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Brusen Villadsen A, Bundgaard-Nielsen C, Ambühl L, Tang Svendsen M, Søkilde Pedersen I, Stæhr Hansen E, Baandrup U, Blaakær J, Sørensen S. Prevalence and type distribution of human papillomavirus infections in Danish patients diagnosed with vulvar squamous cell tumors and precursors. Gynecol Oncol Rep 2021; 37:100828. [PMID: 34621943 PMCID: PMC8484492 DOI: 10.1016/j.gore.2021.100828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/07/2022] Open
Abstract
Most precursor lesions of VSCC appear to be HPV associated. A noteworthy proportion of keratinizing tumors, normally considered HPV independent, are HPV positive. Our findings pose a challenge to the two-pathway model in vulvar cancer development. HPV-16 is found in the majority of VSCC and vulvar HSIL cases followed by HPV-33, which is the second most common type.
Objective To study the prevalence and type distribution of human papillomavirus (HPV) in patients with vulvar high-grade precancerous lesions and vulvar squamous cell carcinoma (VSCC). Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from Danish patients diagnosed with vulvar precancerous lesions or VSCC in the period from 2010 to 2012 were obtained. HPV-DNA detection was carried out by the use of polymerase chain reaction (PCR) using GP5+/GP6+ primers and genotyped by sequencing. A systematic literature search on the PubMed database was performed to investigate the prevalence and genotype distribution worldwide. Results In the present study population (n = 149) 52 vulvar high-grade squamous intraepithelial lesions (HSIL), 2 differentiated vulvar intraepithelial neoplasia (dVIN), and 95 VSCC cases were identified. HPV was detected in 85 patients (57.0%). Overall, a higher proportion of the vulvar high-grade precancerous lesions were HPV positive compared to VSCC (83.6% vs. 42.1%, p < 0.001). Additionally, HSIL had a significantly higher HPV-positive rate compared to keratinizing VSCC (84.6% vs. 33.3%, p < 0.001). However, the HPV positivity was comparable between HSIL and non-keratinizing VSCC (84.6% vs. 82.4%, p = 0.825). One dVIN was HPV positive whereas the other was HPV negative. HPV-16 was the most common HPV type (68.2%), followed by HPV-33 (18.8%) and HPV-18 (8.2%). Conclusions Most vulvar HSIL and non-keratinizing VSCCs appear to be HPV associated. However, we find a high HPV association in keratinizing VSCC, which needs to be further studied. HPV-16 remains the predominant genotype, but HPV-33 also seems to play a role in the development of VSCC.
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Affiliation(s)
- Annemarie Brusen Villadsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Caspar Bundgaard-Nielsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lea Ambühl
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Majbritt Tang Svendsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Inge Søkilde Pedersen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark.,Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | | | - Ulrik Baandrup
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jan Blaakær
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Suzette Sørensen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Lillsunde Larsson G, Kaliff M, Sorbe B, Helenius G, Karlsson MG. HPV16 viral characteristics in primary, recurrent and metastatic vulvar carcinoma. PAPILLOMAVIRUS RESEARCH 2018; 6:63-69. [PMID: 30391517 PMCID: PMC6249404 DOI: 10.1016/j.pvr.2018.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/06/2018] [Accepted: 10/28/2018] [Indexed: 01/06/2023]
Abstract
Vulvar carcinoma is the fourth most common gynecological malignancy. Two separate carcinogenic pathways are suggested, where one is associated with the human papillomavirus (HPV) and HPV16 the most common genotype. The aim of this study was to evaluate HPV-markers in a set of primary tumors, metastases and recurrent lesions of vulvar squamous cell carcinomas (VSCC). Ten HPV16-positive VSCC with metastatic regional lymph nodes, distant lymphoid/hematogenous metastases or local recurrent lesions were investigated for HPV genotype, HPV16 variant, HPV16 viral load, HPV16 integration and HPV16 E2BS3 and 4 methylation. In all 10 analyzed case series, the same HPV genotype (HPV16), HPV16 variant and level of viral load were detected in all lesions within a patient case. Primary tumors with a high E2/E6 ratio were found to have fewer vulvar recurrences and/or metastases after diagnosis and treatment. Also, a significantly lower viral load was evident in regional lymph nodes compared to primary tumors. The data presented strengthens the evidence for a clonal HPV-induced pathway for vulvar carcinoma.
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Affiliation(s)
- Gabriella Lillsunde Larsson
- School of Health Sciences, Örebro University, SE-701 82 Örebro, Sweden; Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden.
| | - Malin Kaliff
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Bengt Sorbe
- Department of Oncology, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Gisela Helenius
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Mats G Karlsson
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
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Zhang J, Zhang Y, Zhang Z. Prevalence of human papillomavirus and its prognostic value in vulvar cancer: A systematic review and meta-analysis. PLoS One 2018; 13:e0204162. [PMID: 30256833 PMCID: PMC6157864 DOI: 10.1371/journal.pone.0204162] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/03/2018] [Indexed: 01/11/2023] Open
Abstract
The purpose of this study was to estimate the prevalence of human papillomavirus (HPV) in vulvar cancer and determine whether positive HPV in vulvar cancer was associated with a better prognosis. Literature searches of Ovid EMBASE, PubMed, Web of Science and Cochrane Library were performed to identify related studies published from January 2000 to May 2017. A total of 33 studies including 7,721 subjects were selected in this meta-analysis. Overall, the HPV prevalence in vulvar cancer tissue was 34% (95% CI: 28%-39%) with 45% (95% CI: 28%-64%) in Asian populations and 34% (95% CI: 26%-42%) in Caucasian populations. The HPV-positive vulvar cancer was associated with better overall survival (hazard ratio = 0.64, 95% CI: 0.47–0.87; P = 0.004) and recurrence-free survival (hazard ratio = 0.66, 95% CI: 0.45–0.97; P = 0.03) compared with HPV-negative counterpart. HPV status may play an important role in predicting the prognosis of patients with vulvar cancer. The HPV-positive vulvar cancer women might relatively have a better survival than HPV-negative ones.
