective tonsillectomy at hospitals throughout England and Southern Scotland from 2004 to 2008. Homogenised fresh-frozen tonsil tissue was also obtained from archive for two random subsets of males aged 25-34 and over 44. HPV status was assessed in all samples for 20 mucosal HPV types by GP5+/6+ polymerase chain reaction (PCR) enzyme immunoassay and by HPV16 type-specific PCR targeting the E6 gene. In the homogenised material, HPV status was also assessed for 44 HPV types by SPF10-PCR enzyme immunoassay. Of 4,095 randomly sampled FFPE specimens, amplifiable DNA was extracted from 3,377 (82.5%) and from 511 of 524 (97.5%) homogenised tonsils. HPV DNA was identified in 0 of 3,377 (0%, 95% CI 0-0.089%) fixed samples and 0 of 511 (0%, 95% CI 0-0.58%) homogenised samples. This suggests HPV infection may be rare in tonsil reticulated crypt epithelia. Furthermore, we found no evidence of HPV-associated premalignant neoplasia. These data suggest that if HPV-associated premalignant lesions do occur, they are likely to be rare and may have a high risk of progression to carcinoma.
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Affiliation(s)
- Elizabeth Palmer
- HPV Research Group, Institute of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Evans MF, Peng Z, Clark KM, Adamson CSC, Ma XJ, Wu X, Wang H, Luo Y, Cooper K. HPV E6/E7 RNA in situ hybridization signal patterns as biomarkers of three-tier cervical intraepithelial neoplasia grade. PLoS One 2014; 9:e91142. [PMID: 24625757 PMCID: PMC3953338 DOI: 10.1371/journal.pone.0091142] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/07/2014] [Indexed: 11/19/2022] Open
Abstract
Cervical lesion grading is critical for effective patient management. A three-tier classification (cervical intraepithelial neoplasia [CIN] grade 1, 2 or 3) based on H&E slide review is widely used. However, for reasons of considerable inter-observer variation in CIN grade assignment and for want of a biomarker validating a three-fold stratification, CAP-ASCCP LAST consensus guidelines recommend a two-tier system: low- or high-grade squamous intraepithelial lesions (LSIL or HSIL). In this study, high-risk HPV E6/E7 and p16 mRNA expression patterns in eighty-six CIN lesions were investigated by RNAscope chromogenic in situ hybridization (CISH). Specimens were also screened by immunohistochemistry for p16INK4a (clone E6H4), and by tyramide-based CISH for HPV DNA. HPV genotyping was performed by GP5+/6+ PCR combined with cycle-sequencing. Abundant high-risk HPV RNA CISH signals were detected in 26/32 (81.3%) CIN 1, 22/22 (100%) CIN 2 and in 32/32 (100%) CIN 3 lesions. CIN 1 staining patterns were typified (67.7% specimens) by abundant diffusely staining nuclei in the upper epithelial layers; CIN 2 lesions mostly (66.7%) showed a combination of superficial diffuse-stained nuclei and multiple dot-like nuclear and cytoplasmic signals throughout the epithelium; CIN 3 lesions were characterized (87.5%) by multiple dot-like nuclear and cytoplasmic signals throughout the epithelial thickness and absence/scarcity of diffusely staining nuclei (trend across CIN grades: P<0.0001). These data are consistent with productive phase HPV infections exemplifying CIN 1, transformative phase infections CIN 3, whereas CIN 2 shows both productive and transformative phase elements. Three-tier data correlation was not found for the other assays examined. The dual discernment of diffuse and/or dot-like signals together with the assay's high sensitivity for HPV support the use of HPV E6/E7 RNA CISH as an adjunct test for deciding lesion grade when CIN 2 grading may be beneficial (e.g. among young women) or when 'LSIL vs. HSIL' assignment is equivocal.
