Association of Epstein-Barr virus infection and breast carcinoma

Introduction

A controversy regarding the association of Epstein-Barr virus (EBV) with breast carcinomas has recently been reported in the literature. The present study was carried out in an attempt to determine whether there is a relationship between latent infection with EBV and breast carcinomas in Jordanian females.

Material and methods

Extraction of DNA from the archive samples of breast carcinoma cases embedded in paraffin wax was performed and the extracted DNA was subjected to polymerase chain reaction amplification to detect the EBV genome using four sets of primers for EBER 2, BNLF-1, EBNA 2, and Gp220. Immunohistochemistry study was performed on sections of 4 µm which were cut from paraffin blocks of tumor and control groups. Monoclonal antibody against EBNA-1 was applied to all slides to identify the EBV-infected tumor cells. Detection was performed using the Dako envision dual link system.

Results

DNA was successfully extracted from 92 paraffin embedded samples of breast carcinoma patients, and from 49 normal samples. The extracted DNA was confirmed by using glyceraldehyde-3-phosphate-dehydrogenase (GAPDH) primers. Twenty-four out of 92 breast carcinoma specimens was found to be infected with EBV as compared to 3 out of 49 control group specimens, which represented a statistically significant difference (p-value using χ² = 0.008). Immunohistochemically, 24 (26%) of the 92 studied samples were found to be positive, showing EBNA-1 granular nuclear staining in tumor epithelial cells.

Conclusions

These findings suggest an association between EBV infection and breast carcinoma development.     

EB病毒与乳腺癌的相关性

目的：探讨EB病毒( Epstein-Barr virus, EBV)与乳腺癌发生、发展的相关性。方法随机选取不同发展阶段的乳腺病变组织246例,采用聚合酶链反应( polymerase chain reaction, PCR)、原位杂交( in situ hybridization, ISH)、激光捕获显微切割( laser capture microdissection, LCM)、免疫组化染色EnVision法检测EBV DNA、RNA、蛋白质水平,分析EBV与乳腺癌发生、发展的关系。结果免疫组化标记246例乳腺病变均未检测到EBV潜伏膜蛋白LMP1的表达。 PCR法在乳腺癌(12/23)、原位癌(0/10)以及乳腺良性病变(0/15)中检测到EBV DNA,但用地高辛标记的EBV DNA探针对48例乳腺良、恶性病变组织(包括PCR扩增阳性的12例乳腺癌标本)进行ISH检测,在癌细胞、乳腺上皮细胞和间质淋巴细胞内均未检测到阳性杂交信号。采用LCM PCR检测12例PCR扩增阳性和12例阴性乳腺标本的乳腺上皮细胞和间质淋巴细胞,在12例PCR阳性标本的间质细胞中扩增出EBV DNA,癌组织中未检出EBV DNA。用EBV RNA探针和ISH方法在75例乳腺良恶性病变组织中均未检测到EBER表达。结论在该文选择的标本中,乳腺癌发生、发展与EBV感染无关。     

石蜡包埋肝组织中丙型肝炎病毒的原位PCR检测

以丙型肝炎病毒（HCV）为研究对象探讨原位PCR这一新技术。用原位PCR和原位杂交检测石蜡包理肝组织中的HCV。7例肝硬变及8例肝细胞癌痛旁组织HCV的检出率分别为86％（6／7例）和50％（4／8例），明显高于同组原位杂交的42％（3／7例）和12．5％（1／8例），并且显示了良好的特异性。研究发现HCV主要分布于肝细胞浆中，并且在胆小管上皮细胞及单核细胞中也出现阳性信号。我们的研究表明原位PCR是一项敏感、特异的方法，它的广泛应用不仅可以提高丙型肝炎的诊断率，同时有助于其分子病理学的研究。     

Detection of hepatitis B virus genome in hepatocellular carcinoma tissues with PCR-in situ hybridization.

The detection is described of hepatitis B virus (HBV)-DNA in preserved hepatocellular carcinoma tissues, which were derived from 14 HBV-seropositive patients. Detection was by polymerase chain reaction (PCR) amplification of the target sequence, followed by specific localization of the PCR product with in situ hybridization. PISH (PCR-in situ hybridization) yielded strong positive signals in most of the tumor tissues despite very low copy numbers of chromosome-integrated HBV genome, whereas no signal was detected in control samples, indicating that the signals were specific for HBV. Positive signals were sometimes detected in cirrhotic nodules surrounding the tumor regions, indicating that HBV had infected non-transformed liver cells. HBV-DNA was detected in both nucleus and cytoplasm in some specimens, possibly representing HBV at different stages of the life cycle. In one case, a gradient of viral DNA was revealed, with the highest DNA signal centered at the site of viral antigen expression. Taken together, PISH is shown to be a highly sensitive molecular detection method that is capable of detecting the presence of a low copy number viral genome in situ.     