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Affiliation(s)
- Jianxin Zhang
- Department of Obstetrics and Gynecology, Capital Medical University affiliated Beijing Chaoyang Hospital, Chaoyang District, Beijing, PR. China
| | - Yang Zhang
- Department of Obstetrics and Gynecology, Capital Medical University affiliated Beijing Chaoyang Hospital, Chaoyang District, Beijing, PR. China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Capital Medical University affiliated Beijing Chaoyang Hospital, Chaoyang District, Beijing, PR. China
- * E-mail:
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Östensson E, Silfverschiöld M, Greiff L, Asciutto C, Wennerberg J, Lydryp ML, Håkansson U, Sparén P, Borgfeldt C. The economic burden of human papillomavirus-related precancers and cancers in Sweden. PLoS One 2017. [PMID: 28651012 PMCID: PMC5484479 DOI: 10.1371/journal.pone.0179520] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background High-risk (HR) human papillomavirus (HPV) infection is an established cause of malignant disease. We used a societal perspective to estimate the cost of HR HPV-related cervical, vulvar, vaginal, anal, and penile precancer and cancer, and oropharyngeal cancer in Sweden in 2006, 1 year before HPV vaccination became available in the country. Materials and methods This prevalence-based cost-of-illness study used diagnosis-specific data from national registries to determine the number of HR HPV-related precancers and cancers. The HR HPV-attributable fractions of these diseases were derived from a literature review and applied to the total burden to estimate HR HPV-attributable costs. Direct costs were based on health care utilization and indirect costs on loss of productivity due to morbidity (i.e., sick leave and early retirement) and premature mortality. Results The total annual cost of all HR HPV-attributable precancers and cancers was €94 million (€10.3/inhabitant). Direct costs accounted for €31.3 million (€3.4/inhabitant) of the total annual cost, and inpatient care amounted to €20.7 million of direct costs. Indirect costs made up €62.6 million (€6.9/inhabitant) of the total annual cost, and premature mortality amounted to €36 million of indirect costs. Cervical precancer and cancer was most costly (total annual cost €58.4 million). Among cancers affecting both genders, anal precancer and cancer, and oropharyngeal cancer were the most costly (€11.2 million and €11.9 million, respectively). For oropharyngeal cancer, males had the highest health care utilization and represented 71% of the total annual cost. Penile precancer and cancer was least costly (€2.6 million). Conclusion The economic burden of HR HPV-related precancers and cancers is substantial. The disease-related management and treatment costs we report are relevant as a point of reference for future economic evaluations investigating the overall benefits of HPV vaccination in females and males in Sweden.
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Affiliation(s)
- Ellinor Östensson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Women´s and Children´s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Maria Silfverschiöld
- Department of Otorhinolaryngology Head & Neck Surgery, Skånes University Hospital, Lund University, Lund, Sweden
| | - Lennart Greiff
- Department of Otorhinolaryngology Head & Neck Surgery, Skånes University Hospital, Lund University, Lund, Sweden
| | - Christine Asciutto
- Department of Obstetrics and Gynecology, Skånes University Hospital, Lund University, Lund, Sweden
| | - Johan Wennerberg
- Department of Otorhinolaryngology Head & Neck Surgery, Skånes University Hospital, Lund University, Lund, Sweden
| | | | - Ulf Håkansson
- Department of Urology, Skånes University Hospital, Lund University, Malmö, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skånes University Hospital, Lund University, Lund, Sweden
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Faber MT, Sand FL, Albieri V, Norrild B, Kjaer SK, Verdoodt F. Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva. Int J Cancer 2017; 141:1161-1169. [DOI: 10.1002/ijc.30821] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 05/11/2017] [Accepted: 05/22/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Mette T. Faber
- Danish Cancer Society Research Center; Virus, Lifestyle and Genes; Copenhagen Denmark
| | - Freja L. Sand
- Danish Cancer Society Research Center; Virus, Lifestyle and Genes; Copenhagen Denmark
| | - Vanna Albieri
- Danish Cancer Society Research Center; Statistics and Pharmacoepidemiology; Copenhagen Denmark
| | - Bodil Norrild
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
| | - Susanne K. Kjaer
- Danish Cancer Society Research Center; Virus, Lifestyle and Genes; Copenhagen Denmark
- Department of Gynecology; Rigshospitalet, University of Copenhagen; Copenhagen Denmark
| | - Freija Verdoodt
- Danish Cancer Society Research Center; Virus, Lifestyle and Genes; Copenhagen Denmark
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Salopek KM, Jukić S, Babić D. Correlation of the HPV detection, protein expression and DNA content in cutaneous pre-invasive and invasive carcinoma among Croatian patients. Exp Mol Pathol 2017; 102:123-127. [DOI: 10.1016/j.yexmp.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 01/11/2017] [Indexed: 01/30/2023]
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Progress in the Research on the Relationship between Infection with Human Papillomavirus and Tumorigenesis. INFECTION INTERNATIONAL 2016. [DOI: 10.1515/ii-2017-0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractHuman papillomavirus (HPV) is a DNA virus that infects the skin and mucous membranes of the human body. Approximately 80% of sexually active women are likely infected with HPV. Cervical cancer is one of the most common malignant tumors and is second in incidence only to breast cancer. Infection with high-risk HPV types is the main risk factor for cervical cancer, which is currently the only malignant tumor with a clearly defined etiology. HPV infection is also closely related to the incidence and development of other malignant tumors. In addition to cervical cancer, HPV can cause other urogenital tumors, as well as tumors in the digestive tract, lungs, eyes, skin, and other organ systems. This paper provides a review of the progress in HPV infection-related research and provides novel ideas for the study of tumor etiology and mechanisms.