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Affiliation(s)
- Mark F. Evans
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
- * E-mail:
| | - Zhihua Peng
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
| | - Kelli M. Clark
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
- Department of Pathology and Laboratory Medicine, Fletcher Allen Health Care, Burlington, Vermont, United States of America
| | - Christine S.-C. Adamson
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
| | - Xiao-Jun Ma
- Advanced Cell Diagnostics, Inc., Hayward, California, United States of America
| | - Xingyong Wu
- Advanced Cell Diagnostics, Inc., Hayward, California, United States of America
| | - Hongwei Wang
- Advanced Cell Diagnostics, Inc., Hayward, California, United States of America
| | - Yuling Luo
- Advanced Cell Diagnostics, Inc., Hayward, California, United States of America
| | - Kumarasen Cooper
- Department of Pathology, University of Vermont, Burlington, Vermont, United States of America
- Department of Pathology and Laboratory Medicine, Fletcher Allen Health Care, Burlington, Vermont, United States of America
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Chen L, Watanabe K, Haruyama T, Kobayashi N. Simple and rapid human papillomavirus genotyping method by restriction fragment length polymorphism analysis with two restriction enzymes. J Med Virol 2014; 85:1229-34. [PMID: 23918541 DOI: 10.1002/jmv.23582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2013] [Indexed: 11/08/2022]
Abstract
Cervical cancer, the third most common cancer that affects women worldwide, is caused by the human papillomavirus (HPV) and is treatable when detected at an early stage. To date, more than 100 different HPV types have been described, and the development of simple, low-cost, and accurate methods to distinguish HPV genotypes is highly warranted. In this study, an HPV genotyping assay based on polymerase chain reaction (PCR) was evaluated. This method involved the use of MY09/11 primers followed by restriction fragment length polymorphism (RFLP) analysis with the restriction enzymes HpyCH4V and NlaIII. Cervical specimens preserved using CytoRich Blue fluid were collected from 1,134 female volunteers for HPV detection, and 1,111 valid samples were amplified using PCR. The PCR method was sensitive enough to detect 25 copies of HPV18, and three copies of HPV16. Out of 202 PCR-positive samples, HPV genotypes were determined in 189 samples (93.6%) by this RFLP method. Results were then evaluated further by capillary sequencing method. Concordant results between the two tests were as high as 96.0%. Thirteen samples, which tested negative with RFLP, were verified as non-specific amplifications with PCR. In conclusion, this PCR-RFLP method using restriction enzymes HpyCH4V and NlaIII is simple, non-labor intensive, and is applicable for the inexpensive determination of HPV genotypes in clinical samples.
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Affiliation(s)
- Linghan Chen
- Laboratory of Molecular Biology of Infectious Agents, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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31
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Clinical validation of the HPV-risk assay, a novel real-time PCR assay for detection of high-risk human papillomavirus DNA by targeting the E7 region. J Clin Microbiol 2014; 52:890-6. [PMID: 24391196 DOI: 10.1128/jcm.03195-13] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The HPV-Risk assay is a novel real-time PCR assay targeting the E7 region of 15 high-risk human papillomavirus (HPV) types (i.e., HPV16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, -67, and -68), and provides additional genotype information for HPV16 and HPV18. This study evaluated the clinical performance and reproducibility of the HPV-Risk assay with cervical scraping specimens and its utility with self-collected (cervico)vaginal specimens. The clinical performance of the HPV-Risk assay for cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) with cervical scraping specimens was evaluated by a noninferiority analysis, relative to high-risk HPV GP5+/6+ PCR, following international guidelines for HPV test requirements for cervical cancer screening. The HPV-Risk assay showed clinical sensitivity for CIN2+ of 97.1% (95% confidence interval [CI], 89.1 to 99.3%; 67/69 samples) and a clinical specificity for CIN2+ of 94.3% (95% CI, 92.5 to 95.7%; 777/824 samples). The clinical sensitivity and specificity were noninferior to those of GP5+/6+ PCR (noninferiority score test, P=0.006 and 0.0003, respectively). Intralaboratory reproducibility over time (99.5% [95% CI, 98.6 to 99.8%]; 544/547 samples, kappa=0.99) and interlaboratory agreement (99.2% [95% CI, 98.6 to 99.8%]; 527/531 samples, kappa=0.98) for the HPV-Risk assay with cervical scraping specimens were high. The agreement of the HPV-Risk assay results for self-collected (cervico)vaginal specimens and clinician-obtained cervical scraping specimens was also high, i.e., 95.9% (95% CI, 85.1 to 99.0%; 47/49 samples, kappa=0.90) for self-collected lavage samples and 91.6% (95% CI, 84.6 to 95.6%; 98/107 samples, kappa=0.82) for self-collected brush samples. In conclusion, the HPV-Risk assay meets the cross-sectional clinical and reproducibility criteria of the international guidelines for HPV test requirements and can be considered clinically validated for cervical screening purposes. The compatibility of the HPV-Risk assay with self-collected specimens supports its utility for HPV self-sampling.
