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Bellott TR, Luz FB, Silva AKFD, Varella RB, Rochael MC, Pantaleão L. Merkel cell polyomavirus and its etiological relationship with skin tumors. An Bras Dermatol 2023; 98:737-749. [PMID: 37407331 PMCID: PMC10589487 DOI: 10.1016/j.abd.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 07/07/2023] Open
Abstract
Viruses have been frequently identified in several human neoplasms, but the etiological role of these viruses in some tumors is still a matter of controversy. Polyomaviruses stand out among the main viruses with oncogenic capacity, specifically the Merkel cell polyomavirus (MCPyV). Recent revisions in the taxonomy of polyomaviruses have divided the Polyomaviridae family into six genera, including 117 species, with a total of 14 currently known human-infecting species. Although the oncogenicity of polyomaviruses has been widely reported in the literature since 1950, the first description of a polyomavirus as an etiological agent of a neoplasm in humans was made only in 2008 with the description of MCPyV, present in approximately 80% of cases of Merkel cell carcinoma (MCC), with the integration of its genome to that of the tumor cells and tumor-specific mutations, and it is considered the etiological agent of this neoplasm since then. MCPyV has also been detected in keratinocyte carcinomas, such as basal cell carcinoma and squamous cell carcinoma of the skin in individuals with and without immunosuppression. Data on the occurrence of oncogenic viruses potentially involved in oncogenesis, which cause persistence and tissue injury, related to the Merkel cell polyomavirus are still scarce, and the hypothesis that the Merkel cell polyomavirus may play a relevant role in the genesis of other cutaneous carcinomas in addition to MCC remains debatable. Therefore, the present study proposes to explore the current knowledge about the presence of MCPyV in keratinocyte carcinomas.
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Affiliation(s)
- Thiago Rubim Bellott
- Department of Pathology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil.
| | - Flávio Barbosa Luz
- Department of Dermatology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - Rafael Brandão Varella
- Department of Microbiology and Parasitology, Instituto Biomédico, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Mayra Carrijo Rochael
- Department of Pathology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | - Luciana Pantaleão
- Department of Pathology, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil
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2
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Park TJ, Ki SH, Yoon JM. Reconstruction of Rapidly Growing Merkel Cell Carcinoma of the Cheek With Multidisciplinary Cooperation. J Craniofac Surg 2023; Publish Ahead of Print:00001665-990000000-00706. [PMID: 37220656 DOI: 10.1097/scs.0000000000009367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/04/2023] [Indexed: 05/25/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a rare and very aggressive skin cancer. An 83-year-old female presented with a 1.5 cm-sized non-tender mass on her left cheek and was diagnosed with MCC. The margin of MCC was well-defined and there was no cervical node metastasis on pre-operative computed tomography. Three weeks after the first visit, the mass rapidly increased in size. We checked the magnetic resonance imaging, a rapid-growing 2.5 cm sized nodular region and metastatic cervical lymph node were found. We performed wide excision of the MCC and neck lymph need dissection with multidisciplinary cooperation. The soft tissue defect was about 6.0×5.0 cm2 in size and reconstructed with radial forearm free flap. On permanent biopsy, the size of MCC was 3.0×2.3 cm2. There was no recurrence of MCC with radiation therapy during an 18-month follow-up. We experienced an older patient with a rapid-growing MCC and cervical lymph node metastasis in a brief time. With our experience, we discuss the evaluation and treatment plan of the rapid-growing MCC for good results.
