Tumor-specific and gender-specific pre-vaccination distribution of human papillomavirus types 6 and 11 in anogenital warts and laryngeal papillomas: a study on 574 tissue specimens

Anogenital warts and laryngeal papillomas are two most important benign tumors etiologically linked with HPV. In the study, which included both the largest number of laryngeal papilloma tissue specimens (152 specimens from 152 patients) to date and the largest number of prospectively collected and histologically confirmed tissue specimens of anogenital warts obtained from both genders (422 specimens from 315 patients), HPV DNA was detected in 413/422 (97.9%) of anogenital warts and 139/152 (91.4%) of laryngeal papillomas. HPV‐6 and/or HPV‐11 were detected in 291/315 (92.4%) patients with anogenital warts and in 138/152 (90.8%) patients with laryngeal papillomas, indicating that the great majority of both tumors could be prevented with prophylactic quadrivalent vaccine. The HPV‐6 gender‐specific distribution in both anogenital warts and laryngeal papillomas was not statistically significant. In contrast, HPV‐11 was found almost three times more often in males than in females with anogenital warts (16.5% vs. 6.3%; P = 0.008), with a gender neutral HPV‐11 type distribution in laryngeal papillomas. The overall HPV DNA prevalence in anogenital warts was significantly different from that in laryngeal papillomas (97.1% vs. 91.4%; P = 0.01). In the first comparison of the HPV‐6/HPV‐11 type‐specific distribution between patients suffering from anogenital warts and laryngeal papillomas with the same geographic and ethnic background, a significant imbalance in tumor‐specific distribution of HPV‐6 and HPV‐11 was identified: HPV‐6 was statistically more often present in anogenital warts than in laryngeal papillomas (79.0% vs. 59.2%; P = 0.000013), whereas HPV‐11 was statistically more frequent in laryngeal papillomas than in anogenital warts (28.9% vs. 12.4%; P = 0.00003). J. Med. Virol. 84: 1233–1241, 2012. © 2012 Wiley Periodicals, Inc.     

Loop-mediated isothermal amplification method for detection of human papillomavirus type 6, 11, 16, and 18

A new method was developed for detection of human papillomavirus (HPV) by loop-mediated isothermal amplification (LAMP), which was compared with the polymerase chain reaction (PCR), and real-time PCR for specificity and sensitivity. All initial validation studies with the control DNA proved to be type-specific. In order to evaluate the reliability of HPV type-specific LAMP detecting HPV DNA from clinical samples, tissue specimens were obtained from 27 patients with external genital polypoid lesions. The histologic diagnoses included condyloma acuminatum (n = 21), bowenoid papulosis (n = 2), seborrheic keratosis (n = 2), epidermolytic acanthoma (n = 1), and hairy nymphae (n = 1). HPV-6 DNA and HPV-11 DNA were detected in 18 and 3 of 21 condylomata acuminata, respectively, and there was no simultaneous infection. HPV-16 DNA was detected in one of two bowenoid papuloses. HPV DNA was not detected in the seborrheic keratoses, epidermolytic acanthoma, and hairy nymphae. These results correlated perfectly with those from real-time PCR analysis. Most positive samples contained high copy numbers of HPV DNA. HPV-11 DNA was detected in one case that could not be detected by PCR. The average reaction time was about 59 min. There was a linear correlation between the genome quantity and reaction time to reach the threshold. The LAMP method has an additional advantage as a quantitative method, and is superior in terms of sensitivity, specificity, rapidity, and simplicity, and can potentially be a valuable tool for the detection of HPV DNA.     

