膀胱移行细胞癌P21,P185,p53蛋白表达及ras,p53基因突变的检测

为探讨基因的改变在膀胱移行细胞癌发生过程中的意义，应用免疫组织化学及聚合酶链反应－限制性片段长度多肽性法，检测１５０例膀胱移行细胞癌Ｐ２１、Ｐ１８５、ｐ５３蛋白表达以及５０例ｒａｓ、ｐ５３基因突变。结果表明：膀胱移行细胞癌Ｐ２１、Ｐ１８５、ｐ５３蛋白表达阳性率分别为５９．３％（８９例）、５５．３％（８３例）、２９．３％（４４例）。Ｐ２１、ｐ１８５蛋白表达阳性率与膀胱移行细胞癌分级呈负相关（Ｐ＜０．０５），ｐ５３蛋白表达与膀胱移行细胞癌分级呈正相关（Ｐ＜０．０１）。Ｐ２１、ｐ５３蛋白表达阳性率与预后呈显著相关，Ｐ２１与预后呈负相关。７３例膀胱移行细胞癌存在两种以上蛋白共同表达。膀胱移行细胞癌Ｈａ－ｒａｓ癌基因第１２位密码子突变１６例（３２％），ｐ５３基因突变９例（１８％），均为２４８位点突变。Ｈａ－ｒａｓ第１２位点突变随病理分级增高而增高，与膀胱移行细胞癌分级显著相关（Ｐ＜０．０５）。ｒａｓ基因、ｐ５３基因突变与预后显著相关（Ｐ＜０．０５）。ｒａｓ基因、ｐ５３基因突变患者死亡率高于无突变患者。４例膀胱移行细胞癌存在ｒａｓ基因及ｐ５３基因共同突变。     

乳头瘤病毒16型E6,P53,RB,PCNA在宫颈癌中的表达状态及相关性

应用核酸原位杂交和免疫组织化学技术，检测人子宫颈癌中人乳头瘤病毒（ＨＰＶ）１６型Ｅ６ＯＲＦ与抑癌基因产物Ｐ５３，ＲＢ和增殖细胞核抗原（ＰＣＮＡ）。在４４例宫颈癌石蜡切片中，原位杂交检测出ＨＰＶ１６Ｅ６ＯＲＦ阳性２７例（６１．３６％），其中免疫组化检测出Ｐ５３、ＲＢ、ＰＣＮＡ阳性分别为８例（２９．６３％），１４例（５２．８５％）、２０例（７４．０７％），而在１７例ＨＰＶ１６Ｅ６阴性标本中Ｐ５３、ＲＢ、ＰＣＮＡ阳性分别为７例（４１．１７％），９例（５２．９４％）、１２例（７０．５８％）。而在５例正常宫颈组织中未测出ＨＰＶ１６Ｅ６ＯＲＦ，ＰＣＮＡ只在宫颈组织上皮基底层细胞中表达。统计学分析表明，ＨＰＶ１６Ｅ６与宫颈癌密切相关（Ｐ＜０．０５），ＰＣＮＡ在宫颈癌与正常宫颈组织中有显著性差异（Ｐ＜０．０５）。未能发现宫颈癌组织中ＨＰＶ１６Ｅ６ＯＲＦ与Ｐ５３蛋白相关性（Ｐ＞０．０５）。     