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Affiliation(s)
- Tae Jun Park
- Department of Plastic and Reconstructive Surgery, Inha University Hospital
| | - Sae Hwi Ki
- Department of Plastic and Reconstructive Surgery, Inha University Hospital
- Department of Plastic and Reconstructive Surgery, Inha University School of Medicine, Incheon, Korea
| | - Jin Myung Yoon
- Department of Plastic and Reconstructive Surgery, Inha University Hospital
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3
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Wijaya WA, Liu Y, Qing Y, Li Z. Prevalence of Merkel Cell Polyomavirus in Normal and Lesional Skin: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:868781. [PMID: 35392226 PMCID: PMC8980839 DOI: 10.3389/fonc.2022.868781] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/28/2022] [Indexed: 02/05/2023] Open
Abstract
The prevalence of Merkel cell polyomavirus(MCPyV) in Merkel cell carcinoma(MCC) and non-MCC skin lesions and its possible role in the etiology of other skin diseases remain controversial. To systematically assess the association between MCPyV infection and MCC, non-MCC skin lesions, and normal skin. For this systematic review and meta-analysis, a comprehensive search for eligible studies was conducted using Medline Ovid, Pubmed, Web of Science, and the Cochrane CENTRAL databases until August 2021; references were searched to identify additional studies. Observational studies that investigated the association between MCPyV infection and MCC, non-MCC skin lesions, and normal skin using polymerase chain reaction(PCR) as a detection method and provided sufficient data to calculate the prevalence of MCPyV positivity. A total of 50 articles were included in the study after exclusion criteria were applied. Two reviewers independently reviewed and assessed the eligibility of the studies, and all disagreements were resolved by consensus. To determine the association between MCPyV and MCC, overall odds ratio (OR) were calculated with 95% CI using a random-effects model. Single-arm meta-analyses were performed to examine the prevalence rate of MCPyV+ in MCC, non-MCC skin lesions, and normal skin. The primary analysis was the prevalence rate of MCPyV+ in MCC. Secondary outcomes included the prevalence rate of MCPyV+ in non-MCC skin lesions and normal skin. A total of 50 studies involving 5428 patients were reviewed based on our inclusion and exclusion criteria. Compared with the control group, MCPyV infection was significantly associated with MCC (OR = 3.51, 95% CI = 2.96 - 4.05). The global prevalence of MCPyV+ in MCC, melanoma, squamous cell carcinoma, basal cell carcinoma, Bowen's disease, actinic keratosis, keratoacanthoma, seborrheic keratosis, and normal skin was 80%, 4%, 15%, 15%, 21%, 6%, 20%, 10%, and 11%, respectively. The current results suggest that MCPyV infection is significantly associated with an increased risk of MCC. However, the low prevalence rate of MCPyV+ in non-MCC skin lesions does not exclude a pathogenic association of this virus with the development of non-MCC skin lesions.
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Affiliation(s)
- Wilson A Wijaya
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Qing
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhengyong Li
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China
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4
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Lee CH, Su CJ, Lan J. A 10-case series of Merkel cell carcinoma in tropical Taiwan: Focusing on clinical outcomes and the interaction of oxidative stress and Merkel cell polyomavirus infections. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_12_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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5
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Dellambra E, Carbone ML, Ricci F, Ricci F, Di Pietro FR, Moretta G, Verkoskaia S, Feudi E, Failla CM, Abeni D, Fania L. Merkel Cell Carcinoma. Biomedicines 2021; 9:718. [PMID: 34201709 PMCID: PMC8301416 DOI: 10.3390/biomedicines9070718] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare and extremely aggressive neuroendocrine carcinoma of the skin, with increasing incidence worldwide. This review intends to propose a comprehensive evaluation of MCC epidemiology, clinical features, pathogenetic mechanisms, diagnosis, and therapies. A section is dedicated to immunological aspects and another to the involvement of angiogenesis and angiogenic growth factors in MCC progression, proposing novel diagnostic and therapeutic approaches. Advanced MCC tumors have been treated with immune checkpoint inhibitors with effective results. Therefore, the state of art of this immunotherapy is also examined, reporting on the most recent clinical trials in the field. We conclude by underlining the achievements in the understanding of MCC pathology and indicating the present needs for effective diagnosis and therapeutic management of the disease.
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Affiliation(s)
- Elena Dellambra
- Molecular and Cell Biology Laboratory, IDI-IRCCS, 00167 Rome, Italy;
| | - Maria Luigia Carbone
- Experimental Immunology Laboratory, IDI-IRCCS, 00167 Rome, Italy; (E.F.); (C.M.F.)
| | | | - Francesco Ricci
- Dermatology Department, IDI-IRCCS, 00167 Rome, Italy; (F.R.); (G.M.); (L.F.)
| | | | - Gaia Moretta
- Dermatology Department, IDI-IRCCS, 00167 Rome, Italy; (F.R.); (G.M.); (L.F.)