Analysis of the Epstein-Barr viral genome in so-called malignant histiocytosis syndrome

Malignant histiocytosis has been described as a proliferation of morphologically atypical hlstiocytes, but It Is difficult to determine whether or not malignant proliferation is present based on morphology alone. Recently the disorder has been thought to be heterogeneous, and therefore a true histtocytlc origin is considered to be rare. The Epstein-Barr virus (EBV) is thought to have the ability to transform human cells. Therefore, eight cases of malignant MsHocytic (MH) syndrome and five cases of virus-associated hemophagocytic syndrome (VAHS) were analyzed using a polymerase chain reaction (PCR) and the In situ hybridization (ISH) method in order to determine their relationship to EBV Infection. At the same time, the cellular origin of these syndromes was also studied. The results indicated that three of the MH cases were derived from T cells while four the MH cases were from hlstiocytes. The amplification of the EBV-LYDMA region, which was used to determine the monoclonallty, was detected in two MH cases and one VAHS case, and all these cases showed only one band. An ISH study also demonstrated the presence of an EBV in these three cases. One of the EBV-positive cases revealed an amplification of the EBV-LYDMA region by the PCR method before showing any sign of MH clinically. In the VAHS cases, the EBV genome was detected In hemophagocytic cells. The EBV-poslttve cases all demonstrated a rapid clinical course. Based on these results it is possible that EBV infection causes similar rapid clinical features in some cases of both MH and VAHS by the same mechanism.     

Detection of hepatitis B virus genome in hepatocellular carcinoma tissues with PCR-in situ hybridization

The detection is described of hepatitis B virus (HBV)-DNA in preserved hepatocellular carcinoma tissues, which were derived from 14 HBV-seropositive patients. Detection was by polymerase chain reaction (PCR) amplification of the target sequence, followed by specific localization of the PCR product with in situ hybridization. PISH (PCR-in situ hybridization) yielded strong positive signals in most of the tumor tissues despite very low copy numbers of chromosome-integrated HBV genome, whereas no signal was detected in control samples, indicating that the signals were specific for HBV. Positive signals were sometimes detected in cirrhotic nodules surrounding the tumor regions, indicating that HBV had infected non-transformed liver cells. HBV-DNA was detected in both nucleus and cytoplasm in some specimens, possibly representing HBV at different stages of the life cycle. In one case, a gradient of viral DNA was revealed, with the highest DNA signal centered at the site of viral antigen expression. Taken together, PISH is shown to be a highly sensitive molecular detection method that is capable of detecting the presence of a low copy number viral genome in situ.     

Demonstration of coxsackie virus RNA in formalin-fixed tissue sections from childhood myocarditis cases by in situ hybridization and the polymerase chain reaction

This is a combined study using in situ hybridization and the polymerase chain reaction to investigate the presence of Coxsackie virus RNA in formalin-fixed tissue from cases of childhood myocarditis. Of the ten cases studied, two were positive by both methods. The virus RNA was predominantly located in areas showing an inflammatory cell infiltrate and myofibre necrosis. These findings suggest that direct lytic infection of myocytes by virus is responsible for myocaiditis in these cases, rather than an autoimmune process, which has been suggested previously. The findings in one case, where the virus showed a marked sub-endocardial distribution, may have implications for the aetiology of endocardial fibroelastosis by confirming a viral tropism for this location. The techniques used in this study are easily repeatable and can be directly applied to look for viruses in a number of other diseases where a viral aetiology is suspected.     

原位PCR技术检测石蜡包埋脑组织中人巨细胞病毒DNA

应用原位聚合酶链反应（ＩＳＰＣＲ）技术检测了２５例尸检畸形胎儿石蜡包埋脑组织中人巨细胞病毒（ＨＣＭＶ）ＤＮＡ，并与普通ＰＣＲ及原位杂交（ＩＳＨ）进行了比较。ＩＳＰＣＲ、ＰＣＲ及ＩＳＨ检测阳性率分别为４４％，３６％及２０％。与ＩＳＨ相比较，ＩＳＰＣＲ不仅检出阳性率高，而且信号强度增强。研究结果提示，ＩＳ－ＰＣＲ是诊断ＨＣＭＶ感染的快速、敏感、特异的实用方法。     