p53、ras p21、c-erbB-2和nm23在肺癌组织中的表达

目的：探讨癌基因与肺癌临床病理特征及预后的关系。方法：应用免疫组化ＳＰ法对５８ 例肺癌行ｐ５３、ｒａｓｐ２１、ｃｅｒｂＢ２和ｎｍ２３ 的检测。结果：癌组织中阳性反应检出率分别为４６－６％ 、２４－１ ％ 、５０－０ ％ 和５３－４ ％ ,腺癌和差分化癌ｒａｓ ｐ２１ 、ｃｅｒｂＢ２表达高于鳞癌和分化好的癌（ Ｐ＜ ０－０５） ,术后长期生存患者ｒａｓｐ２１ 、ｃｅｒｂＢ２ 表达低于短期死亡患者（Ｐ＜ ０－０５ ,Ｐ＜ ０－０１）,吸烟患者ｒａｓ ｐ２１ 表达高于不吸烟患者（Ｐ＜ ０－０５） ,淋巴结癌转移阴性组ｎｍ２３ 表达高于淋巴结癌转移阳性组（ Ｐ＜ ０－０１）,ｐ５３ 与ｒａｓ ｐ２１、ｃｅｒｂＢ２ 阳性表达具有协同性（ Ｐ＜ ０－０５） 。结论：肺癌发生发展和转移与ｒａｓｐ２１ 、ｃｅｒｂＢ２ 的激活和ｐ５３ 、ｎｍ２３ 的失活密切相关,部分基因的改变存在协同性,ｒａｓ ｐ２１ 基因的激活与吸烟有关,ｒａｓ ｐ２１、ｃｅｒｂＢ２ 的检测对判断肺癌预后有价值。     

乳头瘤病毒16型E6,P53,RB,PCNA在宫颈癌中的表达…

应用核酸原位杂交和免疫组织化学技术，检测人子宫颈癌中人乳头瘤病毒（ＨＰＶ）１６型Ｅ６ＲＦ与抑癌基因产物Ｐ５３，ＲＢ和增殖细胞核抗原（ＰＣＮＡ）。在４４例宫颈癌石蜡切片中，原位杂交检测出ＨＰＶ１６Ｅ６ＯＲＦ阳性２７例（６１．３６％），其中免疫组化检测出Ｐ５３、ＲＢ、ＰＣＮＡ一分别为８例（２９．６３＃），１４例（５２．８５％）、２０例（７４．０７％），而在１７例ＨＰＶ１６Ｅ６阴性 本中Ｐ５３、ＲＢ、Ｐ     

大肠腺瘤与腺癌P21,P53,P185蛋白表达及ras,p53基因突变的检测

应用免疫组化及ＰＣＲ－ＲＦＬＰ法检测３０例大肠腺瘤、７４例大肠腺癌及癌旁粘膜Ｐ２１、Ｐ５３、Ｐ１８５蛋白表达及ｒａｓ、ｐ５３基因突变。结果表明，大肠腺瘤Ｐ２１、Ｐ５３蛋白阳性率（５３．３％，２７．６％）高于癌旁粘膜（Ｐ＜０．０１），二者过度表达与腺瘤恶性倾向有关。大肠腺癌Ｐ２１、Ｐ５３及Ｐ１８５蛋白阳性率（７２．９％，３７．８％，４７．２％）皆高于腺瘤Ｉ级不典型增生（Ｐ＜０．０１，Ｐ＜０．０５及Ｐ＜０．０５）。９例腺瘤，４０例腺癌存在两种以上蛋白表达，共同表达与腺瘤恶性倾向及腺癌预后有关。大肠腺瘤及腺癌ｒａｓ基因突变率分别为２６．７％及４１．９％，ｒａｓ基因突变与腺瘤恶性倾向有关。大肠腺瘤及腺癌ｐ５３基因２４８位点突变率分别为３．３％及１４．９％。６例腺癌存在两种基因突变，两种基因协同突变与大肠癌预后有关。提示ｒａｓ、ｐ５３及ｃ－ｅｒｂＢ－２基因改变均参与了大肠癌的发生、发展过程。     

卵巢上皮性肿瘤p16抑癌基因突变与HPV感染的研究

采用聚合酶链反应－单链构象多态性分析（ＰＣＲ－ＳＳＣＰ）技术，对同一卵巢上皮性肿瘤石蜡包埋组织中ｐ１６基因（第二外显子）突变及人乳头状瘤病毒（ＨＰＶ）感染进行相关性研究。并与正常卵巢组织进行对照。结果，２８例卵巢上皮性肿瘤组织中ｐ１６基因突变１５例，突变率为５３．６％（１５／２８），其中７例伴有ＨＰＶ１６型或ＨＰＶ１８型感染，占突变率的４６．７％。在卵巢上皮性肿瘤组ＨＰＶ１６、１８ＤＮＡ阳性率为５３．６％（１５／２８），对照组ＨＰＶ１６、１８ＤＮＡ阳性率为５．６（１／１８），二者比较有显著性差异。提示：卵巢上皮性肿瘤中ｐ１６基因突变与ＨＰＶ１６、１８型感染有关。ＨＰＶ１６、１８型感染与卵巢上皮肿瘤密切相关     