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Magaña-León C, Oros C, López-Revilla R. Human papillomavirus types in non-cervical high-grade intraepithelial neoplasias and invasive carcinomas from San Luis Potosí, Mexico: a retrospective cross-sectional study. Infect Agent Cancer 2015; 10:33. [PMID: 26417386 PMCID: PMC4584459 DOI: 10.1186/s13027-015-0027-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/19/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Viral infections and the burden of high-grade intraepithelial neoplasias (HIN) and invasive carcinomas (IC) associated to infections by human papillomavirus (HPV) types may be prevented by type-specific anti-HPV vaccines. This study determined the prevalence of HPV types in non-cervical HIN and IC diagnosed from 1999 to 2011 at a general hospital in San Luis Potosí, Mexico. METHODS Review of the 67 formaldehyde-fixed paraffin-embedded non-cervical specimens initially diagnosed as HIN (n = 28) or IC (n = 39) confirmed the presence of tumor tissue in 63 of them and changed the diagnosis of 24 from HIN to low-grade intraepithelial neoplasias, that were excluded from the study. HPV DNA was detected with the SPF10-DNA enzyme immunoassay in the 39 cases included, and viral types in the HPV-positive tumors were identified with the INNO-LiPA linear probe array. RESULTS Among the cases included, four HIN were located in the vagina (n = 3) and vulva (n = 1), and 35 IC in the oral cavity (n = 19), penis (n = 8), vagina (n = 7) and vulva (n = 1). There were 13 HPV-positive cases from the vagina (n = 7), vulva (n = 1), penis (n = 1) and oral cavity (n = 1). The viral types identified were the high-risk types HPV16 in the vagina (n = 3) and vulva (n = 3), HPV45 in the vagina (n = 2), HPV59 in the vagina (n = 1) and penis (n = 1), HPV33 in the vagina (n = 1),and HPV35 in the tongue(n = 1); and the low-risk types HPV54 in the vagina (n = 1), and HPV11 in the vulva (n = 1). CONCLUSIONS Five high-risk viral types (HPV16, 45, 59, 33 and 35) and two low-risk types (HPV11 and 54) infect one third of the non-cervical HIN and IC included. Most infections are by a single HPV high-risk type, the most prevalent one being HPV16. Vagina is the most frequent location of the HPV-positive tumors. Vaccination against HPV16 and HPV18 could have prevented around half of the HPV-positive tumors.
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Affiliation(s)
- Claudia Magaña-León
- />División de Biología Molecular, Instituto Potosino de Investigación Científica y Tecnológica, Camino a la Presa San José 2055, 78216 San Luis Potosí, S.L.P. Mexico
| | - Cuauhtémoc Oros
- />Departamento de Patología, Hospital Central Ignacio Morones Prieto, Av. Venustiano Carranza 2395, 78240 San Luis Potosí, S.L.P. Mexico
| | - Rubén López-Revilla
- />División de Biología Molecular, Instituto Potosino de Investigación Científica y Tecnológica, Camino a la Presa San José 2055, 78216 San Luis Potosí, S.L.P. Mexico
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Siriaunkgul S, Settakorn J, Sukpan K, Srisomboon J, Utaipat U, Lekawanvijit S, Khunamornpong S. HPV Detection and Genotyping in Vulvar Squamous Cell Carcinoma in Northern Thailand. Asian Pac J Cancer Prev 2014; 15:3773-8. [DOI: 10.7314/apjcp.2014.15.8.3773] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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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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Liang W, Wang J, Wang C, Lv Y, Gao H, Zhang K, Liu H, Feng J, Wang L, Ma R. Detection of high-risk human papillomaviruses in fresh breast cancer samples using the hybrid capture 2 assay. J Med Virol 2013; 85:2087-92. [PMID: 23959946 DOI: 10.1002/jmv.23703] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2013] [Indexed: 11/10/2022]
Abstract
The etiology of breast cancer remains unknown and the role of human papillomavirus (HPV) in breast carcinogenesis is controversial. This study investigated the prevalence of high-risk HPV infections in Chinese women with breast cancer and the possible relationship between high-risk HPV infection and the clinicopathological characteristics of breast cancer. Tumor cells from 224 fresh breast cancer samples and 37 fresh breast fibroadenomas were collected for hybrid capture 2 (HC2) assay. HC2 was the only technique approved by the United States Food and Drug Administration for screening for high-risk HPV infection in 2008. The prevalence of high-risk HPV infection in breast cancer samples was 21.4%, which was slightly higher than the 16.2% observed in breast fibroadenomas. Age and menopausal status were not risk factors for high-risk HPV infection among breast cancer patients. The clinical and pathological characteristics of breast cancer showed no significant correlation with high-risk HPV infection. Although the prevalence of 13 subtypes of high-risk HPV infections was similar in breast cancer and nonmalignant breast samples, the presence of high-risk HPVs in both malignant and benign breast samples implies that a possible causal role in breast cancer carcinogenesis could not be ruled out. Clarifying the possible link between high-risk HPVs and breast cancer might benefit women vaccinated against HPV and could decrease the incidence of HPV-related breast cancer.
