Low Prevalence of Human Papilloma Virus in Patients with Breast Cancer,Kerman; Iran

Breast cancer is the first of the most important causes of the deaths of women in the world and in Iran. There arevarious causes and causes of this cancer, one of which has recently been described as a cause of breast cancer, is the humanpapillomavirus (HPV). The HPV is transmitted through sexual contact and skin lesions. There are more than 100 types ofHPV that can influence different parts of the body. Some types of HPV can cause cancer (such as cervical or anal cancer)and others can cause warts (such as genital or plantar warts). To study the risk of HPV infection in Breast Cancer, wemanaged a Case-Control study in Kerman, southeast of Iran. For this purpose, 98 paraffin blocks of breast cancer and40 paraffin blocks of fibrocystic as a control were tested for the presence of HPV DNA using Real-Time PCR, andHPV typing was done using INNo-Lippa assay. HPV DNA was detected in 8 out of 98 patients (8.2%), while it wasnot detected in the control group samples. HPV types 16, 18 were the most common (62.5%) types in positive samples.The prevalence of HPV in patients with breast cancer of Iran is very low and less than other regions of the world,it seems that maybe rout of transmission of HPV in Iran is under control. No one knows exactly why breast canceroccurs. The environment, hormones, Viruses, or your lifestyle could all play a role in the development of breast cancer.Currently, Vaccination is the best way to prevent cancer that’s due to HPV. However, additional studies on the largergroup of patients are needed to explain the roles of HPV in Breast cancer.     

Human Papilloma Virus Prevalence,Genotype Distribution,and Pattern of Infection in Thai Women

Background: The pattern of infection in cervical lesions with respect to HPV subtype has not beensystematically studied in Thai women. The aim here was to determine HPV prevalence, genotype, and infectionpattern in cervical lesions and to estimate the potential efficacy of an HPV prophylactic vaccine. Design: Formalinfixedparaffin-embedded cervical tissue blocks of 410 Thai patients from 8 institutes in 4 regions of Thailand(northern, southern, north-eastern, and central) were studied. The samples included 169 low grade squamousintraepithelial lesions (LSILs), 121 high grade squamous intraepithelial lesions (HSILs), and 120 squamouscell carcinomas (SCCs). HPV-DNA was amplified by PCR using consensus primers GP5+ and GP6+. TheHPV genotype was then determined by reverse linear blot assay that included 37 HPV-specific 5’-amino-linkedoligonucleotide probes. Patterns of infection were classified as single infection (one HPV type), double infection(two HPV types), and multiple infection (three or more HPV types). Results: The mean age of the subjects was42 years. The prevalence of HPV infection was 88.8%. The highest HPV prevalence was found in the southernregion (97.1%) and the lowest in the central region (78.6%). HPV-DNA was detected in 84.6% of LSILs, 90.1%of HSILs, and 93.3% of SCCs. A total of 20 HPV genotypes were identified. The five most common high riskHPV were HPV16 (83.2%), HPV18 (59.3%), HPV58 (9.3%), HPV52 (4.1%), and HPV45 (3.8%). In double andmultiple infection patterns, the most common genotypes were HPV16/18 (27.8%) and HPV11/16/18 (54.9%).HPV6 was found only in LSIL and never in combination with other subtypes. HPV11 was most common inLSIL. Conclusion: There is no difference of HPV type distribution in women from 4 regions of Thailand withprominent HPV16 and HPV18 in all cases. The bivalent and quadrivalent vaccines have the potential to prevent48.6 % and 74.5% of cervical cancers in Thai women. The potential of cancer prevention would rise to 87.6%if other frequent HR-HPV types (HPV58, 52, and 45) were also targeted by an HPV vaccine.     