人乳头瘤病毒11型DNA中CpG基序甲基化状态分析及生物活性的研究

目的　对人乳头瘤病毒 11型全核苷酸序列的CpG基序 (CpGmotifs)进行分析 ,为阐明尖锐湿疣的发病机制和提高DNA疫苗的效能奠定理论基础。方法　对从pBR32 2 HPV11重组质粒上酶切下来的HPV11全长DNA进行计算机分析 ,包括分类、计数和定位 ;并用限制性内切酶PCR法分析HPV11DNA中CpG基序的甲基化状态 ,即分别用甲基化敏感的限制性内切酶AccⅡ、HaeⅡ和HpaⅡ对HPV11DNA进行酶切消化 ,再以HpaⅡ切割位点侧翼序列为引物 ,以HpaⅡ酶切产物为模板 ,用聚合酶链反应 (PCR)扩增HPV11DNA片断 ,并用HPV11DNA刺激表达有pCIneo TLR9的HEK2 93细胞 ,ELISA法检测TNF al pha、IFN alpha和IL 12的分泌。结果　CpG的“C”的侧翼为两个嘌呤 ,“G”的侧翼为两个嘧啶 ,在HPV11中共 14个。HPV11全基因组被AccⅡ切成 2个片断、被HaeⅡ切成 3个片断、被HpaⅡ切成 5个片断 ,而且以HpaⅡ酶切产物为模板进行PCR扩增 ,未能得到相应的片断。HPV 11DNA刺激有人TLR9表达的HEK2 93细胞后能检测到TNF alpha、IFN alpha和IL 12的分泌。结论　乳头瘤病毒 11型DNA中含有GACGTT等非甲基化的CpG基序 ,而且具有免疫原性     

Solitary squamous cell papilloma of the lung in a 40-year-old woman with recurrent laryngeal papillomatosis

A rare case of recurrent respiratory papillomatosis (RRP) is reported with a review of the literature. A 40-year-old Japanese woman had suffered from RRP since 1 year of age. She developed a pulmonary squamous papilloma with a thin-walled cavity, which was suspected as being lung carcinoma. The trachea and bronchi around the tumor were intact, and no malignant transformation was present. Two types of human papillomavirus, 6 and 16, were detected, both in the laryngeal and pulmonary papillomas by in situ hybridization and the polymerase chain reaction method. To date, only 40 cases of juvenile laryngeal papilloma with pulmonary involvement have been reported in the English literature.     

Metachronous squamous cell carcinomas evolving from independent oropharyngeal and pulmonary squamous papillomas: association with human papillomavirus 11 and lack of aberrant p53, Rb, and p16 protein expression

Squamous cell carcinoma evolving from squamous papilloma in both the upper and lower respiratory tract in the same patient is uncommon. The molecular mechanisms underlying the progression have not been well investigated. We herein describe a case of squamous cell carcinoma arising from respiratory papilloma in two independent occasions. The patient initially had oropharyngeal squamous cell carcinoma arising in a squamous papilloma at the age of 25 years. He subsequently developed squamous cell carcinoma in the left lower lobe of the lung, which was also associated with squamous papilloma, 8 years after the complete excision of the oropharyngeal lesion. Polymerase chain reaction-based broad-spectrum human papillomavirus DNA amplification and typing showed the presence of human papillomavirus type 11 DNA in both oropharyngeal and pulmonary tumors. Immunohistochemical studies showed that the expression status of p53, Rb, and p16 proteins was unaltered during tumor progression. These observations indicate that human papillomavirus 11-associated neoplastic transformation and tumor progression in the respiratory tract may not involve aberrant regulation of the p53 and Rb signaling pathways.     

Demonstration of human papillomavirus types 6 and 11 in juvenile laryngeal papillomatosis by in-situ DNA hybridization

A study is reported in which an in situ hybridization technique for the demonstration of human papillomavirus (HPV) employing a biotin--streptavidin polyalkaline phosphatase complex has been successfully applied to formalin-fixed paraffin-processed tissue obtained from ten patients with juvenile laryngeal papillomatosis. In all cases, positive results were obtained for either HPV type 6 or 11. Normal vocal cord epithelium was negative.     

肺癌组织中人乳头瘤病毒16和18型DNA相关序列的检测

采用聚合酶链反应技术（ＰＣＲ）及用ＰＣＲ法制备生物素标记探针的斑点杂交法,检测５０例肺癌、１８例肺良性病及４例胎肺组织中高危险型人乳头瘤病毒（ＨＰＶ）１６、１８型ＤＮＡ相关序列,以探讨ＨＰＶ与肺癌之间发生的关系。结果３２％的肺癌组织中检测出ＨＰＶ１６、１８ＤＮＡ,其中ＨＰＶ１６ＤＮＡ阳性１０例,ＨＰＶ１８ＤＮＡ阳性５例,１例同时含ＨＰＶ１６、１８ＤＮＡ。２７例鳞癌组织中ＨＰＶＤＮＡ阳性率为４８．２％。而肺良性病组织及胎肺组织均未发现ＨＰＶＤＮＡ。ＨＰＶＤＮＡ呈阳性的肺癌患者绝大多数为重度吸烟者。提示原发性肺癌的发生可能与ＨＰＶ感染有关。     