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Affiliation(s)
- Weili Liang
- Department of Breast Surgery, Qilu Hospital of Shandong University, Shandong, P.R., China
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Jain KS, Sikora AG, Baxi SS, Morris LGT. Synchronous cancers in patients with head and neck cancer: risks in the era of human papillomavirus-associated oropharyngeal cancer. Cancer 2013; 119:1832-7. [PMID: 23423883 DOI: 10.1002/cncr.27988] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 01/08/2013] [Accepted: 01/11/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Second primary malignancies (SPMs) are the leading cause of death in survivors of head and neck squamous cell carcinoma (HNSCC). Synchronous SPMs are of significant clinical interest because they potentially can be identified by screening procedures at the time of diagnosis of the index cancer. Recently, human papillomavirus (HPV) has emerged as a distinct risk factor for oropharyngeal head and neck squamous cell carcinoma (HNSCC), differing from classic tobacco/alcohol-associated HNSCC, suggesting that there also may be distinct patterns of synchronous SPMs. METHODS The authors performed a population-based cohort study in 64,673 patients in the National Cancer Institute Surveillance, Epidemiology, and End Results registry (1979-2008), defining risks of synchronous SPM in patients with HNSCC who were diagnosed before and after the emergence of prevalent HPV-associated oropharyngeal HNSCC. Excess risk was calculated using standardized incidence ratios (SIR) and excess absolute risk per 100 patients. RESULTS Among patients with HNSCC, the SIR of synchronous SPM was 5.0, corresponding to 2.62 excess cases per 100 patients. The site with the highest excess risk of a second cancer was the head and neck (SIR, 41.4), followed by the esophagus (SIR, 21.8), and lung (SIR, 7.4). The risk of synchronous SPM changed markedly over time for patients with oropharyngeal HNSCC. In the 1970s and 1980s, oropharyngeal cancers carried the highest risk of SPM. Risk began to dramatically decline in the 1990s; and currently, oropharyngeal cancers carry the lowest risk of synchronous SPM. CONCLUSIONS The current data are consistent with the etiologic shift of oropharyngeal HNSCC, from a primarily tobacco-associated malignancy associated with significant field cancerization of the upper aerodigestive mucosa, to a malignancy primarily caused by oncogenic human papillomavirus.
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Affiliation(s)
- Kunal S Jain
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Larsson GL, Helenius G, Andersson S, Elgh F, Sorbe B, Karlsson MG. Human Papillomavirus (HPV) and HPV 16–Variant Distribution in Vulvar Squamous Cell Carcinoma in Sweden. Int J Gynecol Cancer 2012; 22:1413-9. [DOI: 10.1097/igc.0b013e31826a0471] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ObjectiveTo investigate the human papillomavirus (HPV) and HPV type 16–variant distribution in a series of vulvar squamous cell carcinomas (VSCC) and to evaluate the impact of HPV and HPV 16–variant on prognosis.MethodsA series of 133 patients who had a diagnosis of VSCC (1983-2008) was selected for the study. Detection of 11 high-risk HPV types (16, 18, 31, 33, 39, 45, 51, 52, 56, 58, and 59) and 2 low-risk HPV types (6 and 11) was performed with real-time polymerase chain reaction. Samples positive for HPV 16 were further analyzed for variant determination of 7 positions in theE6gene with polymerase chain reaction and pyrosequencing.ResultsForty (30.8%) of 130 tumors were found to be HPV positive. Human papillomavirus type 16 was found in 31 cases, HPV 18 was found in 2 cases, HPV 33 was found in 5 cases, and HPV 56 and HPV 59 were found in one case each. All but one tumor harboring HPV 16 were of European linage, and the 3 most common variants were E-p (n = 13), E-G350 (n = 7), and E-G131 (n = 5). HPV positivity was associated with the basaloid tumor type and occurred in significantly younger patients. Overall and recurrence-free survival rates were better in HPV-positive cases, but after correction for age and tumor size, HPV status was no longer an independent and significant prognostic factor. The survival rates of the various HPV 16 variants were not significantly different, but there was a trend of worse outcome for the E-G131–variant group.ConclusionsHuman papillomavirus positivity of 30.8% is similar to other reports on VSCC. To our knowledge, this first variant determination of HPV 16 in vulvar carcinoma in a Swedish cohort indicated that the variant E-G131 may have an increased oncogenic potential in patients with VSCC.