宫颈癌组织HPV16DNA相关序列检测与临床分析

用Southern blot核酸杂交技术检测宫颈组织HPV 16 DNA相关序列。山东省儿6例宫颈癌病人的癌组织HPV 16 DNA相关序列阳性率为50.9％,36例无宫颈疾病妇女的宫颈组织阳性率为5.6％,宫颈癌与HPV 16感染有很强的联系,OR=17.60,x~2=23.47,P<0.001.HPV 16 DNA相关序列阳性率与宫颈癌病人的年龄、肿瘤的组织类型、临床类型及临床分期均无统计学联系(P均大于0.25).本文首次从山东省宫颈癌病人癌组织中检测到HPV 33 DNA4例及HPV31 DNA 1例。     

Cervical Human Papilloma Virus Infection among the General Female Population in Vietnam: A Situation Analysis

Human papilloma virus (HPV) is the necessary cause of cervical cancer. This survey used a sample of 1,500married women aged 15-69 to examine the prevalence of HPV infection and HPV specific types in Vietnam aswell as risk factors of HPV infection. Results indicated that the prevalence of HPV infection in Hanoi and HCMwas 6.13 and 8.27. The proportion of multiple HPV infection was also higher in HCM than in Hanoi (35.5% vs.17.4%). Risk factors having significant associations with general HPV infection were early age at first sexualintercourse, number of life time sexual partners and period of use of oral contraceptives. Future implementationof HPV vaccine campaigns in Vietnam should consider the fact that HPV type 58 is common among both Hanoiand HCM populations, which none of the currently available vaccines target.     

Genetic Polymorphism of the Glutathione S-transferase Pi 1 (GSTP1) and Susceptibility to Cervical Cancer in Human Papilloma Virus Infected Northeastern Thai Women

Objective: We aimed to investigate any association between a genetic polymorphism of the detoxification GSTP1gene and risk of cervical cancer in northeastern Thailand. Materials and Methods: Genotyping of GSTP1 was performedfor 198 squamous cell cervical cancer (SCCA) patients and 198 age-matched healthy controls with the PCR-RFLPmethod. Results: The respective frequencies of the G allele were 0.33 and 0.26 in the controls and cases, the differencebeing significant (OR = 0.69 [95% CI: 0.50-0.95, p=0.0192]). Among women infected with high-risk types of HPV, beinga heterozygous carrier was associated with a reduced risk of cervical cancer (adjusted OR = 0.32 [95% CI: 0.12-0.91,p=0.031]). Similarly, a decreased risk was observed in heterozygous women with a non-smoking partner (adjusted OR= 0.27 [95% CI: 0.09-0.83, p=0.023]). Conclusions: GSTP1 polymorphism could influence susceptibility to cervicalcancer among northeast Thai women; either as a independent factor or in combination with high-risk HPV infection.Dual-testing of HPV and the GSTP1 might prove an effective screening tool for cervical cancer.     

高危型人乳头瘤病毒感染作为宫颈癌初筛的价值分析

目的 探讨高危型人乳头瘤病毒（HR-HPV）阳性感染在普通人群宫颈病变程度评估中的作用。方法 2013年杭州市拱墅区女性居民,年龄20~60岁女性且一年内未做宫颈癌筛查者行CervistaHR-HPV检测,并对HR-HPV阳性患者进一步行液基细胞学（TCT）检查。 结果 在879例HR-HPV阳性且行TCT检查的女性居民中,Ａ5/6阳性234例,占26.6%;Ａ7阳性119例,占13.5%;Ａ9阳性336例,占38.2%。HR-HPV型别以A9型最常见,20~30岁、≥30~40岁、≥40~50岁、≥50岁组A9型别占HR-HPV阳性的比例分别为35.2%、42.2%、37.6%和36.7%。对于初筛HPV阳性879例进行细胞学检查,TCT正常者813人,占92.5%。TCT异常者66人,TCT异常率为7.5%。Ａ5/6型234例中TCT异常比例为6.8%;Ａ7型119例中TCT异常比例为5.9%,Ａ9型336例中TCT异常比例为9.8%。结论　HR-HPV检测结果阳性并不等同于宫颈癌及癌前病变。A9型HR-HPV阳性的患者属高危人群,应密切随访。Cervista检测HPV-DNA方法也许能取代宫颈细胞学检查,成为新一代宫颈病变的常规筛查方法。     