荧光定量聚合酶链反应检测人乳头瘤病毒6/11型

目的 了解女性阴道炎患者人乳头瘤病毒6／11型（HPV6／11）的感染情况。方法 用荧光定量聚合酶链反应（FQ－PCR）技术检测129例门诊患者阴道分泌物中HPV6／11的病毒拷贝数。结果 共检出HPV6／11阳笥者47例,阳性率为36．43％;拷贝数在10^5以上者39例,占阳性者中的82．98％;40岁以上年龄组阳性率高且病毒复制量均在10^5以上。结论 中老年阴道炎患者就诊晚,感染重。FQ－PCR检测HPV敏感、快速、准确,特别是其定量特点对临床很有意义。     

妊娠期人乳头瘤病毒的感染状况及母婴传播的研究

应用聚合酶链反应检测孕妇尖锐湿疣（ＣＡ）组织、无ＣＡ孕妇宫颈分泌物、外周血及羊水、新生儿咽分泌物、脐血中人乳头瘤病毒（ＨＰＶ）感染及母婴传播。结果表明：ＣＡ组织中ＨＰＶＤＮＡ阳性率为９０．３２％，以ＨＰＶ６／１１型为主；无ＣＡ孕妇宫颈分泌物中ＨＰＶＤＮＡ阳性率为３５．７１％，以ＨＰＶ１６／１８型为主；孕妇血中ＨＰＶＤＮＡ阳性率为５７．６９％；母婴间经产道垂直传播率为４４．４４％，血性经胎盘传播传播率为６０％。说明ＨＰＶ不仅存在于ＣＡ组织中，还存在于无ＣＡ孕妇生殖道及外周血中，母婴间传播途径除产道外，还有胎盘传播     

Human papillomavirus DNA detected in peripheral blood samples from healthy Australian male blood donors

Recent studies have shown that human papillomavirus (HPV) DNA can be found in circulating blood, including peripheral blood mononuclear cells (PBMCs), sera, plasma, and arterial cord blood. In light of these findings, DNA extracted from PBMCs from healthy blood donors were examined in order to determine how common HPV DNA is in blood of healthy individuals. Blood samples were collected from 180 healthy male blood donors (18–76 years old) through the Australian Red Cross Blood Services. Genomic DNA was extracted and specimens were tested for HPV DNA by PCR using a broad range primer pair. Positive samples were HPV‐type determined by cloning and sequencing. HPV DNA was found in 8.3% (15/180) of the blood donors. A wide variety of different HPV types were isolated from the PBMCs; belonging to the cutaneous beta and gamma papillomavirus genera and mucosal alpha papillomaviruses. High‐risk HPV types that are linked to cancer development were detected in 1.7% (3/180) of the PBMCs. Blood was also collected from a healthy HPV‐positive 44‐year‐old male on four different occasions in order to determine which blood cell fractions harbor HPV. PBMCs treated with trypsin were negative for HPV, while non‐trypsinized PBMCs were HPV‐positive. This suggests that the HPV in blood is attached to the outside of blood cells via a protein‐containing moiety. HPV was also isolated in the B cells, dendritic cells, NK cells, and neutrophils. To conclude, HPV present in PBMCs could represent a reservoir of virus and a potential new route of transmission. J. Med. Virol. 81:1792–1796, 2009. © 2009 Wiley‐Liss, Inc.     

人乳头瘤病毒E6、E7的表达对足叶乙甙作用下细胞凋亡的影响

目的探讨人乳头瘤毒(HPV)16早期基因E6和E7的表达对NIKS细胞凋亡表型的影响。方法用含有HPV16的E6、HPV16E7、HPV16E6E7病毒癌基因的逆转录病毒感染角质生成细胞株NIKS,puromycin筛选稳定表达细胞;基因组PCR和Western blot方法验证E6和E7的表达;转染后的NIKS细胞用不同浓度的足叶乙甙处理,流式细胞仪和Annexin V染色检测细胞凋亡情况。结果经逆转录病毒感染后,建立表达E6、E7及E6E7的NIKS细胞株,基因组PCR证明E6和E7整合入NIKS细胞基因组;Western blot证实表达的E6、E7具有生物学活性,能够分别降解p53和pRB;在足叶乙甙处理后,E6、E7以及E6E7表达细胞发生明显的细胞死亡,E6和E7具有叠加作用,且具有剂量依赖性,Annexin V染色证实细胞发生凋亡,凋亡率分别为(33.5±3.2)%、(38.3±2.4)%和(56.7±4.3)%。结论人乳头瘤病毒E6和E7的表达都可以促进细胞对DNA损伤药物的敏感性,提示乳头瘤病毒感染状态有可能影响肿瘤细胞对化疗的敏感性。     