High prevalence of human papillomaviruses in fresh frozen breast cancer samples

While the etiology of breast cancer remains enigmatic, some recent reports have examined the role of human papillomavirus (HPV) in breast carcinogenesis. The purpose of this study was to determine the prevalence of HPV in breast cancer tissue using PCR analysis and sequencing. Fifty-four (54) fresh frozen breast cancers samples that were removed from a cohort of breast cancer patients were analyzed. Samples were tested for HPV using comprehensive PCR primers, and in situ hybridization was performed on paraffin embedded tissue sections. Findings were correlated with clinical and pathological characteristics. The HPV DNA prevalence in the breast cancer samples was 50% (27/54) with sequence analysis indicating all cases to be positive for HPV-18 type. While HPV patients were slightly younger, no correlation was noted for menopausal status or family history. HPV positive tumors were smaller with earlier T staging and demonstrated lesser nodal involvement compared to HPV negative cancers. In situ hybridization analyses proved negative. The high proportion of HPV positive breast cancers detected in this series using fresh frozen tissues cannot be dismissed, however the role of HPV in breast carcinogenesis remains unclear and may ultimately be ascertained by monitoring future breast cancer incidence amongst women vaccinated against high risk HPV types.     

Vitreous fluid sampling and viral genome detection for the diagnosis of viral retinitis in patients with AIDS

Cytomegalovirus (CMV) causes severe necrotizing retinitis in patients with the acquired immune deficiency syndrome (AIDS) and other herpesviruses have been implicated in the acute retinal necrosis syndrome (ARN), seen in both the immunocompetent and the immunosuppressed. At present the diagnosis of viral retinitis relies solely on clinical appearances. In order to assess whether the detection of herpesvirus-specific DNA in cell-free vitreous biopsy samples could be useful in the early diagnosis of viral retinitis, vitreous fluid samples were taken from 100 patients. Fifty patients had AIDS as defined by the Centers for Disease Control, (MMWR 36 (suppl 1S):1S–15S, 1987) and retinal disease. The remainder were not known to be HIV infected and had no clinical evidence of retinal infection. Each sample was tested for the presence of CMV, herpes simplex virus 1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV6), by amplification of viral DNA using a sensitive and specific nested poly-merase chain reaction (PCR). The presence of detectable CMV or VZV DNA was clearly associated with clinical disease whereas the presence of HSV-1, EBV, and HHV6 sequences were not. Clinical discrimination between CMV- and VZV-associated retinitis was greatly enhanced when the PCR results were taken into consideration. © 1994 Wiley-Liss, Inc.     

A PCR based DNA hybridisation capture system for the detection of human cytomegalovirus. A comparative study with other identification methods

A simple, sensitive and specific colourimetric hybridisation method for the detection of HCMV DNA in clinical specimens is described. This method combines a PCR assay with a sensitive sandwich hybridisation assay. It relies on the use of a specific capture probe linked covalently to polystyrene microplates and a specific polybiotinylated detection probe. Amplified DNA fragments, sandwiched between these two probes, are detected by an enzymatic colour reaction. This PCR-based colourimetric hybridisation method was compared with other known HCMV detection methods. Clinical specimens (n=145, corresponding to 106 patients) were tested by both a nested PCR assay and this colourimetric hybridisation method; and by either the culture method or the pp65 antigenaemia test depending on the type of sample used. The results showed that the PCR-based hybridisation method has a specificity similar to tissue culture, known as the conventional gold standard method, and could be used for the examination of the clinical specimens.     

乳腺癌和非癌组织中DLC1基因及蛋白表达与Ki-67的关系

目的探讨乳腺癌和非癌组织中DLC1表达及其与Ki-67的相互关系。方法应用原位杂交技术和免疫组织化学En-Vision两步法,检测52例乳腺浸润性导管癌和42例非癌组织(包括癌旁乳腺组织20例和乳腺纤维腺瘤22例)中DLC1-mR-NA、DLC1和Ki-67的表达。结果DLC1-mRNA和蛋白在乳腺癌中的阳性率(50%和57.7%)低于非癌乳腺组织(90.5%和92.9%),差异有统计学意义(χ2=17.518和10.729,P0.01)。DLC1-mRNA与蛋白的表达呈正相关(rs=0.379,P0.01)。Ki-67在乳腺癌中的阳性率为61.5%,而在非癌组织中均呈阴性表达,两者差异有显著统计学意义(χ2=39.186,P0.01)。乳腺癌中DLC1与Ki-67的表达呈负相关(rs=-0.507,P0.01)。结论DLC1-mRNA和蛋白在乳腺癌中呈低表达或缺失,提示其与乳腺癌的发生、发展有关,DLC1有抑制乳腺癌细胞增殖的功能,可作为乳腺癌新的分子标记物。联合检测DLC1和Ki-67在乳腺癌中的表达,有望成为估价乳腺癌生物学行为的参考指标。     