人乳头瘤病毒检测对宫颈病变的诊断价值

目的：比较分析阴道镜活检与人乳头瘤病毒（ HPV）检测对宫颈病变诊断的临床应用价值。方法选取接受宫颈病变筛查的2560例已婚妇女为研究对象,其中行阴道镜活检560例,行HPV检测2000例,对两组检查结果进行对比分析。结果560例妇女阴道镜活检HPV阳性率为44．46％,2000例妇女HPV检测HPV阳性率为42．55％,两组比较差异无统计学意义,P＞0．05。经后期确认,上述患者中宫颈囊肿患者180例,阴道镜活检检出172例,漏诊8例,漏诊率为4．44％;HPV检测检出102例,漏诊78例,漏诊率为43．33％,阴道镜活检的漏诊率明显低于HPV检测,P＜0．01,差异具有统计学意义。结论阴道镜活检与HPV检测在宫颈病变诊断中均有良好效果,根据具体情况选择合适的检测方式。     

Prevalence and Type Distribution of Human Papillomavirus Infection Using the INNo-Lipa Assay,Kerman, Southeast Iran

The human papilloma virus (HPV) causes skin and mucous membrane infections. It crosses from one personto another by skin-to-skin contact, such as sexual contact. There are more than 100 types of HPV that caninfluence different parts of the body. Some types of HPV can cause cancer (such as cervical or anal cancer) andothers can cause warts (such as genital or plantar warts). HPV infection is one of the most common sexuallytransmitted infections (STIs) in Iran and around the world. Considerable molecular evidence suggests a role forhuman papilloma virus (HPV) in the pathogenesis of carcinoma. Epidemiological studies on human papillomaviruses (HPVs) infections in general population are critical for the performing of health policy guidelines fordeveloping the strategies to hinder the primary and secondary different cancer. In different parts of Iran, thereis a lack of population-based studies to determine the prevalence of HPV in the general population. The aim ofthis population-based study was therefore to report the prevalence ratse of HPV types among Iranian patients.To study the risk of human papilloma virus (HPV) infection, we managed a retrospective study in Kermanprovince, southeast of Iran. For this purpose, 410 patients tested for the presence of HPV DNA using PCR andINNo- Lipa assays. HPV DNA was detected in 108 out of 410 patients (26.34%), while it was not detected in anyof the control group samples. Patients included 23 (21.1%) males and 86 (78.8%) females. HPV type 6 was themost common (49%) followed by HPV type 16 (10.1%), and also HPV type11 (9.2%). The prevalence of HPV inIran is comparable to those reported in other regions of the world. In a similar manner, it seems that HPV types6, 16 and11 are the most common types in Kerman. Additional studies on larger group of patients, particularlyin those with pre-invasive forms of disease, are needed to explain the roles of different HPV types in this locationof Iran.     

Awareness of Human Papilloma Virus and Its Association with Cervical Cancer among Female University Students: A Study from United Arab Emirates

Cervical cancer is the neoplasm of the uterine cervix in women, which is highly preventable. With the advent of vaccination against HPV infection, a gradual decline in the incidence of cervical cancer cases has been observed in developing countries. The developing nations bear the brunt of cervical cancer incidence due to low acceptance of vaccination. This survey-based study was designed to assess the awareness and opinions of female university students regarding human papilloma virus, vaccination and cervical cancer. A survey questionnaire was distributed among female expatriate students (18 to 26 years of age) of a private university. The survey sought information on socio-demographic characteristics, family and personal health history, knowledge of cervical cancer, its association with HPV, preventive care and their opinions on vaccination. GraphPad was used for statistical calculations. Of the 269 respondents, only 6% had attended awareness programs and 11% reported having read any information leaflet. 78% of the respondents did not know how HPV infection occurs and less than 40% of the participants believed that cervical cancer is preventable. 75% of the respondents had not heard about the PAP smear test. 20% of the participants stated that they were uninterested in taking the vaccination and only 5% of the survey respondents had received vaccination. Majority of the respondents (78%) demonstrated positive attitude towards practices related to influence of nutrition in having a disease-free life. The present study indicates low levels of awareness regarding HPV and its role in cervical cancer among female university-going students. It was found that the awareness of HPV, their role in cervical cancer development and the availability of information regarding vaccination was very low. The authors recommend that educational institutions and government health authorities must offer a well-designed comprehensive awareness cum vaccination camp in order to educate young women about HPV infection and risk of developing cervical cancer. This will help ensure future economic and health benefits for all.     