| | - Sofia Verkoskaia
- Oncology Department, IDI-IRCCS, 00167 Rome, Italy; (F.R.D.P.); (S.V.)
| | - Elisa Feudi
- Experimental Immunology Laboratory, IDI-IRCCS, 00167 Rome, Italy; (E.F.); (C.M.F.)
| | - Cristina M. Failla
- Experimental Immunology Laboratory, IDI-IRCCS, 00167 Rome, Italy; (E.F.); (C.M.F.)
| | - Damiano Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, 00167 Rome, Italy;
| | - Luca Fania
- Dermatology Department, IDI-IRCCS, 00167 Rome, Italy; (F.R.); (G.M.); (L.F.)
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6
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Seo JK, Park HJ, Shin MK, Jeong KH. A Case of Merkel Cell Carcinoma on the Finger. Ann Dermatol 2019; 31:357-358. [PMID: 33911610 PMCID: PMC7992728 DOI: 10.5021/ad.2019.31.3.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/22/2018] [Accepted: 07/04/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jong-Kil Seo
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyung-Jin Park
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Min Kyung Shin
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ki-Heon Jeong
- Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea
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7
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Kim DK. No Association between Merkel Cell Polymavirus Infection
and Keratoacanthoma in Korean Patients. Asian Pac J Cancer Prev 2019; 20:1299-1301. [PMID: 31127879 PMCID: PMC6857863 DOI: 10.31557/apjcp.2019.20.5.1299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: Keratoacanthoma (KA) is a relatively common benign tumor and resembles squamous cell carcinoma (SCC). The definitive cause of KA remains unclear, but trauma, ultraviolet light, chemical carcinogens, human papillomavirus, genetic factors, and immunocompromised status have been implicated as etiologic or triggering factors. Merkel cell polyomavirus (MCPyV) is suspected to cause the majority of cases of Merkel cell carcinoma (MCC). MCPyV-DNA was found significantly more frequently in MCC and only found in about one fourth of KAs. In a recent study, MCPyV was found in Korean patients with MCC. The aim of this study was to determine the presence of MCPyV in Korean patients with KA. Methods: Paraffin-embedded tissue samples were analyzed for the presence of MCPyV-DNA by polymerase chain reaction (PCR). A total of 105 KA samples were analyzed. Results: A study of MCPyV has not been reported about KA in Korean cases. In the present study the MCPyV was not detected with KA in the Korean patients. Conclusions: This supports that KA and MCPyV are not related to each other and MCVyP is not a major factor in the pathogenesis of KA.
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Affiliation(s)
- Dae-Kwang Kim
- Department of Medical Genetics, School of Medicine, Keimyung University, 1095, Dalgubeol-daero, Dalseo-gu, Daegu, Republic of Korea.
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8
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Uchi H. Merkel Cell Carcinoma: An Update and Immunotherapy. Front Oncol 2018; 8:48. [PMID: 29560342 PMCID: PMC5845720 DOI: 10.3389/fonc.2018.00048] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/19/2018] [Indexed: 01/30/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a rare but aggressive skin cancer with frequent metastasis and death. MCC has a mortality rate of 30%, making it more lethal than malignant melanoma, and incidence of MCC has increased almost fourfold over the past 20 years in the USA. MCC has long been considered to be an immunogenic cancer because it occurs more frequently in immunosuppressed patients from organ transplant and HIV infection than in those with immunocompetent. Chronic UV light exposure and clonal integration of Merkel cell polyomavirus (MCPyV) are two major causative factors of MCC. Approximately 80% of MCC are associated with MCPyV, and T cells specific for MCPyV oncoproteins are present in the blood and tumors of patients. Several studies have shown that a subset of MCCs express PD-1 on tumor-infiltrating lymphocytes and express PD-L1 on tumor cells, which suggests an endogenous tumor-reactive immune response that might be unleashed by anti-PD-1 or anti-PD-L1 drugs.