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Gargano JW, Wilkinson EJ, Unger ER, Steinau M, Watson M, Huang Y, Copeland G, Cozen W, Goodman MT, Hopenhayn C, Lynch CF, Hernandez BY, Peters ES, Saber MS, Lyu CW, Sands LA, Saraiya M. Prevalence of human papillomavirus types in invasive vulvar cancers and vulvar intraepithelial neoplasia 3 in the United States before vaccine introduction. J Low Genit Tract Dis 2012; 16:471-9. [PMID: 22652576 PMCID: PMC5553114 DOI: 10.1097/lgt.0b013e3182472947] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The study aimed to determine the baseline prevalence of human papillomavirus (HPV) types in invasive vulvar cancer (IVC) and vulvar intraepithelial neoplasia 3 (VIN 3) cases using data from 7 US cancer registries. MATERIALS AND METHODS Registries identified eligible cases diagnosed in 1994 to 2005 and requested pathology laboratories to prepare 1 representative block for HPV testing on those selected. Hematoxylin-eosin-stained sections preceding and following those used for extraction were reviewed to confirm representation. Human papillomavirus was detected using L1 consensus polymerase chain reaction (PCR) with PGMY9/11 primers and type-specific hybridization, with retesting of samples with negative and inadequate results with SPF10 primers. For IVC, the confirmatory hematoxylin-eosin slides were re-evaluated to determine histological type. Descriptive analyses were performed to examine distributions of HPV by histology and other factors. RESULTS Human papillomavirus was detected in 121/176 (68.8%) cases of IVC and 66/68 (97.1%) cases of VIN 3 (p < .0001). Patients with IVC and VIN 3 differed by median age (70 vs 55 y, p = .003). Human papillomavirus 16 was present in 48.6% of IVC cases and 80.9% of VIN 3 cases; other high-risk HPV was present in 19.2% of IVC cases and 13.2% of VIN 3 cases. Prevalence of HPV differed by squamous cell carcinoma histological subtype (p < .0001) as follows: keratinizing, 49.1% (n = 55); nonkeratinizing, 85.7% (n = 14), basaloid, 92.3% (n = 14), warty 78.2% (n = 55), and mixed warty/basaloid, 100% (n = 7). CONCLUSIONS Nearly all cases of VIN 3 and two thirds of IVC cases were positive for high-risk HPV. Prevalence of HPV ranged from 49.1% to 100% across squamous cell carcinoma histological subtypes. Given the high prevalence of HPV in IVC and VIN 3 cases, prophylactic vaccines have the potential to decrease the incidence of vulvar neoplasia.
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Affiliation(s)
- Julia W Gargano
- Epidemic Intelligence Service, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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16
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Verma SB, Wollina U. Condyloma-like squamous cell carcinoma of the vulva: report of two midline cases. Clin Cosmet Investig Dermatol 2012; 5:129-33. [PMID: 23055761 PMCID: PMC3459548 DOI: 10.2147/ccid.s34120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Vulvar cancer is uncommon and may be confused with genital condylomata. We report two cases of middle-aged women presenting with exophytic vulvar tumors of the midline for which diagnosis of a vulvar squamous cell carcinoma was confirmed by histopathology. Risk factors, staging, and treatment options are discussed.
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Sandberg A, Lindell G, Källström BN, Branca RM, Danielsson KG, Dahlberg M, Larson B, Forshed J, Lehtiö J. Tumor proteomics by multivariate analysis on individual pathway data for characterization of vulvar cancer phenotypes. Mol Cell Proteomics 2012; 11:M112.016998. [PMID: 22499770 DOI: 10.1074/mcp.m112.016998] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Vulvar squamous cell carcinoma (VSCC) is the fourth most common gynecological cancer. Based on etiology VSCC is divided into two subtypes; one related to high-risk human papilloma virus (HPV) and one HPV negative. The two subtypes are proposed to develop via separate intracellular signaling pathways. We investigated a suggested link between HPV infection and relapse risk in VSCC through in-depth protein profiling of 14 VSCC tumor specimens. The tumor proteomes were analyzed by liquid-chromatography tandem mass spectrometry. Relative protein quantification was performed by 8-plex isobaric tags for relative and absolute quantification. Labeled peptides were fractionated by high-resolution isoelectric focusing prior to liquid-chromatography tandem mass spectrometry to reduce sample complexity. In total, 1579 proteins were regarded as accurately quantified and analyzed further. For classification of clinical groups, data analysis was performed by comparing protein level differences between tumors defined by HPV and/or relapse status. Further, we performed a biological analysis on individual tumor proteomes by matching data to known biological pathways. We here present a novel analysis approach that combines pathway alteration data on individual tumor level with multivariate statistics for HPV and relapse status comparisons. Four proteins (signal transducer and activator of transcription-1, myxovirus resistance protein 1, proteasome subunit alpha type-5 and legumain) identified as main classifiers of relapse status were validated by immunohistochemistry (IHC). Two of the proteins are interferon-regulated and on mRNA level known to be repressed by HPV. By both liquid-chromatography tandem mass spectrometry and immunohistochemistry data we could single out a subgroup of HPV negative/relapse-associated tumors. The pathway level data analysis confirmed three of the proteins, and further identified the ubiquitin-proteasome pathway as altered in the high risk subgroup. We show that pathway fingerprinting with resolution on individual tumor level adds biological information that strengthens a generalized protein analysis.