No association of mouse mammary tumor virus-related retrovirus with Japanese cases of breast cancer

Mouse mammary tumor virus (MMTV) is the causative agent of breast tumors in mice. Recently, DNA sequences homologous or closely related to MMTV env gene have been specifically detected in breast cancer tissue from significant numbers of American, Australian, and Tunisian women, suggesting a viral etiology for at least a part of human breast cancer. However, the viral sequences have not been detected from any of breast cancer samples in several subsequent studies. Thus, whether MMTV-related retrovirus is a causative agent of human breast cancer remains controversial. To demonstrate if MMTV-related retrovirus is involved in Japanese cases of breast cancer, breast tissue specimens from 46 breast cancer patients and 3 patients with benign mammary tumors were investigated. Extensive analysis using PCR and Southern blot hybridization, however, could not detect the MMTV env gene-like sequence in any of the samples tested as well as in MCF7 cells that has previously been described as a positive control. Thus, MMTV itself or MMTV-related retrovirus is not associated with breast carcinogenesis in Japanese women, and it is unclear whether this conclusion is merely a reflection of regional differences in its epidemics.     

间接法原位PCR检测喉鳞癌组织HPV感染

建立稳定的原位ＰＣＲ方法，并探讨ＨＰＶ感染与喉鳞癌发生的关系。方法采用免疫组化、原位杂变、ＰＣＲ和间接原位ＰＣＲ技术，检测了５０例喉鳞癌中的ＨＰＶ感染情况。结果免疫组化衣壳抗原阳性者６例（１２％），原位杂交阳性者１３例（２６％），ＰＣＲ阳性者１０例（２０％），原位ＰＣＲ阳性者１７例（３４％），综合上述方法的检出率为４２％（２１例）。结论ＨＰＶ感染与喉癌有着明显的关系，间接原位ＰＣＲ在检测ＨＰＶ感染     

检测病毒性肝炎患者血清中SEN病毒及其临床意义

目的：检测病毒性肝炎患者血清中SEN病毒D和H(SENV-D、SENV-H),并探讨其临床意义。方法：采用巢式聚合酶链反应法（nPCR）检测甲、乙、丙、戊型肝炎和非甲－戊型肝炎患者血清中SENV-D和SENV-H DNA。结果：在180例病毒性肝炎患者血清中，SENV-D和SENV-H检出率分别为17.2%(31/180)和5.6%(10/180)，总检出率为18.3%(33/180)、甲、乙、丙、戊型肝炎患者的SENV-D/H检出率高于非甲－戊型肝炎患者。从甲、乙、丙、戊型肝炎和非甲－戊型肝炎患者分离的SENV-D/H核苷酸序列，与SENV-D/H原型株比较，其同源性在94％以上。甲、乙、丙和戊型肝炎患者有无SENV-D/H合并感染，其血清生化学指标无明显差异。结论：SENV-D/H可能不是非甲-戊型肝炎的病原，甲、乙、丙和戊型肝炎患者合并感染SENV-D/H并不加重病情。     

Persistence of virus and viral genome in myocardium after coxsackievirus B3-induced murine myocarditis.

Following infection with Coxsackievirus B3 (CVB3), A-strain mice develop ongoing myocarditis that persists after the virus ceases to be cultivatable from heart tissue. We studied the natural history of this virus-induced but apparently autoimmune inflammation by means of in situ hybridization (ISH) and by polymerase chain reaction (PCR). Both ISH and culture allowed detection of virus up to 2 weeks post-infection in virtually all heart tissues. In contrast, PCR revealed the presence of viral genome for a substantially longer period of time, i.e. at least 34 days after CVB3 infection. Similarly, the majority of mice showed myocardial inflammation at this time point. However, the persistence of virus did not correlate with ongoing myocarditis, and vice versa. Most mice with ongoing myocarditis produced heart myosin autoantibodies, most probably as a result of tissue damage. The lack of correlation between presence of ongoing inflammation and persistence of virus supports our previous view that the late phase of CVB3-induced myocarditis is mediated by autoimmunological mechanisms.