c─erbB─2、ras p21及p53在大肠癌表达的免疫组化研究

对４８例大肠癌连续切片进行ｃ─ｅｒｂＢ─２、ｒａｓｐ２１及ｐ５３３种癌相关基因产物的免疫组化ＡＢＣ法及ＡＰＡＡＰ－ＩＧＳＳ双重标记研究，结果表明：（１）癌相关基因ｃ─ｅｒｂＢ─２、ｒａｓｐ２１和ｐ５３阳性表达率在癌组织分别为５０．２％（２５／４８）、４３．８％（２１／４８）和５４．２％（２６／４８）；癌旁粘膜分别为２５％（１２／４８）、１８．８（９／４８）和２０．８％（１０／４８）；而在＂正常＂结肠粘膜则分别为１２．５％（６／４８）、６．３％（３／４８）和０．（２）有２种以上癌相关基因产物同时表达者在癌组织中有２６例（５４．２％）．在癌旁粘膜有５例（１０．５％），而在正常粘膜则未见有２种癌相关基因同时表达，（３）癌组织中ｃ─ｅｒｂＢ─２＋ｐ２１、ｃ─ｅｒｂＢ─２＋ｐ５３、ｐ２１＋ｐ５３及ｃ─ｅｒｂＢ─２＋ｐ２１＋ｐ５３同时表达者分别为２．１％、１２．５％、１６．７％及２２．９％，（４）ＡＰＡＡＰ－ＩＧＳＳ双重免疫标记结果表明，单一癌细胞可同时表达２种癌基因产物。上述结果提示：ｃ─ｅｒｂＢ─２、ｒａｓｐ２１及ｐ５３可能与大肠病的发生有关，三者在大肠病的发生中可能起协同作用。     

子宫颈癌组织中HPV16癌基因及p53基因的检测

利用ＨＰＶ１６Ｅ６、Ｅ７基因特异性引物，ＰＣＲ技术及抗癌基因ｐ５３外显子７特异性引物，ＰＣＲ－ＳＳＣＰ技术对３５例进展期子宫颈癌组织进行研究，发现：（１）３５例标本中ＨＰＶ１６Ｅ６、Ｅ７ＤＮＡ的总检出率为７１．４２％（２５例），其中同时检出Ｅ６、Ｅ７为３１．４２％（１１例），另外８．５７％及３１．４２％（３例及１１例）仅分别检出Ｅ６、Ｅ７序列。（２）全组未见１例有ｐ５３基因外显子７的点突变及等位基因缺失。该结果说明ＨＰＶ１６与本地区妇女子宫颈癌发生有密切关系，并且癌组织中ＨＰＶ１６Ｅ６、Ｅ７亚基因的分布是不均一的，ｐ５３基因外显子７的改变并不常见。在实验中我们还建立了使用生物素标记的ｄＵＴＰ进行ＰＣＲ－ＳＳＣＰ的技术。     