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Affiliation(s)
- Annsofi Sandberg
- Clinical Proteomics Mass Spectrometry, Department of Oncology-Pathology, Science for Life Laboratory and Karolinska Institutet, Stockholm, Sweden
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18
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Tsimplaki E, Argyri E, Michala L, Kouvousi M, Apostolaki A, Magiakos G, Papassideri I, Panotopoulou E. Human papillomavirus genotyping and e6/e7 mRNA expression in greek women with intraepithelial neoplasia and squamous cell carcinoma of the vagina and vulva. JOURNAL OF ONCOLOGY 2011; 2012:893275. [PMID: 22187556 PMCID: PMC3236520 DOI: 10.1155/2012/893275] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 09/19/2011] [Accepted: 09/20/2011] [Indexed: 11/18/2022]
Abstract
A large proportion of vaginal and vulvar squamous cell carcinomas (SCCs) and intraepithelial neoplasias (VAIN and VIN) are associated with HPV infection, mainly type 16. The purpose of this study was to identify HPV genotypes, as well as E6/E7 mRNA expression of high-risk HPVs (16, 18, 31, 33, and 45) in 56 histology samples of VAIN, VIN, vaginal, and vulvar SCCs. HPV was identified in 56% of VAIN and 50% of vaginal SCCs, 71.4% of VIN and 50% of vulvar SCCs. E6/E7 mRNA expression was found in one-third of VAIN and in all vaginal SCCs, 42.9% of VIN and 83.3% of vulvar SCCs. Our data indicated that HPV 16 was the commonest genotype identified in VAIN and VIN and the only genotype found in SCCs of the vagina and vulva. These findings may suggest, in accordance with other studies, that mRNA assay might be useful in triaging lesions with increased risk of progression to cancer.
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Affiliation(s)
- Elpida Tsimplaki
- Department of Virology, “G. Papanicolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Elena Argyri
- Department of Virology, “G. Papanicolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Lina Michala
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Vas Sofias 80, 11528 Athens, Greece
| | - Maria Kouvousi
- Department of Virology, “G. Papanicolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Aikaterini Apostolaki
- Department of Pathology, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - George Magiakos
- 1st Department of Gynecology, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
| | - Issidora Papassideri
- Department of Cell Biology and Biophysics, Faculty of Biology, University of Athens, Panepistimiopolis, 15784 Athens, Greece
| | - Efstathia Panotopoulou
- Department of Virology, “G. Papanicolaou” Research Center of Oncology and Experimental Surgery, Regional Anticancer Oncology Hospital of Athens “St. Savvas”, 171 Alexandras Avenue, 11522 Athens, Greece
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Kotsopoulos IC, Tampakoudis GP, Evaggelinos DG, Nikolaidou AI, Fytili PA, Kartsiounis VC, Gerasimidou DK. Implication of human papillomavirus-66 in vulvar carcinoma: a case report. J Med Case Rep 2011; 5:232. [PMID: 21702970 PMCID: PMC3150314 DOI: 10.1186/1752-1947-5-232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 06/25/2011] [Indexed: 11/17/2022] Open
Abstract
Introduction Vulvar cancer in older women is seldom associated with human papillomavirus infection. Case presentation We present the case of an 80-year-old Greek Caucasian woman with an undetermined obstetric and gynecologic history. The patient underwent radical vulvectomy and bilateral inguinal lymphadenectomy for a vulvar carcinoma. A human papillomavirus infection was suggested on the basis of histological and cytological examinations followed by human papillomavirus DNA typing, which revealed the presence of human papillomavirus-66. Conclusion Even though human papillomavirus-16 and human papillomavirus-18 are most frequently implicated in the pathogenesis of vulvar carcinoma, human papillomavirus-66 can also be regarded as a causative factor. Suspicious lesions should be biopsied, and in the presence of carcinoma, vulvectomy with bilateral lymphadenectomy, if necessary, must be performed. Furthermore, polymerase chain reaction assay analysis with clinical arrays in cytological samples is an accurate test for the detection of a wide range of human papillomavirus genotypes and can be used to verify the infection and specify the human papillomavirus type implicated.
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20
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Clinico-pathological and biological prognostic variables in squamous cell carcinoma of the vulva. Crit Rev Oncol Hematol 2011; 83:71-83. [PMID: 22015047 DOI: 10.1016/j.critrevonc.2011.09.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 08/08/2011] [Accepted: 09/21/2011] [Indexed: 11/23/2022] Open
Abstract
Several clinical-pathological parameters have been related to survival of patients with invasive squamous cell carcinoma of the vulva, whereas few studies have investigated the ability of biological variables to predict the clinical outcome of these patients. The present paper reviews the literature data on the prognostic relevance of lymph node-related parameters, primary tumor-related parameters, FIGO stage, blood variables, and tissue biological variables. Regarding these latter, the paper takes into account the analysis of DNA content, cell cycle-regulatory proteins, apoptosis-related proteins, epidermal growth factor receptor [EGFR], and proteins that are involved in tumor invasiveness, metastasis and angiogenesis. At present, the lymph node status and FIGO stage according to the new 2009 classification system are the main predictors for vulvar squamous cell carcinoma, whereas biological variables do not have yet a clinical relevance and their role is still investigational.