Knowledge and Attitude of Iranian University Students toward Human Papilloma Virus

Introduction: Increasing prevalence of human papilloma virus (HPV) infection and its association withcervical cancer as a leading cause of death make it necessary to evaluate and improve the public knowledge,especially of university students, about this cause of disease. Methods: A cross-sectional study of knowledgeand attitude of a total 669 students from Tabriz University of Medical Sciences was therefore performed witha modified validated questionnaire, arranged into 5 parts and containing 55 questions, in July 2011. Questionswere directed to study socio-demographic characteristics of the participant, knowledge about HPV disease,transmission route, relationship with cervical cancer, predisposing factors, and participants attitude towardpeople with HPV infection. Results: All of the participants were Moslem with a mean age 25.6±5.33 years of age.All of the participants had heard of HPV, and acquired their knowledge through university courses (90.6%); themajority of them knew that HPV is a sexually transmitted disease and a potential cause for genital warts butgeneral knowledge about details was not high. Mean knowledge score of residents and post graduate midwiferyand nursing students was high as compared to other groups (P<0.001). Statements that indicated the presence offear to communicate with people suffering HPV and people’s avoidance to rely on babysitting of these patientswere observed. Educational level (β=0.21, P<0.001), age (β=0.18, P=0.002,) and smoking (β=-0.11, P=0.006) werepredicted to effect knowledge. Conclusions: Moderate level of knowledge about HPV among medical universitystudents makes it necessary to set effective national public health efforts on HPV education and preventionconsidering he excess of young population in Iran vulnerable to cervical cancer.     

高危型人乳头瘤病毒在女性感染者中的分布特征及其用于筛查宫颈癌的价值分析

目的分析人乳头瘤病毒在女性感染者中的分布特征,评估HPV-DNA分型检测用于筛查宫颈癌的临床价值。方法选择行宫颈癌筛查的患者2560例。采集患者宫颈细胞进行HPV-DNA检测,对HPV-DNA高危型阳性患者行液基细胞学(TCT)检测,TCT阳性者行阴道镜取活检病理检测。结果 2560例妇女中共检测出HPV-DNA阳性者711例(27.8%),其中高危型265例(10.4%),低危型446例(17.4%)。不同分级宫颈病变中HPV类型感染分布差异有统计学意义(P<0.05)。HPV-DNA高危型感染以30岁以下和50岁以上的人群感染率较高,各年龄段患者HPV-DNA高危型感染率差异无统计学意义(χ~2=5.673,P=0.339)。HPV-DNA高危型感染者中病理诊断为宫颈癌患者10例(3.8%),低危型感染者中病理诊断为宫颈癌者2例(0.4%),二者差异有统计学意义(P<0.05)。TCT联合HPV-DNA分型检测的敏感度高于二者单独检测,特异度和假阳性率低于HPV-DNA分型检测,假阴性率低于二者单独检测,差异均有统计学意义(P<0.05)。结论高危型HPV检测用于筛查宫颈癌敏感性和特异性高,可作为辅助宫颈细胞学检测的手段,临床应用价值较高。     

HR-HPV对CIN冷刀锥切后的随访价值

探讨HR-HPV监测CIN冷刀锥切后病变残余或复发的价值。方法：118例冷刀锥切后患者第3、6、12、18、24个月均检测HR-HPV和细胞学及阴道镜,病理证实存在CIN视为残留或复发。结果：术后病理切缘阳性10例（8.5%）;术后24个月残留或复发18例（15.3%）。术后第6个月HR-HPV转阴率较术后第3个月升高,差异有统计学意义,较6个月后的转阴率无统计学意义。术后第6个月HR-HPV阳性者28例（23.7%）,阳性者发病18例（64.3%）,阴性患者无发病。术后第6个月HR-HPV诊断病变残留或复发的敏感度和特异度分别为100.0%和90.0%,阳性预测价值和阴性预测价值分别为64.3%和100.0%。HR-HPV与TCT正确诊断率为91.5%和81.4%,Youden's指数为0.900和0.598,HR-HPV优于TCT。切缘阳性者残留或复发率（40.0%）较阴性患者（13.0%）高（P=0.045）,切缘阳性者发病风险是阴性者4.5倍（95% CI=1.121～17.866）。结论：术后第6个月HR-HPV检测是监测冷刀锥切后病变残留或复发的早期敏感指标,阳性者密切监测,阴性者常规监测不增加发病风险。此外,切缘阳性是病变残留或复发的一个重要危险因素。     