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Rietbergen MM, Snijders PJ, Beekzada D, Braakhuis BJ, Brink A, Heideman DA, Hesselink AT, Witte BI, Bloemena E, Baatenburg-De Jong RJ, René Leemans C, Brakenhoff RH. Molecular characterization of p16-immunopositive but HPV DNA-negative oropharyngeal carcinomas. Int J Cancer 2013; 134:2366-72. [DOI: 10.1002/ijc.28580] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 10/10/2013] [Indexed: 01/15/2023]
Affiliation(s)
- Michelle M. Rietbergen
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Peter J.F. Snijders
- Department of Pathology; VU University Medical Center; Amsterdam The Netherlands
| | - Derakshan Beekzada
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Boudewijn J.M. Braakhuis
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Arjen Brink
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | | | | | - Birgit I. Witte
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - Elisabeth Bloemena
- Department of Pathology; VU University Medical Center; Amsterdam The Netherlands
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | | | - C. René Leemans
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
| | - Ruud H. Brakenhoff
- Department of Otolaryngology/Head and Neck Surgery; VU University Medical Center; Amsterdam The Netherlands
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Reppas G, Fyfe J, Foster S, Smits B, Martin P, Jardine J, Lam A, O'Brien C, Malik R. Detection and identification of mycobacteria in fixed stained smears and formalin-fixed paraffin-embedded tissues using PCR. J Small Anim Pract 2013; 54:638-46. [DOI: 10.1111/jsap.12149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G. Reppas
- Vetnostics; North Ryde New South Wales 2113 Australia
| | - J. Fyfe
- Victorian Infectious Diseases Reference Laboratory; North Melbourne Victoria Australia
| | - S. Foster
- Vetnostics; North Ryde New South Wales 2113 Australia
| | - B. Smits
- Gribbles Veterinary; Hamilton New Zealand
| | - P. Martin
- Faculty of Veterinary Science; The University of Sydney; B14 New South Wales 2006 Australia
| | - J. Jardine
- Vetpath; Ascot Western Australia 6104 Australia
| | - A. Lam
- Small Animal Specialist Hospital; Richardson Place North Ryde New South Wales Australia
| | - C. O'Brien
- Faculty of Veterinary Science; The University of Melbourne; Parkville Victoria Australia
| | - R. Malik
- Centre for Veterinary Education, Conference Centre B22; The University of Sydney; New South Wales Australia
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Söderlund-Strand A, Kjellberg L, Dillner J. Human papillomavirus type-specific persistence and recurrence after treatment for cervical dysplasia. J Med Virol 2013; 86:634-41. [PMID: 24123176 DOI: 10.1002/jmv.23806] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 01/08/2023]
Abstract
Human papillomavirus (HPV) infection is a necessary factor in the cervical cancer development. Also after treatment for cervical dysplasia, HPV can be present and promote the recurrence of cervical disease. In the present study, the aim was to perform a long-term follow-up on the ability of HPV testing with genotyping, as compared with cytology, to predict recurrence of high-grade cervical intraepithelial neoplasia and to evaluate the effectiveness of treatment with loop electrosurgical excision procedure (LEEP) conization. Cervical samples for HPV DNA testing and cytological analysis were obtained from 178 women with abnormal smears referred for treatment with LEEP conization. These women were scheduled for HPV DNA testing and Pap smears before and 3, 6, 12, 24, and 36 months after treatment. Three years after treatment 3.1% (N = 4) of women were still persistently HPV-positive with the same type as had been detected at treatment. Recurrent or residual cervical intraepithelial neoplasia II+ in histopathology was found among 9 (5.1%) women during follow-up. All of these women had type-specific HPV-persistence (sensitivity 100% [95% CI 63-100%] and specificity 94.7% [89.8-97.4%]), but only 7/9 had abnormal cytology (sensitivity 77.8% [40.2-96.1%] and specificity 94.7% [89.8-97.4%]). No recurrent or residual disease was found among women with any other patterns of HPV positivity (e.g., type change or fluctuating positivity) (sensitivity 0% [95% CI 0-37.1%] and specificity 80.5% [73.5-86.0%]). In conclusion, only type-specific HPV persistence predicted recurrent or residual disease, and HPV genotyping appears useful to improve the specificity when using HPV testing in post-treatment follow-up.
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Affiliation(s)
- Anna Söderlund-Strand
- Department of Clinical Microbiology, Jan Waldenströms Gata 59, Skåne University Hospital (SUS), Malmö, Sweden
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35
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Rietbergen MM, Braakhuis BJM, Moukhtari N, Bloemena E, Brink A, Sie D, Ylstra B, Baatenburg de Jong RJ, Snijders PJF, Brakenhoff RH, Leemans CR. No evidence for active human papillomavirus (HPV) in fields surrounding HPV-positive oropharyngeal tumors. J Oral Pathol Med 2013; 43:137-42. [PMID: 24118314 DOI: 10.1111/jop.12123] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinomas (OPSCCs) have a better prognosis than patients with HPV-negative OPSCCs. Important factors contributing to this better prognosis are relatively low numbers of local/regional recurrences (LRRs) and second primary tumors (SPTs) in patients with HPV-positive OPSCC. These low numbers may be explained in addition by the absence of a 'field cancerization' effect, which is a cause of LRRs and SPTs in patients with HPV-negative OPSCC. We aimed to detect a possible 'field effect' in patients with HPV-positive OPSCC. As HPV is involved in the early stage of carcinogenesis in OPSCCs, its presence is considered a reliable marker for the detection of such a field effect. Therefore, the presence of transcriptionally active HPV was analyzed in the mucosa surrounding HPV-positive OPSCCs. METHODS We included 20 patients who were surgically treated for an HPV-positive OPSCC in the period 2000-2006. Of each patient, the formalin-fixed paraffin-embedded tumor sample and all available resection margins were collected. In total, 97 resection margins were investigated with an average of five resection margins per tumor. All samples were analyzed for the presence of tumor and the presence of transcriptionally active HPV by HPV16-E6-mRNA detection. RESULTS All tumors were HPV16-E6-mRNA positive. HPV16-E6-mRNA could be detected in the resection margins that contained tumor (n = 6). All tumor-negative resection margins (n = 91) scored negative for HPV16-E6-mRNA. CONCLUSIONS In conclusion, transcriptional active HPV could not be detected in the mucosa surrounding an HPV-positive OPSCC, which suggests the absence of field effect. This observation may explain the lower number of LRRs and SPTs in HPV-positive patients.