p53、p21、p185蛋白表达与横纹肌肉瘤分化及预后的关系

目的研究ｐ５３、ｒａｓ和ｃ－ｅｒｂＢ－２癌基因蛋白产物ｐ２１、ｐ１８５在横纹肌肉瘤（ＲＭＳ）中的表达及其与ＲＭＳ的分型、分级和预后的关系。方法对确诊的５０例中的４１例有随访的ＲＭＳ用免疫组化ＡＢＣ法标记ｐ５３、ｐ２１、ｐ１８５蛋白，结果发现ｐ５３、ｐ２１、ｐ１８５在ＲＭＳ的阳性率分别为７２％、６８％、６０％，其阳性表达与年龄、性别和ＲＭＳ的组织类型差异无显著性（Ｐ＞０．０５）；但与分化程度有关，其中ｐ５３、ｐ２１在低分化ＲＭＳ的阳性率分别为８５％和８０％，显著高于高分化ＲＭＳ的４２．９％和２８．６％（Ｐ＜０．０５）；ｐ５３蛋白在有转移组ＲＭＳ的阳性率为８６．４％，显著高于无转移组６０．７％（Ｐ＜０．０５）；有随访的４１例病例中。存活１年的ｐ５３蛋白阳性率为８６．７％，显著高于３年的４１．７％（Ｐ＜０．０５）。结论ｐ５３、ｐ２１蛋白表达可作为肿瘤分化及恶性程度的评价指标，而ｐ５３更能反映肿瘤预后，是肿瘤预后差的重要指标之一。     

大鼠单克隆抗体夹心ELISA法检测肝病病人血清中p21^ras蛋白

本文应用抗癌基因ｒａｓ表达产物Ｐ２１ｒａｓ蛋白的大鼠单克隆抗体建立的双抗体夹心ＥＬＩＳＡ法，检测了肝癌及癌病变前病人血清中ｐ２１ｒａｓ蛋白的浓度。所获阳性检出率分别为：慢性乙型肝炎为１３．０％（１２／９２），肝硬化为２７．８％（１０／３６）和肝癌为５０．０％（８／１６）。另外，对试验方法的敏感性、特异性及稳定性，以及检测Ｐ２１ｒａｓ蛋白与ＡＦＰ的关系进行了评价。结果表明，Ｐ２１ｒａｓ蛋白的过高表达发生在肝细胞癌变之前。提示在慢性乙型肝炎及肝硬化病人血清中检出Ｐ２１ｒａｓ蛋白，是预测肝细胞癌变的危险信号。     

HPV感染和p53异常表达与宫颈鳞癌的关系

目的研究宫颈鳞癌与p53蛋白表达和HPV感染的关系,探讨宫颈鳞癌的形成机制。方法采用RT-PCR法分别检测p53基因在39例宫颈鳞癌组织和39例正常宫颈黏膜组织中的表达情况以及PCR方法检测HPV在这些组织中的感染情况。结果 HPV在宫颈鳞癌组中阳性率为48.72%(19/39),正常组织中为14.81%(4/27),p53基因表达在宫颈鳞癌组中阳性率为53.85%(21/39),正常组织中为18.52%(5/27),宫颈癌组的HPV感染和p53表达均高于正常组(P0.05)。结论 HPV感染与p53基因的异常表达与宫颈鳞癌发生密切相关,联合检测能提高准确性。     

Expression of p16, Rb, and p53 proteins in squamous cell carcinomas of the anorectal region harboring human papillomavirus DNA.

Human papillomavirus (HPV) has been implicated as an etiologic agent for the development of squamous cell carcinoma of the anorectal region. It has been shown that the HPV E6 and E7 oncoproteins are able to inactivate the tumor suppressor functions of p53 and Rb. In cervical and head and neck cancers, HPV infection is also associated with an overexpression of p16, a cyclin-dependent kinase inhibitor. The expression of these cell cycle regulators in squamous cell carcinomas of the anorectal region has not been well studied. In the current study, 29 cases of squamous cell carcinoma of the anorectal region were immunohistochemically examined for the expression of p16, Rb, and p53 proteins. Tumor cell DNA was also extracted from paraffin blocks and subjected to broad-spectrum HPV DNA testing and typing. The results show that the tumor cells exhibited a strong and diffuse nuclear stain (with some cytoplasmic positivity) for p16 in all 29 cases (100%). The adjacent nonneoplastic squamous epithelium or colonic mucosa, in contrast, was completely negative. Loss of Rb nuclear staining in tumor cells was observed in 20 cases (69%). The p53 protein was essentially undetectable, with only 6 cases containing <10% positive cells. HPV DNA was detected in every case (100%), with 25 cases (86%) harboring Type 16. In addition, almost identical results were obtained in 12 HPV-positive squamous cell carcinomas of the upper aerodigestive tract. This was in marked contrast to those of HPV-negative tumors, where positive p16 staining and loss of Rb expression were seen in only 2/21 (10%) and 1/21 (5%) cases, respectively. These observations indicate that overexpression of p16 and loss of Rb nuclear staining are commonly associated with high-risk HPV infection, which may serve as useful surrogate biomarkers for identifying squamous cell carcinomas harboring HPV DNA.     