Prevalence of Human Papillomavirus Genotypes in Women with Normal and Abnormal Cervical Cytology in Iran

Introduction: HPV infection has a prime etiologic role in development and progression of cervical cancer, one ofthe most frequent forms of cancer among women in developing countries. This study was designed to determine themost prevalent HPV genotypes in women with normal and abnormal cervical cytology in Iran. Materials and Methods:Samples from134 patients, including 127 who attended gynecology clinics and 7 with solid cervical tumors wereused. All 127 patients underwent routine Pap tests for cytological evaluation and at the same visit a sample ofcervical epithelial cells was obtained by scraping the cervix osteum. In each case HPV infection was primarily evaluatedby PCR using GP 5/6 primers and then subtyping was performed in proved infected samples with specific primersfor HPV 16, 18, 31, 33, 11 and 6. After cytological evaluation, 50 patients with abnormal Pap tests were categorizedas the abnormal group and the remaining 77 patients as the normal group. Results: In the normal group, HPVinfection was established in 10 cases (13% infection rate), while 30 HPV positive cases were discovered in the abnormalgroup (60% infected). The most prevalent genotypes among the infected samples were HPV 16 (76%), HPV18 (12.7%)and HPV11/6 (8.5%). Moreover, all 7 tumor samples were positive for HPV general primers of which, 5 sampleswere infected with HPV 16, two were co-infected with HPV16,18 and HPV16,31 genotypes and one was infected withHPV 18. Conclusions: Infection with HPV 16 was found to be significantly higher in abnormal group in comparisonwith normal group (42% vs. 11.6%, P value <0.005), likewise HPV18 genotypes were proved to be more prevalent inabnormal group (8% vs. 0%, P value <0.05). No significant relation between other HPV genotypes and pathologiccervical changes was obtained. According to our study high rates of infection with HPV genotypes in sexually activeIranian women makes molecular investigation for HPV16 and 18 very essential in clinical approaches to patientswith proven dysplasia in their screening tests and also for those patients with borderline (i.e. ASCUS) or incongruouspathology reports. Larger studies are required to determine the most appropriate vaccine with highest protection inIranian women.     

Simultaneous Effects of Viral Factors of Human Papilloma Virus and Epstein-Barr Virus on Progression of Breast and Thyroid Cancers: Application of Structural Equation Modeling

This study aimed to assess effects of the sets of EBV and HPV expressed proteins simultaneously on the sets of cellular/inflammatory factors in breast and thyroid cancers using structural equation modeling. In this multi-center case-control study, according to the inclusion and exclusion criteria, 83 breast and 57 thyroid specimens were collected from the eligible patients. In addition, 31 and 18 histopathological evaluated normal breast and thyroid samples were also examined as age-matched healthy controls. In addition, ELISA and Real-time PCR were used to measure the expression level of viral and cellular/inflammatory genes and proteins. Structural equation modeling was used to test the causal associations between the sets of EBV and HPV expressed proteins with inflammatory factors in breast and thyroid cancers development. Breast cancer patients had a higher incidence of HPV-positively and EBV-positively than healthy controls (OR=1.66, 95%CI=0.79-3.47, P-value=0.177), (OR=3.18, 95%CI=1.52-6.63, P-value=0.002), respectively. In addition, thyroid cancer patients had a significantly higher incidence of EBV-positivity than healthy controls (OR=3.72, 95% CI=1.65-8.36, P-value=0.001). After fitting the SEM model, HPV proteins factor has significant direct and total effects on the cellular/inflammatory factors in breast cancer (direct effect: β=0.426, P-value=0.01; total effect: β=0.549, P-value<0.001). However, EBV proteins factor has most significant total effect on the cellular/inflammatory factors in breast cancer (total effect: β=0.804, P-value<0.001) than the cellular/inflammatory factors in thyroid cancer (total effect: β=0.789, P-value<0.001). For the first time, a significant association between EBV and HPV -genes, anoikis resistance and the development of breast and thyroid cancers demonstrated by using SEM, Simultaneously.     