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Affiliation(s)
- Michelle M Rietbergen
- Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
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Guerrero-Setas D, Pérez-Janices N, Ojer A, Blanco-Fernandez L, Guarch-Troyas C, Guarch R. Differential gene hypermethylation in genital lichen sclerosus and cancer: a comparative study. Histopathology 2013; 63:659-69. [PMID: 23998425 DOI: 10.1111/his.12204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Accepted: 06/12/2013] [Indexed: 11/28/2022]
Abstract
AIMS Lichen sclerosus (LS) is a chronic inflammatory disease of the genital skin of unknown aetiology. The role of LS in penile squamous cell carcinogenesis is not well characterized. HPV has been implicated in both, as have epigenetic changes. The presence of HPV and hypermethylation of the MGMT, p16, RASSF1, RASSF2, TSLC1 and TSP1 genes were studied in penile LS; MGMT, RASSF2 and TSLC1 hypermethylation in penile cancer and TSLC1 hypermethylation in vulvar LS and cancer extends previous results reported by our group. METHODS AND RESULTS Thirty-seven HPV genotypes and hypermethylation were evaluated by PCR/reverse-line-blot and methylation-specific PCR respectively, in 27 preputial LS, 24 penile SCC, 30 vulvar SCC, 21 vulvar LS and 22 normal skin cases. HPV66 was present in 3.7% of penile LS cases, and p16 and RASSF2 hypermethylation were more frequent in penile cancer than in penile LS. p16, RASSF1, RASSF2 and TSP1 hypermethylation were similar in penile and vulvar LS. CONCLUSIONS Gene hypermethylation is a common event in penile LS, and occurs approximately as frequently as in vulvar LS. Certain genes can be hypermethylated as an early or late event in LS or cancer, respectively. This suggests a possible sequential role for these alterations in the transition from benign to malignant lesions.
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Evidence that alpha-9 human papillomavirus infections are a major etiologic factor for oropharyngeal carcinoma in black South Africans. Head Neck Pathol 2013; 7:361-72. [PMID: 23797844 PMCID: PMC3824804 DOI: 10.1007/s12105-013-0453-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 06/02/2013] [Indexed: 10/26/2022]
Abstract
Human papillomavirus (HPV) infection, most commonly genotype 16 of the alpha-9 family, is implicated in the etiology of a subset of oropharyngeal squamous cell carcinomas (OPSC) worldwide. Data are scarce regarding OPSC in South Africans, and three prior studies suggest no significant etiologic role for HPV. We aimed to investigate for evidence of HPV etiology in OPSCs from black South Africans by polymerase chain reaction (PCR) methodologies with determination of HPV subtype by sequencing, in situ hybridization (ISH), and p16INK4a immunohistochemistry (IHC), as a surrogate marker for an HPV-driven tumor. It was hypothesized that HPV-driven tumors would be positive by PCR plus IHC and/or ISH whereas OPSCs with HPV background infections (HPV-passenger) would be positive by PCR alone. Formalin-fixed, paraffin embedded tissues from 51 OPSCs collected between 2005 and 2010 from 41 patients were analyzed for HPV by GP5?6? PCR (targeting the HPV L1 region), pU-1M/pU- 2R PCR (targeting the HPV E6/E7 region) and HPV-31 specific PCR (targeting the E5 region), chromogenic ISH, and p16INK4a IHC. All cases positive by PCR were subject to sequencing to determine HPV genotype. The patient mean age was 58.0 years and 88 % were male. Of the 51 evaluable tumors, 48 (94.1 %) were positive for HPV DNA by PCR: 25 (49.1 %) met criteria for an HPV-driven tumor, 23 (45.1 %) for HPV-passenger, and 3 (5.9 %) were HPV unrelated. Sequencing of the PCR-positive cases revealed the following genotypes: combined HPV-16 and 31 (41.7 %), HPV-31 (25.0 %), HPV-16 (22.9 %), combined HPV-16 and 18 (6.3 %), and a single case each of HPV 18 and HPV 33. Studies via ISH were negative in all cases. In accordance with worldwide trends but contrary to prior South African data, HPV likely plays an etiologic role in a significant subset (at least 49.1 %) of OPSC in black South Africans. We found that the alpha-9 HPV family, particularly HPV-16 and 31 either in combination or separately, to predominate in our sample tumors. The use of multiple PCR primers increased sensitivity of viral detection, and a HPV-31 specific primer confirmed the presence of this genotype in many samples. Further studies including HPV E6/E7 mRNA assays are needed to better elucidate the pathogenic role of HPV in black South African OPSCs.