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Affiliation(s)
- Hiroshi Uchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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9
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Eid M, Nguyen J, Brownell I. Seeking Standards for the Detection of Merkel Cell Polyomavirus and its Clinical Significance. J Invest Dermatol 2017; 137:797-799. [PMID: 28340681 DOI: 10.1016/j.jid.2016.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 12/12/2016] [Indexed: 11/17/2022]
Abstract
Merkel cell carcinoma is a rare skin cancer associated with Merkel cell polyomavirus in most cases. Prior studies associating Merkel cell carcinoma viral status with prognosis have inconsistent findings. Moshiri et al. used multimodal virus detection to determine that the 81% of patients with virus-positive Merkel cell carcinoma tumors had earlier stage disease and better outcomes relative to virus-negative cases.
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Affiliation(s)
- Mary Eid
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jannett Nguyen
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Isaac Brownell
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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10
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Hampras SS, Locke FL, Chavez JC, Patel NS, Giuliano AR, Miller K, Gheit T, Tommasino M, Rollison DE. Prevalence of cutaneous viral infections in incident cutaneous squamous cell carcinoma detected among chronic lymphocytic leukemia and hematopoietic stem cell transplant patients. Leuk Lymphoma 2017; 59:911-917. [PMID: 28679298 DOI: 10.1080/10428194.2017.1342822] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The role of cutaneous viral infections in the development of non-melanoma skin cancer (NMSC), including cutaneous squamous cell carcinoma (SCC), among chronic lymphocytic leukemia (CLL) and blood and marrow transplant (BMT) patients is not established. CLL (n = 977) and BMT (n = 3587) patients treated at the Moffitt Cancer Center were included in a retrospective cohort study. Human papillomavirus (HPV) and human polyomavirus (HPyV) DNA were examined in a subset of incident SCC tumors. Five-year cumulative incidence of NMSC was 1.42% in both BMT (n = 31 NMSCs) and CLL (n = 18 NMSCs) cohorts. Of the nine SCC tumors examined from each cohort, 22.2% and 33.3% were positive for viral DNA in the transplant (HPV 65, MCV) and CLL (HPV 38, HPV 15, HPyV6) cohort, respectively. Enhanced skin cancer screening of BMT/CLL patients should be conducted to better capture incident NMSCs and examine the role of viral infections in these tumors.
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Affiliation(s)
- Shalaka S Hampras
- a Department of Cancer Epidemiology , Moffitt Cancer Center , Tampa , FL , USA
| | - Frederick L Locke
- b Department of Blood and Marrow Transplant and Cellular Immunotherapy , Moffitt Cancer Center , Tampa , FL , USA
| | - Julio C Chavez
- c Department of Malignant Hematology , Moffitt Cancer Center , Tampa , FL , USA
| | - Nishit S Patel
- d Department of Dermatology and Cutaneous Surgery, Morsani College of Medicine , University of South Florida , Tampa , FL , USA
| | - Anna R Giuliano
- a Department of Cancer Epidemiology , Moffitt Cancer Center , Tampa , FL , USA.,e Center for Infection Research in Cancer , Moffitt Cancer Center , Tampa , Florida , USA
| | - Kyle Miller
- f College of Agriculture and Life Sciences, University of Florida, Gainesville , Tampa , FL , USA
| | - Tarik Gheit
- g Infections and Cancer Biology Group , International Agency for Research on Cancer-World Health Organization , Lyon , France
| | - Massimo Tommasino
- g Infections and Cancer Biology Group , International Agency for Research on Cancer-World Health Organization , Lyon , France
| | - Dana E Rollison
- a Department of Cancer Epidemiology , Moffitt Cancer Center , Tampa , FL , USA.,e Center for Infection Research in Cancer , Moffitt Cancer Center , Tampa , Florida , USA
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11
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Schadendorf D, Lebbé C, Zur Hausen A, Avril MF, Hariharan S, Bharmal M, Becker JC. Merkel cell carcinoma: Epidemiology, prognosis, therapy and unmet medical needs. Eur J Cancer 2016; 71:53-69. [PMID: 27984768 DOI: 10.1016/j.ejca.2016.10.022] [Citation(s) in RCA: 248] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 10/22/2016] [Indexed: 01/19/2023]
Abstract
Merkel cell carcinoma (MCC) is a rare skin cancer that is associated with Merkel cell polyomavirus infection in most cases. Incidence rates of MCC have increased in past decades. Risk factors for MCC include ultraviolet light exposure, immunosuppression and advanced age. MCC is an aggressive malignancy with frequent recurrences and a high mortality rate, although patient outcomes are generally more favourable if the patient is referred for treatment at an early stage. Although advances have been made recently in the MCC field, large gaps remain with regard to definitive biomarkers and prognostic indicators. Although MCC is chemosensitive, responses in advanced stages are mostly of short duration, and the associated clinical benefit on overall survival is unclear. Recent nonrandomised phase 2 clinical trials with anti-PD-L1/PD-1 antibodies have demonstrated safety and efficacy; however, there are still no approved treatments for patients with metastatic MCC. Patients with advanced disease are encouraged to participate in clinical trials for treatment, indicating the largely unmet need for durable, safe treatment within this population.