The correlation between expression of oncogene protein products p53, p21, p185 and cell differentiation and prognosis in rhabdomyosarcoma

OBJECTIVE: To study the correlation between expression of oncogene protein products p53, P21, p185 and histological type, cell differentiation and prognosis in rhabdomyosarcoma (RMS). METHODS: 41 RMS cases which had follow-up material were selected for this study. Expression of protein products of oncogene p53, p21 and p185 were synchronously detected and compared by immunohistochemical ABC method. RESULTS: The positive rates for p53, p21 ras and P185 c-erbB-2 were 72%, 68% and 60% respectively. Positive expression did not relate to age, sex or RMS histological type, but related to the degree of RMS differentiation. The positive rate of p53 ad p21 ras in well differentiated cases were 42.9% and 28.6% while that of the poorly differentiated group was 85% and 80% respectively (P < 0.05). The psoitive rate of p53 in the RMS group with metastasis was 86.6%, significantly higher than that of the non-metastasized group, which was 66.7% (P < 0.05). There was a significant difference between those with one year survival, whose p52 positive rate was 86.7% and those who survived for more than 3 years, whose p53 positive rate was 47.1% (P < 0.05). CONCLUSION: The results suggest that the irregular expressions of p53 and p21 were related to tumor differentiation and the degree of malignancy. p53 positivity may indicate a poor prognosis.     

Correlation between human papilloma virus infection in cervical lesions and expression of p53, p21 proteins and Ki-67

BACKGROUND: Human papilloma virus (HPV) is the most important factor in the oncogenic mechanism of cervical tumor. Furthermore, in a separate multi-stage process, abnormality in cell cycle kinetics has been demonstrated. In order to elucidate the oncogenic mechanism, we examined the relationship between cervical carcinoma and HPV infection, and also investigated the expression of p53 and p21 proteins as well as the cell proliferation capability by detecting Ki-67, and analyzed the correlations of these factors. MATERIALS AND METHODS: We studied the biopsy specimens from 107 patients of chronic cervicitis, cervical intraepithelial neoplasia and squamous cell carcinoma (SCC). HPV DNA was detected by the hybrid capture method. Immunostaining by LSAB procedures were performed using antibodies to p53 protein, p21 and MIB-1. The PCR-denaturing gradient gel electrophoresis (DGGE) method was used to search for mutation in exons 5, 6, 7 and 8 of p53. RESULTS: Of 107 cases studied, high-oncogenic HPV was detected in 80 cases (74.8%) with a particularly high prevalence in SCC. No correlation was observed between HPV infection and expression of p53, p21 or Ki-67. The degree of positivity of Ki-67 expression tended to be higher with disease progression. Cases strongly positive (2+) for p53 and p21 proteins were weakly positive for Ki-67, and cases positive (1+) or negative for p53 and p21 were strongly positive for Ki-67. CONCLUSION: In oncogenesis of cervical carcinoma, p53 protein, p21 protein and HPV may act separately as independent factors in some cases, and there is a strong possibility that other factors are involved.     