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Faust H, Andersson K, Forslund O, Dillner J. Pseudovirion-binding and neutralizing antibodies to cutaneous human papillomaviruses (HPV) correlated with the presence of HPV DNA in skin. J Gen Virol 2013; 94:1096-1103. [DOI: 10.1099/vir.0.048561-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Whereas the antibody response to the anogenital human papillomaviruses (HPVs) is known to be mainly type-specific, correlated with the presence of viral DNA and mainly directed to conformational epitopes of the virion, it is not known if this applies also to the antibody response to cutaneous HPVs. For 434 non-immunosuppressed patients with skin lesions (squamous cell carcinoma and basal cell carcinoma of the skin, actinic keratosis and benign skin lesions), we compared HPV DNA status with seroreactivity to HPV pseudovirions (PsV) and to GST-L1 fusion proteins from HPV types -5, -6, -15, -16, -32 and -38. Biopsies from the skin lesions were tested for the presence of HPV DNA using three different PCR methods, with typing by sequencing. Serum samples from subjects with HPV DNA-positive biopsies and randomly selected serum samples from subjects with HPV DNA-negative biopsies were also tested with neutralization assays with HPV5, -38 and -76 PsV. Agreement of the three serological methods varied from poor to moderate. Type-specific seroprevalences among patients positive for the same type of HPV DNA (sensitivity of serology) was improved with the PsV-based method (mean of 40 %, maximum 63 %) compared with the GST-L1 method (mean of 20 %, maximum of 25 %). Neutralization was the most sensitive assay for HPV38 (50 %). In summary, cutaneous HPVs also appear to induce a type-specific antibody response that correlates with the presence of HPV DNA and that can be detected with improved sensitivity using PsV-based serology.
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Affiliation(s)
- Helena Faust
- Department of Laboratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Kristin Andersson
- Department of Laboratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Forslund
- Department of Laboratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Joakim Dillner
- Departments of Laboratory Medicine, Medical Epidemiology & Biostatistics, Karolinska Institutet and Departments of Clinical Microbiology and Pathology, Karolinska Hospital, Stockholm, Sweden
- Department of Laboratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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Silva ID, Muniz YC, Sousa MC, Silva KR, Castelli EC, Filho JC, Osta AP, Lima MI, Simões RT. HLA-G 3′UTR polymorphisms in high grade and invasive cervico-vaginal cancer. Hum Immunol 2013; 74:452-8. [DOI: 10.1016/j.humimm.2012.11.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 11/26/2012] [Accepted: 11/27/2012] [Indexed: 11/26/2022]
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40
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Hunt JL, Barnes L, Lewis JS, Mahfouz ME, Slootweg PJ, Thompson LDR, Cardesa A, Devaney KO, Gnepp DR, Westra WH, Rodrigo JP, Woolgar JA, Rinaldo A, Triantafyllou A, Takes RP, Ferlito A. Molecular diagnostic alterations in squamous cell carcinoma of the head and neck and potential diagnostic applications. Eur Arch Otorhinolaryngol 2013; 271:211-23. [PMID: 23467835 DOI: 10.1007/s00405-013-2400-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 02/07/2013] [Indexed: 12/12/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a common malignancy that continues to be difficult to treat and cure. In many organ systems and tumor types, there have been significant advances in the understanding of the molecular basis for tumorigenesis, disease progression and genetic implications for therapeutics. Although tumorigenesis pathways and the molecular etiologies of HNSCC have been extensively studied, there are still very few diagnostic clinical applications used in practice today. This review discusses current clinically applicable molecular markers, including viral detection of Epstein-Barr virus and human papillomavirus, and molecular targets that are used in diagnosis and management of HNSCC. The common oncogenes EGFR, RAS, CCND1, BRAF, and PIK3CA and tumor suppressor genes p53, CDKN2A and NOTCH are discussed for their associations with HNSCC. Discussion of markers with potential future applications is also included, with a focus on molecular alterations associated with targeted therapy resistance.