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Affiliation(s)
- Dirk Schadendorf
- Dermatology, Essen University Hospital, Essen, Germany; German Cancer Consortium Partner Site Essen/Düsseldorf, Essen University Hospital, Essen, Germany.
| | - Céleste Lebbé
- APHP, Dermatology and CIC, Hôpital Saint-Louis, INSERM U976, University Paris 7 Diderot, Paris, France.
| | - Axel Zur Hausen
- Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
| | | | | | - Murtuza Bharmal
- Merck KGaA, Global Evidence & Value Development, Darmstadt, Germany.
| | - Jürgen C Becker
- Translational Skin Cancer Research (TSCR), German Cancer Consortium Partner Site Essen/Düsseldorf, Dermatology, Essen University Hospital, Essen, Germany.
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12
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Hashida Y, Kamioka M, Tanaka M, Hosokawa S, Murakami M, Nakajima K, Kikuchi H, Fujieda M, Sano S, Daibata M. Ecology of Merkel Cell Polyomavirus in Healthy Skin Among Individuals in an Asian Cohort. J Infect Dis 2016; 213:1708-16. [DOI: 10.1093/infdis/jiw040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 01/21/2016] [Indexed: 12/27/2022] Open
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13
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Miles BA, Goldenberg D. Merkel cell carcinoma: Do you know your guidelines? Head Neck 2015; 38:647-52. [PMID: 26716756 DOI: 10.1002/hed.24359] [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: 10/01/2015] [Accepted: 11/04/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine malignancy that exhibits clinically aggressive features and is associated with a poor prognosis. The incidence of MCC seems to be increasing for reasons unknown, and is estimated to be 0.32/100,000 in the United States. METHODS This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of MCC. RESULTS Resection of MCC with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. High-risk patients should undergo adjuvant radiotherapy, which improves oncologic outcomes. The role of chemotherapy is less clear and is currently reserved for advanced-stage MCC and palliative therapy. CONCLUSION The pathogenesis of MCC has recently been impacted with the discovery of the Merkel cell polyomavirus (MCPyV). Research to establish targeted and immunologic therapeutic options are ongoing.
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Affiliation(s)
- Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, New York, New York
| | - David Goldenberg
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
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14
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Hampras SS, Michel A, Schmitt M, Waterboer T, Kranz L, Gheit T, Fisher K, Sondak VK, Messina J, Fenske N, Cherpelis B, Tommasino M, Pawlita M, Rollison DE. Merkel cell polyomavirus (MCV) T-antigen seroreactivity, MCV DNA in eyebrow hairs, and squamous cell carcinoma. Infect Agent Cancer 2015; 10:35. [PMID: 26483848 PMCID: PMC4610041 DOI: 10.1186/s13027-015-0030-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 08/27/2015] [Indexed: 02/05/2023] Open
Abstract
Background The role of Merkel cell polyomavirus (MCV) infection in the etiology of non-melanoma skin cancers, other than Merkel cell carcinoma, is unclear. Previously, we reported a significant association between seropositivity to MCV capsid antigen and MCV DNA-positive cutaneous squamous cell carcinoma (SCC). Here we present associations between SCC and seroreactivity to MCV T-antigen (T-Ag) oncoprotein, as well as MCV DNA detected in eyebrow hairs. Findings A clinic-based case–control study, including 171 SCC cases and 300 controls without skin cancer, was conducted at Moffitt Cancer Center in Tampa, Florida. Multiplex assays were used to measure serum antibodies against MCV small and large T-Ag and MCV DNA in both eyebrow hairs and SCC tumors (n = 144). Odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated using logistic regression to evaluate the associations between MCV and SCC. No significant association was observed between seroreactivity to MCV full-length large or small T-Ag and SCC, overall [ORlarge T-Ag = 0.99 (0.48-2.08), ORsmall T-Ag = 0.31 (0.06–1.62)] or when comparing tumor MCV DNA-positive cases to controls [ORlarge T-Ag = 1.06 (0.38–2.93)]. Only presence of MCV DNA in eyebrow hairs was significantly associated with MCV DNA-positive SCC [OR = 4.05 (2.01–8.18)]. Conclusion MCV infection is unlikely to play a direct role in SCC.