宫颈癌组织中HPV16,18E6蛋白表达的观察

目的观察ＨＰＶ１６、１８早期蛋白Ｅ６在人宫颈鳞状细胞癌中的表达并评价Ｅ６单抗的应用价值。方法采用ＳＰ免疫组化染色法,检测４０例宫颈鳞状细胞癌,３０例慢性宫颈炎及３０例正常宫颈组织中ＨＰＶ１６、１８Ｅ６蛋白的表达。结果癌组中Ｅ６的阳性率为６７．５％（２７／４０）,慢性宫颈炎中为３．３％（１／３０）,正常宫颈组织中均为阴性,良、恶组ＨＰＶ１６、１８Ｅ６的阳性率差异有显著意义（Ｐ＜０．０１）。结论ＨＰＶ１６、１８感染与本地区宫颈癌病因学密切相关,Ｅ６单抗可作为预测ＨＰＶ１６、１８感染及宫颈癌早期诊断的标记之一。     

人乳头瘤病毒与P 53协同致膀胱移行细胞癌关系的研究

目的 研究人类乳头瘤病毒（ＨＰＶ）６、１１、１６和１８型及Ｐ５３与膀胱移行细胞癌的关系。方法 采用聚合酶链反应（ＰＣＲ）方法检测了７５例膀胱移行细胞癌组织中ＨＰＶ的感染,免疫组化ＳＰ法检测Ｐ５３蛋白表达情况。结果 膀胱移行细胞癌组织中ＨＰＶ６、１１、１６和１８的阳性率分别为６．７％（５／７５）,５．３％（４／７５）,３３．３％（２５／７５）和６．７％（５／７５）。低危型ＨＰＶ（６或１１）阳性率为９．３％（７／７５）,高危型ＨＰＶ（１６或１８）阳性率为３４．７％（２６／７５）。同一膀胱癌组织中两种以上（包括两种）ＨＰＶ亚型感染８例,占１０．６％。ＨＰＶ６、１６和１８型之间感染阳性率在肿瘤有无转移组中差异显著（Ｐ〈０．０５）,ＨＰＶ１６、１８的阳性率在肿瘤病理分级中差异有极显著性（Ｐ〈０．０１）。ＨＰＶ ＤＮＡ型别     

Cytogenetic and molecular genetic changes in malignant transformation of immortalized esophageal epithelial cells

The purpose of this study was to evaluate the extent to which the expression of p53, c-myc, bcl-2, ras genes and chromosomes, along with activity of hTERT, impacts on the malignant transformation of immortalized esophageal epithelial cells. The SHEE cell line was established from an embryonic esophageal epithelial cell induced by transduction of E6E7 genes of human papillomavirus type 18 (HPV18E6E7). In cells of the 85th passage (SHEE85), the malignant transformation of SHEE was confirmed by morphology, cell proliferative index and tumor formation in SCID mice. C-myc, p53, bcl-2 and ras genes were assayed by the multi-PCR method with house-keeping gene GAPDH as control. The modal number of chromosomes was analyzed and its expression of subunit of telomerase, hTERT, was assessed by RT-PCR. Expression of HPV18E6E7 was assayed by Western blotting. The results showed that cells of SHEE85 were atypical and exhibited proliferative status with a proliferation index of 45.70%. Tumors formed in SCID mice with invasion of adjacent tissue. The karyotype belonged to hypotriploid and displayed expression of hTERT. C-myc, k-ras, bcl-2 and p53 (expression of phosphoprotein) were positive in SHEE85. Expression of HPV18E6E7 was positive. Taken together, SHEE85 cells were in fully malignant transformation and their molecular mechanism involved the expression of cellular genes, such as p53, bcl-2, c-myc and ras, and aberrance of chromosomes. It is probable that all of these changes were related with HPV18E6E7.     

Proliferating cell nuclear antigen but not p53 or human papillomavirus DNA correlates with advanced clinical stage in renal cell carcinoma