Deletion in the L1 open reading frame of human papillomavirus type 6a genomes associated with recurrent laryngeal papilloma

Human papillomavirus (HPV) type 6a genomes with a large deletion in their L1 open reading frames (ORF) were found in two of five recurrent cases of laryngeal papilloma. One of these mutant HPVs had a 186 base pair (bp) deletion near the N-terminus end of the L1 ORF, which encodes a major capsid protein. The other had a 454 bp deletion at the C-terminus end of L1 at which is located a nuclear localising signal (NLS). No other large deletion or insertion was found in the remaining regions of all five HPV6a genomes. The laryngeal papillomas which harboured the mutant viruses showed typical hyperplasia and pathological changes as observed in tumours induced by the wild-type virus. The biological significance of the two large deletions in the late region of HPV6a associated with laryngeal papilloma is discussed. © Wiley-Liss, Inc.     

Rapid real time PCR to distinguish between high risk human papillomavirus types 16 and 18

Aims—To assess the validity and practicality of real time polymerase chain reaction (PCR) for human papillomavirus (HPV) testing in combination with liquid based cytology samples for cervical screening.Methods—Real time PCR using consensus (GP5+/6+) and type specific primers was developed to detect genital HPV types. This provides rapid, efficient amplification followed by denaturation of the product and computer analysis of the kinetics data that are generated. Liquid based cytology samples were obtained from patients attending routine cervical screening clinics. DNA was extracted from the residual cellular suspension after cytology using spin columns.Results—Real time PCR successfully distinguished between HPV-16 and HPV-18 on the basis of amplification with consensus primers followed by DNA melting temperature (T_m) analysis. Sensitivities of one to 10 copies of HPV-16 (mean T_m = 79.4°C; 2 SD, 0.8) and four to 40 copies of HPV-18 (mean T_m = 80.4°C; 2 SD, 0.4) were obtained. In a mixed population of SiHa and HeLa cells containing known copy numbers of HPV-16 and HPV-18 genomes, HPV-16 and HPV-18 products were clearly separated by T_m analysis in mixtures varying from equivalence to 1/1000. Together with detailed melt analysis, type specific primers from the same region of the L1 gene confirmed the differential ability of this system. The method was applied to 100 liquid based cytology samples where HPV status using conventional GP5+/6+ PCR was already known. There was 95% agreement between the methods, with 55 positives detected by conventional PCR and 59 with real time PCR. The method was then tested on 200 routine liquid based cytology samples. Approximately 10% were positive by real time PCR, most of which were classified as HPV-16 by detailed melt analysis. Thirteen (6.8%) HPV positives were identified in 189 samples showing no evidence of cervical cytological abnormality.Conclusions—Real time PCR is a rapid, efficient method for the detection of HPV with the separation of HPV-16 and HPV-18 on the basis of differential T_m. Preliminary results suggest it could prove useful if HPV testing is added to cervical screening programmes.     

Human papillomavirus infection and invasive cervical neoplasia: a study of prevalence and morphology

The prevalence of human papillomavirus (HPV) DNA sequences in 45 cervical cancer biopsies was examined with the hot-start polymerase chain reaction (PCR), employing HPV consensus primers from the L1 region. The cases comprised 38 squamous cell carcinomas, three adenosquamous carcinomas, and four adenocarcinomas. PCR products were typed with single-strand conformation polymorphism (SSCP) and the HPV types detected were correlated with tumour type. Forty-three biopsies were HPV-positive, HPV16 being the most prevalent type. HPV18/33/45/58 were also detected, but no low-risk or multiple types. Keratinizing squamous cell carcinoma was invariably associated with HPV16 and adenosquamous carcinoma and adenocarcinoma with HPVs 18/45. Non-keratinizing squamous cell carcinomas harboured all five detected types. Our data corroborate the view that malignant cervical tumours are almost invariably associated with high-risk HPV and that certain malignant cervical tumour phenotypes correlate with specific HPV types. © 1997 John Wiley & Sons, Ltd.     