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Affiliation(s)
- Jennifer L Hunt
- Department of Pathology and Laboratory Services, College of Medicine, University of Arkansas for Medical Sciences, Arkansas, USA
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Kizys MML, Cardoso MG, Lindsey SC, Harada MY, Soares FA, Melo MCC, Montoya MZ, Kasamatsu TS, Kunii IS, Giannocco G, Martins JRM, Cerutti JM, Maciel RMB, Dias-da-Silva MR. Optimizing nucleic acid extraction from thyroid fine-needle aspiration cells in stained slides, formalin-fixed/paraffin-embedded tissues, and long-term stored blood samples. ACTA ACUST UNITED AC 2012; 56:618-26. [DOI: 10.1590/s0004-27302012000900004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 07/22/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: Adequate isolation of nucleic acids from peripheral blood, fine-needle aspiration cells in stained slides, and fresh and formalin-fixed/paraffin-embedded tissues is crucial to ensure the success of molecular endocrinology techniques, especially when samples are stored for long periods, or when no other samples can be collected from patients who are lost to follow-up. Here, we evaluate several procedures to improve current methodologies for DNA (salting-out) and RNA isolation. MATERIALS AND METHODS: We used proteinase K treatment, heat shock, and other adaptations to increase the amount and quality of the material retrieved from the samples. RESULTS: We successfully isolated DNA and RNA from the samples described above, and this material was suitable for PCR, methylation profiling, real-time PCR and DNA sequencing. CONCLUSION: The techniques herein applied to isolate nucleic acids allowed further reliable molecular analyses. Arq Bras Endocrinol Metab. 2012;56(9):618-26
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Gisele Giannocco
- Universidade Federal de Sao Paulo, Brazil; Faculdade de Medicina do ABC, Brazil
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Rietbergen MM, Leemans CR, Bloemena E, Heideman DAM, Braakhuis BJM, Hesselink AT, Witte BI, Baatenburg de Jong RJ, Meijer CJLM, Snijders PJF, Brakenhoff RH. Increasing prevalence rates of HPV attributable oropharyngeal squamous cell carcinomas in the Netherlands as assessed by a validated test algorithm. Int J Cancer 2012; 132:1565-71. [PMID: 22949073 DOI: 10.1002/ijc.27821] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/14/2012] [Indexed: 12/11/2022]
Abstract
Human papillomavirus (HPV) infection has been etiologically linked to oropharyngeal squamous cell carcinoma (OPSCC). The prevalence of HPV-positive OPSCC varies between studies, ranging from 20 to 90%. This may be related to the lack of a standardized HPV detection assay as well as to the time period in which HPV prevalence is investigated, as rising incidence rates are reported over the last decades. Here, we validated our previously defined test algorithm for HPV detection in formalin-fixed paraffin-embedded (FFPE) tumor specimen consisting of p16(INK4A) immunostaining followed by high-risk HPV DNA detection by GP5+/6+ PCR on the positive cases (Smeets et al., Int J Cancer 2007;121:2465-72). In addition, we analyzed HPV prevalence rates in OPSCCs in the years 1990-2010. The test algorithm was validated on a consecutive series of 86 OPSCCs collected during 2008-2011, of which both fresh frozen and FFPE samples were available. We performed HPV-E6 RT-PCR on the frozen samples as gold standard and applied the algorithm to the corresponding FFPE samples. The test algorithm showed an accuracy of 98%. Using the validated algorithm, we determined the presence of an oncogenic HPV infection in 240 OPSCCs of patients diagnosed in the years 1990-2010 at our center. A significant increase in the proportion of HPV-positive samples was observed, from 5.1% in 1990 to 29.0% in 2010 (p = 0.001). In conclusion, we confirmed the accuracy of the test algorithm for HPV detection in FFPE tumor specimen and we found a significant increase in the prevalence of HPV in OPSCC over the last two decades at our center.
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Affiliation(s)
- Michelle M Rietbergen
- Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
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High-resolution melting molecular signatures for rapid identification of human papillomavirus genotypes. PLoS One 2012; 7:e42051. [PMID: 22916117 PMCID: PMC3423390 DOI: 10.1371/journal.pone.0042051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 07/02/2012] [Indexed: 11/21/2022] Open
Abstract
Background Genotyping of human papillomarvirus (HPV) is crucial for patient management in a clinical setting. This study accesses the combined use of broad-range real-time PCR and high-resolution melting (HRM) analysis for rapid identification of HPV genotypes. Methods Genomic DNA sequences of 8 high-risk genotypes (HPV16/18/39/45/52/56/58/68) were subject to bioinformatic analysis to select for appropriate PCR amplicon. Asymmetric broad-range real-time PCR in the presence of HRM dye and two unlabeled probes specific to HPV16 and 18 was employed to generate HRM molecular signatures for HPV genotyping. The method was validated via assessment of 119 clinical HPV isolates. Results A DNA fragment within the L1 region was selected as the PCR amplicon ranging from 215–221 bp for different HPV genotypes. Each genotype displayed a distinct HRM molecular signature with minimal inter-assay variability. According to the HRM molecular signatures, HPV genotypes can be determined with one PCR within 3 h from the time of viral DNA isolation. In the validation assay, a 91% accuracy rate was achieved when the genotypes were in the database. Concomitantly, the HRM molecular signatures for additional 6 low-risk genotypes were established. Conclusions This assay provides a novel approach for HPV genotyping in a rapid and cost-effective manner.