In this study we investigated 56 renal cell carcinomas immunohistochemically for the expression of proliferating cell nuclear antigen (PCNA) and tumour suppressor protein p53 . We also analyzed for the presence of human papilloma virus (HPV) DNA subtypes 6, 11, 16, 18, 31 and 33 by in situ hybridization. In carcinomas which showed more than 10% of PCNA positive nuclei there were significantly more cases with invasion ( P = 0.032) or metastatic disease ( P = 0.047). Nine out of 22 grade III-IV tumours (40.9%) but only six out of 30 grade I-II tumours (20%) showed more than 10% of PCNA positive cells ( P = 0.097). Patients with 10% or more PCNA positive cells in kidney tumours had more advanced disease at the time of diagnosis than those showing less PCNA positive cells ( P = 0.05).
Six p53 positive cases were found among 56 tumours (11%), but only one case had more than 10% positive cell nuclei. The presence of HPV DNA was found in 29 out of 56 cases (52%). Multiple subtypes were found in 19 cases (34%). The most commonly occurring subtypes were 18 and 33. There was no association between PCNA, p53 and the presence of HPV DNA subtypes. Because of the association of PCNA with invasion and metastatic disease, it would be worth while to study PCNA further as a possible marker for aggressiveness of renal carcinomas. Both this study and those concentrated on mutational analysis suggest that p53 is generally not important for the development of renal cell carcinoma. On the other hand, the presence of HPV DNA in these tumours implicates HPV viral infection in the aetiology of renal cancer.     

Expression of p21/WAF-1, status of apoptosis and p53 mutation in esophageal squamous cell carcinoma with HPV infection

Human papilloma virus (HPV) is regarded as a causative carcinogenic agent in anogenital squamous cell carcinoma (SCC), but there is controversy about its etiologic role in esophageal SCC (ESCC). In this study, we attempted to clarify whether HPV infection plays a crucial role in the development of ESCC by analysis of multiple factors. These included: detection of HPV DNA; evaluation of immunohistochemical assays for HPV-related cell cycle regulators and apoptosis by the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling method; and genetic analysis of the p53 gene. Twenty of the 48 ESCC examined (42%) were found to be positive for the HPV genome by polymerase chain reaction. They comprised 16 cases with the HPV16 subtype, three with the HPV18 subtype, and one with both HPV16 and 18. Immunohistochemical analysis revealed that the expression of p21/WAF-1 was significantly decreased in HPV-positive cases (chi2 = 9.2614; P = 0.0023). Furthermore, the 10 apoptosis-negative (< or =10%) cases of HPV-positive SCC were almost exclusively p21/WAF-1-negative (chi2 = 12.1406; P = 0.0005), indicating the significance of the relationship between HPV infection and the phenotype that is expected from HPV-induced inhibition of p53. Although 14 cases possessed missense and deletion mutations of the p53 gene (of which four mutations were found in HPV-positive ESCC), no accumulation of the mutation was defined in the phenotype, suggesting that distinct mutation processes might be involved in HPV-negative and -positive ESCC. The data provide significant support for the hypothesis that HPV infection may play a crucial role in the oncogenesis of some ESCC.     

Human papillomavirus infection in Egyptian esophageal carcinoma: correlation with p53, p21, mdm2, C-erbB2 and impact on survival

The etiological role of human papillomavirus (HPV) in esophageal carcinoma (EC) in relation to p53, mdm2, p21(waf), c-erbB2 and the overall survival (OS) rate was investigated. Tumor and normal tissues from 50 EC were evaluated by polymerase chain reaction and InnoLiPA for HPV. Single strand conformation polymorphism/sequencing were used to detect p53 gene mutations. Immunohistochemistry was performed to determine p53, mdm2, p21(waf)and c-erbB2 expression. Human papillomavirus was detected in 54% of tumors and in 24% of normal tissues. p53, mdm2 and c-erbB2 overexpression was detected in 68%, 70% and 60% of tumors and in 14%, 16% and 10% of normal samples, whereas loss of p21(waf) was evident in 64% of tumors. p53 mutations were detected in 20% of cases. Exon 8 and 5 showed the highest mutation rate (40% each), followed by exons 6 and 7 (10% each). There was a significant correlation between HPV and p53, mdm2, c-erbB2 overexpression. The OS was significantly associated with overexpression of p53 and loss of p21(waf). Human papillomavirus infection is frequent in Egyptian EC. Both p53-dependent and p53-independent pathways seem to be involved in HPV-associated EC. mdm2 and c-erbB2 are possible targets for HPV in the p53-independent pathway. However, only advanced stage and aberrant expression of p53 and p21(waf) are independent prognostic markers.