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Affiliation(s)
- Shalaka S Hampras
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612 USA
| | - Angelika Michel
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Markus Schmitt
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany ; Present address: GATC Biotech AG, Constance, Germany
| | - Tim Waterboer
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Lena Kranz
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany ; Present address: Research Center for Immunotherapy (FZI), Langenbeckstrasse 1, Building 708, 55131 Mainz, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, 69372 France
| | - Kate Fisher
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL USA
| | - Vernon K Sondak
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, FL USA
| | - Jane Messina
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, FL USA ; Departments of Pathology and Cell Biology, University of South Florida College of Medicine, Tampa, FL USA ; Dermatology, University of South Florida College of Medicine, Tampa, FL USA
| | - Neil Fenske
- Dermatology, University of South Florida College of Medicine, Tampa, FL USA ; Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL USA
| | - Basil Cherpelis
- Dermatology, University of South Florida College of Medicine, Tampa, FL USA ; Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL USA
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, 69372 France
| | - Michael Pawlita
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33612 USA
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15
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Saini AT, Miles BA. Merkel cell carcinoma of the head and neck: pathogenesis, current and emerging treatment options. Onco Targets Ther 2015; 8:2157-67. [PMID: 26316785 PMCID: PMC4548751 DOI: 10.2147/ott.s72202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a relatively uncommon, neuroendocrine, cutaneous malignancy that often exhibits clinically aggressive features and is associated with a poor prognosis. It typically presents as a painless, rapidly enlarging, dome-shaped red or purplish nodule in a sun-exposed area of the head and neck or upper extremities. Our understanding of MCC has increased dramatically over the last several years and the pathogenesis continues to be an area of active research. The etiology is likely multifactorial with immunosuppression, UV-induced skin damage, and viral factors contributing to the development of MCC. The recent discovery of Merkel cell polyomavirus has allowed for at least one aspect of disease development to be much better understood. In most cases, treatment consists of wide local excision with adjuvant radiation therapy. The role of chemotherapeutics is still being defined. The recent advancement of knowledge regarding the pathogenesis of MCC has led to an explosion research into novel therapeutic agents and strategies. This review seeks to summarize the current body of literature regarding the pathogenesis of MCC and potential targets for future therapies.
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Affiliation(s)
- Alok T Saini
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, New York, NY, USA
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Santos-Juanes J, Fernández-Vega I, Fuentes N, Galache C, Coto-Segura P, Vivanco B, Astudillo A, Martínez-Camblor P. Merkel cell carcinoma and Merkel cell polyomavirus: a systematic review and meta-analysis. Br J Dermatol 2015; 173:42-9. [PMID: 25919492 DOI: 10.1111/bjd.13870] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 12/15/2022]
Abstract
Several observational studies have assessed the correlation between Merkel cell carcinoma and Merkel cell polyomavirus with variable results. The objective of this systematic review was to determine whether there is a correlation between Merkel cell carcinoma and Merkel cell polyomavirus. Studies assessing the relationship between Merkel cell carcinoma and Merkel cell polyomavirus from January 2008 to August 2014 were pooled from Medline, Embase, PubMed, Cochrane Database of Systemic Reviews and Google Scholar. From each study we collected the first author's last name, publication year, country of origin, type of study design, characteristics of participants, possible variables incorporated into the multivariable analyses and the risk ratio (RR) for Merkel cell carcinoma associated with Merkel cell polyomavirus combined with the corresponding 95% confidence interval (CI). Methodological assessment of the study was evaluated using the Newcastle-Ottawa scale. Crude RR was calculated from the data provided in each article. Meta-analyses for the global RR and for the proportion of positives in both case and control samples were performed. In addition, in order to explore the sources of heterogeneity among the studies, meta-regression and sensitivity analyses are also provided. A total of 22 studies were identified for the analysis. The pooled RR from random-effects analysis was determined to be 6.32 (95% CI, 4.02-9.93). Global proportions of positive samples were 0.79 (95% CI, 0.72-0.84) and 0.12 (95% CI, 0.08-0.19) in the case and control groups, respectively. The findings support the association between Merkel cell carcinoma and Merkel cell polyomavirus. However, a non-negligible percentage of positive results have been identified in controls. Some caution must be taken in the interpretation of these results because heterogeneity between studies was found.
