HPV Virus Medical Research - Cancer

HPV Virus Medical Research - Article in Italian

BACKGROUND: The present study analyses cervical dysplastic lesions associated with HIV infection by means of cytological, colposcopic and histologic examinations, and the diagnostic accuracy of the Pap test. METHODS: Cross-sectional study. We have studied colposcopic and histologic findings of 115 HIV-positive women. In 86 patients a cytological examination was also carried out. The results were compared with those of a control group consisting of 127 HIV-negative women in pre-menopause age. RESULTS: The prevalence of cervical dysplastic lesions present at colposcopic/bioptic examination was 3.2 times greater in HIV+ women than in HIV- women (38% vs 12%, p<0.001) and that of lesions of a higher degree 7 times greater. Compared to non-HIV+ women, patients who were positive presented more severe dysplastic lesions, a higher frequency of HPV-derived lesions and inflammatory pictures. There was also a correlation between high incidence of dysplastic cervical lesions and advanced stage of immunodepression. The negative predictive value of the Pap test was higher in the seronegatives (95%) than in the seropositives (83%, p<0.01). The overall agreement between cytology and colposcopy/histology was greater in the seronegati-ves than in the seropositives (87% vs 74%, p<0.05). CONCLUSIONS: Cervical dysplastic lesions in seropositive patients are more frequent and aggressive than in HIV negatives and are related both to the degree of immunodepression and to the HPV infection. Further, the diagnostic value of the Pap test in association with HIV is reduced. These results suggest that in HIV+ patients careful combined cytological-colposcopic screening should be adopted, together with an attentive cyto-colposcopic follow-up in treated patients.

Eur J Gynaecol Oncol. 2002;23(4):311-6.

Content of folic acid and free homocysteine in blood serum of human papillomavirus-infected women with cervical dysplasia.

Kwasniewska A, Tukendorf A, Gozdzicka-Jozefiak A, Semczuk-Sikora A, Korobowicz E. Clinic of Obstetrics and Gynaecology, Lublin Medical Academy, Poland.

The authors estimated the concentrations of folic acid and free homocysteine in the blood serum of women with CIN III (cervical intraepithelial neoplasia-Burghard's classification) infected with DNA HPV (human papillomaviruses) of type 16 and/or 18. The control group consisted of 49 patients with normal cytological smears without HPV infection. Types 16 and/or 18 DNA HPV were found in 50 patients. This women qualified for the studied group. The sequence of DNA HPV type 16 and/or 18 was identified with the PCR method (polymerase chain reaction). The high-performance liquid chromatography (HPLC) method was employed to evaluate the levels of folic acid and free homocysteine in the blood serum of the examined patients. Significantly lower levels of folic acid and higher levels of free homocysteine were observed in the blood serum of HPV-positive patients with CIN III. The correlation was found between serum concentrations of folic acid and free homocysteine in both groups.

Am J Pathol. 2003 Mar;162(3):747-53.

Expression of p16 protein identifies a distinct entity of tonsillar carcinomas associated with human papillomavirus.

Klussmann JP, Gultekin E, Weissenborn SJ, Wieland U, Dries V, Dienes HP, Eckel HE, Pfister HJ, Fuchs PG. Department of Oto-Rhino-Laryngology, Head, and Neck Surgery and the Institute of Virology, University of Cologne, Cologne, Germany. peter.klussmann@uni-koeln.de

Recent analyses of head and neck squamous cell carcinomas revealed frequent infections by oncogenic human papillomavirus (HPV) type 16 in tonsillar carcinomas. Concerning involvement of risk factors, clinical course of the disease, and prognosis there are strong indications arguing that the HPV-positive tonsillar carcinomas may represent a separate tumor entity. Looking for a surrogate marker, which in further epidemiological studies could replace the laborious and expensive HPV detection and typing we analyzed p16 protein expression in 34 tonsillar carcinoma for correlation to HPV status and load of viral DNA. p16 has been shown to be of diagnostic value for clinical evaluation of cervical dysplasia. We found 53% of the tested tonsillar carcinomas to be HPV-positive. Fifty-six percent of all tumors tested were immunohistochemically positive for the p16 protein. In 16 of 18 of the HPV-positive carcinomas diffuse p16 expression was observed. In contrast, only one of the HPV-negative carcinomas showed focal p16 staining (P < 0.001). As determined by laser-assisted microdissection and quantitative real-time polymerase chain reaction, p16 expression correlated with the presence of HPV-DNA in the individual tumor specimens. Clinical outcome analysis revealed significant correlation of p16 expression with increased disease-free survival (P = 0.02). These data indicate that p16 is a technically simple immunohistological marker, applicable for routine pathological histology, and its prognostic value for survival is fully equivalent to HPV-DNA detection.

Cytopathology. 2002 Aug;13(4):220-31.

Do borderline nuclear changes in gynaecological cytology constitute a reliable reporting category?

Borderline Nuclear Changes National Slide Exchange Study Group. Quality Assurance Reference Centre for the Trent NHSCSP, Northern General Hospital, Sheffield, UK.

Fourteen laboratories participated in a national slide exchange study to investigate whether borderline nuclear changes (BNC) constitute a reliable reporting category. Slides were submitted by participating laboratories, having achieved a 100% intralaboratory consensus at the primary screener, checker, and medical levels. Sets of seven slides were examined in laboratories for 1 week, and exchanges were undertaken over a 6-month period. Each laboratory was requested to submit three consensus opinions on each slide at the primary screener, checker, and medical levels. Response patterns for submitted slides achieving a reporting category consensus at the 50 and 80% consensus levels indicated that negative, BNC, and mild dyskaryosis are distinct and comparable categories. Similarly, the two subcategories of BNC with or without human papillomavirus (HPV) are nearly as distinct as the overall BNC category. The percentage of submitted slides achieving consensus at consensus levels between 50 and 80% produced variable findings with regard to the practical success of the main reporting categories. The negative category was reasonably successful, whereas mild dyskaryosis was consistently poor. Borderline nuclear changes were successful at the 50% consensus level but showed a rapid decline by the 65% consensus level. The reason(s) for this remains speculative but indicates a possible potential of BNC to work successfully with additional training and education. Reporting practices were not consistent among the laboratories and differences were identified between medical and nonmedical staff. A high use of the BNC category was noted in slides that failed to achieve consensus. A national study assessing all grades of abnormalities would appear essential.

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