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HPV-related (pre)malignancies of the female anogenital tract in renal transplant recipients. Crit Rev Oncol Hematol 2012; 84:161-80. [PMID: 22425015 DOI: 10.1016/j.critrevonc.2012.02.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 02/03/2012] [Accepted: 02/22/2012] [Indexed: 01/13/2023] Open
Abstract
Renal transplantations (RTs) are performed routinely in many countries. After RT, the administration of lifelong immunosuppressive therapy is required. As a consequence, renal transplant recipients (RTRs) have a high risk to develop virus-associated (pre)malignancies, such as Human papillomavirus (HPV) related anogenital (pre)malignancies. It is known that the majority of the RTRs are infected with HPV and that these women have a 14-fold increased risk of cervical cancer, up to 50-fold of vulvar cancer and up to 100-fold of anal cancer. Often, treatment of these lesions requires concessions and may be suboptimal as radiation therapy and extensive surgery may damage the renal transplant. Therefore, prognosis may be compromised due to inadequately treated malignancies. Especially for these immunocompromised patients prevention is of utmost importance. Yearly cervical cancer screening for RTRs is advised, but appears to be executed poorly. For the future, optimizing screening and prevention of anogenital (pre)malignancies is an important issue for women after RT. This review gives a broad overview of all aspects regarding HPV-related (pre)malignancies of the female anogenital tract in RTRs.
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Evans MF, Matthews A, Kandil D, Adamson CSC, Trotman WE, Cooper K. Discrimination of 'driver' and 'passenger' HPV in tonsillar carcinomas by the polymerase chain reaction, chromogenic in situ hybridization, and p16(INK4a) immunohistochemistry. Head Neck Pathol 2011; 5:344-8. [PMID: 21786153 PMCID: PMC3210222 DOI: 10.1007/s12105-011-0282-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 07/08/2011] [Indexed: 11/25/2022]
Abstract
Human papillomavirus (HPV) positive tonsillar squamous cell carcinoma (TSCC) is associated with a favorable clinical outcome. However, the HPV detected in a given tumor may be causal (driver HPV) or an incidental bystander (passenger HPV). There is a need to discriminate these forms of HPV in TSCCs to understand their impact on HPV as a biomarker for use in TSCC patient management. This study has compared the polymerase chain reaction (PCR), chromogenic in situ hybridization (CISH), and p16(INK4a) immunohistochemistry in the assessment of HPV status in TSCC. Archival specimens of TSCC from thirty patients were investigated. HPV was detected by PCR in 25/30 (83.3%) tumors; HPV16 (70.0%) and HPV52 (6.7%) were the most common types. HPV was corroborated by CISH in 22/25 (88.0%) specimens; integrated HPV was implicated by the presence of punctate signals in each of these cases. p16(INK4a) staining was found in 20/22 (90.9%) HPV PCR positive samples; two PCR/CISH HPV positive cases were p16(INK4a) negative and two HPV negative samples were p16(INK4a) positive. These data suggest that a minority of HPV positive TSCCs are positive for passenger HPV and that two or more assays may be required for diagnosing driver HPV status. Further studies are required to exam whether oropharyngeal tumors positive for passenger HPV have a less favorable prognosis than tumors that are driver HPV positive. The clinical significance of TSCCs that test HPV negative/p16(INK4a) positive, PCR and CISH HPV positive/p16 (INK4a) negative, or PCR HPV positive/p16 (INK4a) and CISH negative, also requires further investigation.
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Affiliation(s)
- Mark Francis Evans
- Department of Pathology, University of Vermont College of Medicine, Burlington, VT 05405, USA.
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Paolini F, Rollo F, Brandi R, Benevolo M, Mariani L, Cercato MC, Vocaturo A, Venuti A. High risk human papillomavirus genotyping in clinical samples: evaluation of different commercial tests. Int J Immunopathol Pharmacol 2011; 24:127-38. [PMID: 21496395 DOI: 10.1177/039463201102400115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the present study is to compare the performance of several commercial human papillomavirus (HPV) tests in a cohort of 281 women. The hybrid capture II, the PreTect-HPV-Proofer, the linear array, and DR.HPVTMIVD were utilized to detect and type HPV in parallel with in-house PCR tests followed by direct automated sequencing or by sub-cloning and sequencing. The concordance levels along with other tests were evaluated with a Cohen's K value varying between 0.60 to 0.88, indicating good correlation with nearly perfect agreement between hybrid capture II, (HCII) and the linear array test. High sensitivity was recorded by the linear array and HCII with 100% (95% CI, 0.8021 to 1.0000) detection of cervical intraepithelial neoplasia (CIN) III by both methods. Conversely, the PreTect-HPV-Proofer showed high specificity with 12% (95% CI, 0.7966 to 0.9163) positivity on normal samples. The genotyping analysis showed that agreement among tests was only low to moderate with great differences between different HPV types. Multiple infections were detected with poor concordance and sub-cloning assays revealed the presence of a lower number of HPV in comparison to the other methods. In summary, the use of different HPV tests applied to the same group of cervical smears may possibly lead to incongruent results, suggesting the need to standardize type-specific sensitivity of genotyping methods and the need to evaluate their accuracy in detecting multiple HPV infections. This would be a prerequisite for the use of genotyping assays in cervical cancer screening programs.