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Alonso I, Fusté V, del Pino M, Castillo P, Torné A, Fusté P, Rios J, Pahisa J, Balasch J, Ordi J. Does human papillomavirus infection imply a different prognosis in vulvar squamous cell carcinoma? Gynecol Oncol 2011; 122:509-14. [DOI: 10.1016/j.ygyno.2011.05.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 05/11/2011] [Accepted: 05/14/2011] [Indexed: 10/18/2022]
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22
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Comparison of Molecular Methods for Detection of HPV in Oral and Oropharyngeal Squamous Cell Carcinoma. ACTA ACUST UNITED AC 2010; 19:218-23. [DOI: 10.1097/pdm.0b013e3181d0cd35] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Guerrero D, Guarch R, Ojer A, Casas JM, Méndez-Meca C, Esteller M, Barba-Ramos E, Garcia-Bragado F, Puras A. Differential hypermethylation of genes in vulvar cancer and lichen sclerosus coexisting or not with vulvar cancer. Int J Cancer 2010; 128:2853-64. [DOI: 10.1002/ijc.25629] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 08/03/2010] [Indexed: 12/12/2022]
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24
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Kowalewska M, Szkoda MT, Radziszewski J, Ptaszynski K, Bidzinski M, Siedlecki JA. The frequency of human papillomavirus infection in polish patients with vulvar squamous cell carcinoma. Int J Gynecol Cancer 2010; 20:434-7. [PMID: 20375810 DOI: 10.1111/igc.0b013e3181d320f1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Vulvar cancer is a rare condition representing about 4% of all female genital tract tumors. In contrast to the established relationship of virtually all cervical cancer cases with the human papillomavirus (HPV) infection, the reported HPV positivity in vulvar carcinoma ranges widely. METHODS Using the Linear Array HPV Genotyping Test, we investigated the HPV incidence in a group of 46 Polish patients with vulvar squamous cell carcinoma (age range, 37-93 years; median age, 70.2 years) in clinical stages T1-2, N0-2, and M0. RESULTS The presence of HPV DNA was confirmed in 7 of 46 (15%) primary tumor samples. HPV 16 was found in 5 tumors (71%). HPVs 6 and 58 were detected in the remaining 2 cases of virus-associated tumors. CONCLUSIONS We conclude that a fraction of cancers of vulva associated with HPV is insignificant, given the HPV prevalence of 8.6% in the Polish population aged 55 to 59 years (the oldest cohort of Polish women studied to date).
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Affiliation(s)
- Magdalena Kowalewska
- Department of Molecular Biology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, 5 W.K. Roentgena, 02-781 Warsaw, Poland.
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25
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Lindell G, Näsman A, Jonsson C, Ehrsson RJ, Jacobsson H, Danielsson KG, Dalianis T, Källström BN, Larson B. Presence of human papillomavirus (HPV) in vulvar squamous cell carcinoma (VSCC) and sentinel node. Gynecol Oncol 2010; 117:312-6. [DOI: 10.1016/j.ygyno.2009.12.031] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 11/27/2009] [Accepted: 12/19/2009] [Indexed: 11/28/2022]
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26
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Garland SM, Insinga RP, Sings HL, Haupt RM, Joura EA. Human papillomavirus infections and vulvar disease development. Cancer Epidemiol Biomarkers Prev 2009; 18:1777-84. [PMID: 19505910 DOI: 10.1158/1055-9965.epi-09-0067] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We describe the prevalence of 14 common types [human papillomavirus (HPV)-6/11/16/18/31/33/35/39/45/51/52/56/58/59] in vulvar intraepithelial neoplasia grades 1 to 3 (VIN 1-3) and HPV genotype-specific infection in relation to the development of VIN 1-3. METHODS Data were analyzed from women enrolled in the placebo arms of three randomized double-blind trials. Anogenital examinations, including collection of labial/vulvar/perineal/perianal swabs, occurred at day 1 and every 6 to 12 months through 48 months. Lesions that were possibly, probably, or definitely HPV related or of unknown etiology were biopsied. Biopsies and swabs were HPV typed. Biopsies were read for endpoint determination (VIN 1-3) by up to four pathologists. RESULTS Incident infection with HPV-16 was the most common (6.0/100 person-years). The mean time from incident infection to the development of VIN 1-3 was 18.5 months (95% confidence interval, 13.4-23.6). HPV-6 or -11 was observed in 64.5% of VIN 1 and 29.0% of VIN 2/3, whereas HPV-16 was observed in 6.5% of VIN 1 and 64.5% of VIN 2/3. CONCLUSION A vaccine that includes both low- and high-risk types could prevent more than half of VIN 1-3 lesions, including the precursor lesions to HPV-related vulvar carcinoma. Understanding the incidence and duration of vulvar HPV infection and risk for progression to VIN 1-3 may inform therapeutic decisions for vulvar disease and mathematical models that assess the cost-effectiveness of vaccination.
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Affiliation(s)
- Suzanne M Garland
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Medical University of Vienna, Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
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27
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The EVER proteins as a natural barrier against papillomaviruses: a new insight into the pathogenesis of human papillomavirus infections. Microbiol Mol Biol Rev 2009; 73:348-70. [PMID: 19487731 DOI: 10.1128/mmbr.00033-08] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Infections by human papillomaviruses (HPVs) are the most frequently occurring sexually transmitted diseases. The crucial role of genital oncogenic HPV in cervical carcinoma development is now well established. In contrast, the role of cutaneous HPV in skin cancer development remains a matter of debate. Cutaneous beta-HPV strains show an amazing ubiquity. The fact that a few oncogenic genotypes cause cancers in patients suffering from epidermodysplasia verruciformis is in sharp contrast to the unapparent course of infection in the general population. Our recent investigations revealed that a natural barrier exists in humans, which protects them against infection with these papillomaviruses. A central role in the function of this HPV-specific barrier is played by a complex of the zinc-transporting proteins EVER1, EVER2, and ZnT-1, which maintain cellular zinc homeostasis. Apparently, the deregulation of the cellular zinc balance emerges as an important step in the life cycles not only of cutaneous but also of genital HPVs, although the latter viruses have developed a mechanism by which they can break the barrier and impose a zinc imbalance. Herein, we present a previously unpublished list of the cellular partners of EVER proteins, which points to future directions concerning investigations of the mechanisms of action of the EVER/ZnT-1 complex. We also present a general overview of the pathogenesis of HPV infections, taking into account the latest discoveries regarding the role of cellular zinc homeostasis in the HPV life cycle. We propose a potential model for the mechanism of function of the anti-HPV barrier.