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Affiliation(s)
- J Santos-Juanes
- Pathology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - I Fernández-Vega
- Pathology Department, Hospital Universitario Araba, Álava, Spain
| | - N Fuentes
- Pathology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C Galache
- Departamento de Radiodiagnóstico, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - P Coto-Segura
- Dermatology II, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - B Vivanco
- Pathology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Astudillo
- Pathology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - P Martínez-Camblor
- Oficina de Investigación Biosanitaria de Asturias (OIB-FICYT), Hospital Universitario Central de Asturias, Oviedo, Spain.,Universidad Autónoma de Chile, Santiago, Chile
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Hampras SS, Giuliano AR, Lin HY, Fisher KJ, Abrahamsen ME, McKay-Chopin S, Gheit T, Tommasino M, Rollison DE. Natural history of polyomaviruses in men: the HPV infection in men (HIM) study. J Infect Dis 2015; 211:1437-46. [PMID: 25387582 PMCID: PMC4462655 DOI: 10.1093/infdis/jiu626] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/31/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Several new polyomaviruses have been discovered in the last decade, including Merkel cell polyomavirus (MCPyV). Little is known about the natural history of the more recently discovered polyomaviruses. We estimated the incidence, prevalence, and persistence of 9 polyomaviruses (MCPyV, BK polyomavirus, KI polyomavirus, JC polyomavirus, WU polyomavirus, Human polyomavirus 6 [HPyV6], HPyV7, HPyV9, and Trichodysplasia spinulosa-associated polyomavirus) and examined factors associated with MCPyV infection in a prospective cohort of 209 men initially enrolled in the HPV Infection in Men (HIM) study. METHODS Participants enrolled at the US site of the HIM study were recruited into a substudy of cutaneous viral infections and followed for a median of 12.6 months. Eyebrow hair and normal skin swab specimens were obtained at each study visit, and the viral DNA load was measured using multiplex polymerase chain reaction. RESULTS MCPyV infection showed the highest prevalence (65.1% of normal skin swab specimens and 30.6% of eyebrow hair specimens), incidence (81.7 cases per 1000 person-months among normal skin swab specimens, and 24.1 cases per 1000 person-months among eyebrow hair specimens), and persistence (85.8% of normal skin swab specimens and 58.9% of eyebrow hair specimens) among all polyomaviruses examined. Age of >44 years (odds ratio [OR], 2.11; 95% confidence interval [CI], 1.03-4.33) and Hispanic race (OR, 2.64; 95% CI, 1.01-6.88) were associated with an increased prevalence of MCPyV infection in eyebrow hair and normal skin swab specimens, respectively. CONCLUSION MCPyV infection is highly prevalent in adults, with age and race being predisposing factors.
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Affiliation(s)
| | | | - Hui-Yi Lin
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida
| | - Kate J. Fisher
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida
| | | | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer–World Health Organization, Lyon, France
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer–World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer–World Health Organization, Lyon, France
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Abstract
The known human tumor viruses include the DNA viruses Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV), Merkel cell polyomavirus (MCPyV), human papillomavirus (HPV), and hepatitis B virus (BV). RNA tumor viruses include human T-cell lymphotrophic virus type 1 (HTLV-1) and hepatitis C virus (HCV). The serological identification of antigens/antibodies in serum is a rapidly progressing field with utility for both scientists and clinicians. Serology is useful for conducting seroepidemiology studies and to inform on the pathogenesis and host immune response to a particular viral agent. Clinically, serology is useful for diagnosing current or past infection and for aiding in clinical management decisions. Serology is useful for screening blood donations for infectious agents and for monitoring the outcome of vaccination against these viruses. Serodiagnosis of human tumor viruses has improved in recent years with increased specificity and sensitivity of the assays, as well as reductions in cost and the ability to assess multiple antibody/antigens in single assays. Serodiagnosis of tumor viruses plays an important role in our understanding of the prevalence and transmission of these viruses and ultimately in the ability to develop treatments/preventions for these globally important diseases.