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Affiliation(s)
- F Paolini
- Laboratory of Virology, Regina Elena-National Cancer Institute, Rome, Italy
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Kocken M, Baalbergen A, Snijders PJF, Bulten J, Quint WGV, Smedts F, Meijer CJLM, Helmerhorst TJM. High-risk human papillomavirus seems not involved in DES-related and of limited importance in nonDES related clear-cell carcinoma of the cervix. Gynecol Oncol 2011; 122:297-302. [PMID: 21620450 DOI: 10.1016/j.ygyno.2011.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 04/30/2011] [Accepted: 05/02/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Over 90% of all cervical adenocarcinoma are caused by a transforming infection with a high-risk type human papillomavirus (hrHPV). Previous studies demonstrated that the association between hrHPV positivity and cervical clear-cell adenocarcinoma (CCAC) varies between 0% and 100%. As approximately 60% of all CCAC are associated with intra-uterine diethylstilbestrol (DES) exposure, we determined in a cohort of both DES-exposed and DES-unexposed women the prevalence of hrHPV infections, and the potential etiological role of hrHPV by additional analysis of p16INK4a and p53 expression. METHODS Representative slides of 28 women diagnosed with CCAC were tested for hrHPV by two PCR methods (the clinically validated GP5+/6+ PCR and the very sensitive SPF(10)PCR/LiPA(25)). Fifteen women were DES-exposed, 10 unexposed and of 3 women DES-exposure was unknown. Twenty-one cases with sufficient material were immuno-histochemically stained for p16INK4a and p53. RESULTS Seven tumors, of which four DES-exposed and two unexposed tested positive for hrHPV with GP5+/6+ PCR. Thirteen tumors, of which five DES-exposed and seven unexposed, tested positive with SPF(10)PCR/LiPA(25). In one women with unknown exposure, a CCAC tested positive in both assays. Only three cases, none in DES-exposed women, and all positive with both hrHPV assays, revealed diffuse p16INK4a immuno-staining and weak p53 staining as well, supporting indisputable hrHPV involvement. CONCLUSIONS Although the prevalence of hrHPV was high, only two DES-unrelated CCAC (25%) and one tumor in a woman with unknown exposure could be attributed to hrHPV.
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Affiliation(s)
- Mariëlle Kocken
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
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Peevor R, Jones J, Fiander A, Hibbitts S. Development of optimal liquid based cytology sample processing methods for HPV testing: Minimising the ‘inadequate’ test result. J Virol Methods 2011; 173:374-7. [DOI: 10.1016/j.jviromet.2011.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 01/16/2011] [Accepted: 01/26/2011] [Indexed: 11/24/2022]
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Rapid genotyping of human papillomavirus by post-PCR array-based hybridization techniques. J Clin Microbiol 2011; 49:1395-402. [PMID: 21325552 DOI: 10.1128/jcm.01606-10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Kinetic hybridization measurements on a microarray are expected to become a valuable tool for genotyping applications. A method has been developed that enables kinetic hybridization measurements of PCR products on a low-density microarray. This is accomplished by pumping a solution containing PCR products up and down through a porous microarray substrate. After every pumping cycle, the fluorescently labeled PCR products hybridized to capture probes immobilized on the solid surface of the porous microarray substrate are measured. By this method, both binding curves and high-resolution melting curves are obtained instead of the single endpoint hybridization intensities as with commonly used post-PCR array-based hybridization techniques. We used 20 subtypes of the human papillomavirus (HPV) as a model system to test our detection method and blindly analyzed 216 clinical samples. We compared our microarray flowthrough method with a reference method, PCR followed by a reverse line blot (RLB). Real-time hybridization measurements followed by high-resolution melting curves of low concentrations of fluorescently labeled HPV targets on a microarray were successfully carried out without any additional chemical signal amplification. The results of our new method were in good agreement (93%, with a kappa coefficient of κ = 0.88 [95% CI, 0.81 to 0.94]) with the RLB results. All discrepant samples were analyzed by a third method, enzyme immunoassay (EIA). Furthermore, in a number of cases, we were able to identify false-positive samples by making use of the information contained in the kinetic binding and melting curves. This clearly demonstrates the added value of the use of kinetic measurements and high-resolution melting curves, especially for highly homologous targets.
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