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28
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van de Nieuwenhof HP, van Kempen LC, de Hullu JA, Bekkers RL, Bulten J, Melchers WJ, Massuger LF. The Etiologic Role of HPV in Vulvar Squamous Cell Carcinoma Fine Tuned. Cancer Epidemiol Biomarkers Prev 2009; 18:2061-7. [DOI: 10.1158/1055-9965.epi-09-0209] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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29
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De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer 2009; 124:1626-36. [PMID: 19115209 DOI: 10.1002/ijc.24116] [Citation(s) in RCA: 634] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This meta-analysis investigated human papillomavirus (HPV) prevalence in vulvar, vaginal and anal intraepithelial neoplasia (VIN, VAIN, AIN) grades 1-3 and carcinoma from 93 studies conducted in 4 continents and using PCR assays. Overall HPV prevalence was 67.8%, 85.3% and 40.4% among 90 VIN1, 1,061 VIN2/3 and 1,873 vulvar carcinomas; 100%, 90.1% and 69.9% among 107 VAIN1, 191 VAIN2/3 and 136 vaginal carcinomas; and 91.5%, 93.9% and 84.3% among 671 AIN1, 609 AIN2/3 and 955 anal carcinomas, respectively. HPV16 was found more frequently (>75%) and HPV18 less frequently (<10%) in HPV-positive vulvar, vaginal and anal carcinomas than in cervical carcinoma. HPV6 and 11 were common in VIN1 and AIN1, but not in VAIN1. HPV prevalence in vulvar carcinoma varied most by histological type (69.4% in warty-basaloid and 13.2% in keratinized type) and was also higher in women 60 years or younger and in studies carried out in North America. HPV prevalence in anal carcinoma was higher among women (90.8%) than men (74.9%), but no difference by gender emerged in North America. The majority of AIN2/3 derived from studies of HIV-positive individuals and/or men who have sex with men. Among AIN2/3, HIV infection was associated with higher HPV prevalence, more multiple-type infections and a relative under-representation of HPV16. In conclusion, approximately 40% of vulvar, 60% of vaginal and 80% of anal carcinoma may be avoided by prophylactic vaccines against HPV16/18. This proportion would be similar for the corresponding high-grade lesions of the vagina and anus, but higher for VIN2/3 (75%) than for vulvar carcinoma.
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Affiliation(s)
- Hugo De Vuyst
- International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon cedex 08, France
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30
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Affiliation(s)
- F Plantier
- Laboratoire d'anatomie pathologique, hôpital Tarnier-Cochin, AP-HP, 89, rue d'Assas, 75006 Paris, France.
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Klein F, Amin Kotb WFM, Petersen I. Incidence of human papilloma virus in lung cancer. Lung Cancer 2008; 65:13-8. [PMID: 19019488 DOI: 10.1016/j.lungcan.2008.10.003] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 08/14/2008] [Accepted: 10/04/2008] [Indexed: 12/27/2022]
Abstract
HPV has been identified not only in gynaecological carcinomas but also in tumors of other organs, especially of the oropharynx and upper aero-digestive tract. In this study we focused on the available literature on HPV in lung carcinomas. In total, 53 publications reporting on 4508 cases were reviewed and assessed for the following parameters: continent and region of the study, number of cases, detection method, material type, HPV type, histological subtype and number of the HPV-positive cases. Overall, the mean incidence of HPV in lung cancer was 24.5%. While in Europe and the America the average reported frequencies were 17% and 15%, respectively, the mean number of HPV in asian lung cancer samples was 35.7%. There was a considerable heterogeneity between certain countries and regions. Particular high frequencies of up to 80% were seen in Okinawa (Japan) and Taichung (Taiwan). However, there were also discrepant results within the same region pointing to methodological differences and the need for validation. All lung cancer subtypes were affected and especially the high risk types 16, 18, 31 and 33 as well as the low risk types 6 and 11 were found, the later mainly in association with squamous cell carcinomas. The data suggest that HPV is the second most important cause of lung cancer after cigarette smoking and strongly argues for additional research on this issue.
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Affiliation(s)
- Friederike Klein
- Institute of Pathology, Universitätsklinikum Jena, Ziegenmühlenweg 1, Jena D-07740, Germany
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Growdon WB, Boisvert SL, Akhavanfard S, Oliva E, Dias-Santagata DC, Kojiro S, Horowitz NS, Iafrate AJ, Borger DR, Rueda BR. Decreased survival in EGFR gene amplified vulvar carcinoma. Gynecol Oncol 2008; 111:289-97. [DOI: 10.1016/j.ygyno.2008.07.038] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 07/15/2008] [Accepted: 07/16/2008] [Indexed: 11/30/2022]
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