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Affiliation(s)
- Brian J Morrison
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Nazzarena Labo
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Wendell J Miley
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Denise Whitby
- Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, MD.
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Hashida Y, Imajoh M, Kamioka M, Taniguchi A, Kuroda N, Hayashi K, Nakajima H, Sano S, Daibata M. Phylogenetic analysis of Merkel cell polyomavirus based on full-length LT and VP1 gene sequences derived from neoplastic tumours in Japanese patients. J Gen Virol 2014; 95:135-141. [DOI: 10.1099/vir.0.058149-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Most Merkel cell polyomavirus (MCPyV) gene sequences have been reported from Western countries and few data are available for the virus sequences from other geographical areas, especially Asia. Thus, we performed phylogenetic analyses based on the nucleotide sequences of the full-length large T-antigen (LT) and viral protein 1 (VP1) genes derived from a variety of cancers in Japanese patients and compared them with sequences from Caucasians. The LT and VP1 gene-based phylogenetic trees identified two main genetic clades. One clade comprised strains isolated from Caucasians, whereas all of the Japanese tumour-derived MCPyV strains belonged to another clade. These findings confirm that most of the MCPyV strains present in Japan form a clade, distinct from Caucasian strains.
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Affiliation(s)
- Yumiko Hashida
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Masayuki Imajoh
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Mikio Kamioka
- Department of Laboratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Ayuko Taniguchi
- Division of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Naoto Kuroda
- Department of Pathology, Kochi Red Cross Hospital, Kochi 780-8561, Japan
| | - Kazuhiko Hayashi
- Division of Molecular Pathology, Department of Microbiology and Pathology, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Hideki Nakajima
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
| | - Masanori Daibata
- Department of Microbiology and Infection, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan
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Chan JKC, Ip YT, Cheuk W. The Utility of Immunohistochemistry for Providing Genetic Information on Tumors. Int J Surg Pathol 2013; 21:455-75. [PMID: 24065374 DOI: 10.1177/1066896913502529] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
With advances in immunohistochemical technology and growing knowledge of the molecular genetics of tumors, immunohistochemistry is playing an increasingly important role in providing genetic information for tumors. Specific chromosomal translocations can be demonstrated through detection of the protein product of one of the genes involved in gene fusion (such as BCL2, cyclin D, and ALK). Some mutations can be detected by (1) aberrant localization of the protein product (such as β-catenin and nucleophosmin), (2) abnormal accumulation of the protein product as a result of stabilization of the protein (such as p53), and (3) mutation-specific antibodies directed against the mutant protein (such as isocitrate dehydrogenase gene R132H mutation, epidermal growth factor receptor gene L858R and exon 19 deletion mutations, and BRAF gene V600E mutation). Gene deletion or loss of function can be demonstrated by the loss of immunostaining for the protein product (such as mismatch repair proteins in microsatellite-unstable tumors, E-cadherin in lobular carcinoma of the breast, and INI1 in rhabdoid tumors, atypical teratoid/rhabdoid tumors, and epithelioid sarcomas). Gene amplification can be demonstrated by overexpression of the protein product (such as HER2 in breast and gastric cancers, and MDM2 or CDK4 in well-differentiated/dedifferentiated liposarcomas). Viruses associated with tumors can be demonstrated directly (such as Epstein-Barr virus latent membrane protein-1 in Hodgkin lymphomas, human herpesvirus 8 in Kaposi sarcomas, and Merkel cell polyomavirus in Merkel cell carcinomas) or by a surrogate marker (such as p16 in human papillomavirus infection). In this review, examples are given to illustrate the principles and pitfalls of these applications.
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Affiliation(s)
| | | | - Wah Cheuk
- Queen Elizabeth Hospital, Kowloon, Hong Kong, SAR China
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