Parental Knowledge and Attitudes about Human Papilloma Virus in Iran

Infection by human papillomavirus (HPV) is one of common sexually transmitted diseases leading to cervicalcancer. Evaluation of parental knowledge and attitudes toward HPV were aims of present study to provide anappropriate method to decrease burden of this infection on society. During this study, 358 parents were assessedfor knowledge about HPV and its related disorders. Some 76% of parents had no information about HPVinfection and among the informed parents 36% had obtained their information via internet and others fromstudying medical resources. The average score of mothers information about HPV infection was higher thanthat of fathers, and also educational level and age had significant impact on knowledge of parents about HPV.Parent knowledge about the hazards of HPV was higher than their knowledge about modes of transmission.Lack of awareness about HPV infection was high in this study, underlining the urgency of education among alladult people in our society.     

环氧合酶-2在宫颈癌中的表达及其与HPV16感染的关系

目的：探讨环氧合酶-2(COX-2)在宫颈癌发生发展中的作用，分析COX-2与宫颈癌中HPV16感染之间的关系。方法：收集46例宫颈癌组织作为实验组，31例健康的宫颈组织作为对照组。用免疫组化方法检测各组的COX-2表达水平。用PCK方法检测宫颈癌组的HPV16DNA。结果：COX-2在宫颈癌组织中有较高表达；COX-2在宫颈癌组织中表达与年龄、临床分期、组织分化程度、浸润深度之间均无相关性。而与淋巴结转移有显著相关性；宫颈癌组织中HPV16DNA阳性率为5652％(26/46)。在COX-2表达阳性的宫颈癌组织中，HPV16DNA阳性组的染色分值明显高于HPV16DNA阴性组。结论：宫颈癌的发生发展中有COX-2的参与。并且COX-2与宫颈癌的转移密切相关。宫颈癌中COX-2高表达与HPV16感染可能有一定的相关性。     

Distribution of Human Papilloma Virus Infections of Uterine Cervix among Women of Reproductive Age - a Cross Sectional Hospital-Based Study from North East India

Infection of the uterine cervix by human papilloma viruses (HPV) may be associated with cervical pre-cancerand invasive cervical carcinoma if left untreated. With advance in molecular techniques, it has become easier todetect the resence of HPV DNA long before the appearance of any lesion. This study concerned cervical scrapesamples of 310 married non-pregnant women attending a gynecology outpatient department for both Pap andPCR testing to detect HPV DNA. Nested PCR using primers for L1 consensus gene with My9/My11 and GP6+/GP5+followed by multiplex PCR were carried out to detect HPV 16 and HPV18. Result: HPV prevalence was11.9% out of which 3.67% cases of negative for intra-epithelial lesion or malignancy (NILM) and in 71.1%(27/38) of atypical cervical smears were HPV positive. There was increasing trend of high-risk-HPV positivity(HR HPV 16 and 18), from 20% in benign cytology (NILM) to 42.9 % in LSIL, 71.41% in HSIL and 100% inSCC. There was highly significant association of HPV infection with cervical lesion (x2=144.0, p<0.01) and alsowith type specific HPV prevalence (x2=7.761*(p<0.05).     

Human Papilloma Virus (HPV) and Host Cellular Interactions

Viral-induced carcinogenesis has been attributed to the ability of viral oncoproteins to target and interact with the host cellular proteins. It is generally accepted that Human papilloma virus (HPV) E6 and E7 function as the dominant oncoproteins of ‘high-risk’ HPVs by altering the function of critical cellular proteins. Initially it was shown that HPV E6 enhances the degradation of p53, while HPV E7 inactivates the function of the retinoblastoma tumor suppressor protein Rb. However, recent studies during the last decade have identified a number of additional host cellular targets of both HPV E6 and E7 that may also play an important role in malignant cellular transformation. In this review we present the interactions of HPV E6 and E7 with the host cellular target proteins. We also present the role of DNA integration in the malignant transformation of the epithelial cell.