Human papillomavirus infection and the malignant transformation of sinonasal inverted papilloma: A meta-analysis

A growing number of molecular epidemiological studies have been conducted to evaluate the association between human papillomavirus (HPV) infection and the malignancy of sinonasal inverted papilloma (SNIP). However, the results remain inconclusive. Here, a meta-analysis was conducted to quantitatively assess this association. Case-control studies investigating SNIP tissues for presence of HPV DNA were identified. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by the Mantel-Haenszel method. An assessment of publication bias and sensitivity analysis were also performed. We calculated a pooled OR of 2.16 (95% CI = 1.46–3.21, P < 0.001) without statistically significant heterogeneity or publication bias. Stratification by HPV type showed a stronger association for patients with high-risk HPV (hrHPV) types, HPV-16, HPV-18, and HPV-16/18 infection (OR = 8.8 [95% CI: 4.73–16.38], 8.04 [95% CI: 3.34–19.39], 18.57 [95% CI: 4.56–75.70], and 26.24 [4.35–158.47], respectively). When only using PCR studies, pooled ORs for patients with hrHPV, HPV-16, and HPV18 infection still reached statistical significance. However, Egger’s test reflected significant publication bias in the HPV-16 sub-analysis (P = 0.06), and the adjusted OR was no longer statistically significant (OR = 1.65, 95%CI: 0.58–4.63). These results suggest that HPV infection, especially hrHPV (HPV-18), is significantly associated with malignant SNIP.     

Development and evaluation of a PCR and mass spectroscopy (PCR–MS)-based method for quantitative, type-specific detection of human papillomavirus

Knowledge of the central role of high-risk human papillomavirus (HPV) in cervical carcinogenesis, coupled with an emerging need to monitor the efficacy of newly introduced HPV vaccines, warrant development and evaluation of type-specific, quantitative HPV detection methods. In the present study, a prototype PCR and mass spectroscopy (PCR–MS)-based method to detect and quantitate 13 high-risk HPV types is compared to the Hybrid Capture 2 High-Risk HPV DNA test (HC2; Digene Corp., Gaithersburg, MD) in 199 cervical scraping samples and to DNA sequencing in 77 cervical tumor samples. High-risk HPV types were detected in 76/77 (98.7%) cervical tumor samples by PCR–MS. Degenerate and type-specific sequencing confirmed the types detected by PCR–MS. In 199 cervical scraping samples, all 13 HPV types were detected by PCR–MS. Eighteen (14.5%) of 124 cervical scraping samples that were positive for high-risk HPV by HC2 were negative by PCR–MS. In all these cases, degenerate DNA sequencing failed to detect any of the 13 high-risk HPV types. Nearly half (46.7%) of the 75 cervical scraping samples that were negative for high-risk HPV by the HC2 assay were positive by PCR–MS. Type-specific sequencing in a subset of these samples confirmed the HPV type detected by PCR–MS. Quantitative PCR–MS results demonstrated that 11/75 (14.7%) samples contained as much HPV copies/cell as HC2-positive samples. These findings suggest that this prototype PCR–MS assay performs at least as well as HC2 for HPV detection, while offering the additional, unique advantages of type-specific identification and quantitation. Further validation work is underway to define clinically meaningful HPV detection thresholds and to evaluate the potential clinical application of future generations of the PCR–MS assay.     

Human papillomavirus localization in cervical adenocarcinoma and adenosquamous carcinoma using in situ polymerase chain reaction: review of the literature of human papillomavirus detection in these carcinomas

Many studies have suggested that human papillomavirus (HPV) infection plays an important role in the carcinogenesis of the cervical adenocarcinoma. However, the prevalence of HPV infection in cervical adenocarcinoma and adenosquamous carcinoma varies among the studies. Cervical adenocarcinoma (24 cases) and adenosquamous carcinoma (16 cases), including the underlying non-neoplastic epithelium were examined for HPV-DNA using in situ polymerase chain reaction (PCR), which enabled visualization of the localization on a glass slide. In adenocarcinoma, HPV-DNA was found in 13 cases (54%) and in eight cases in underlying non-neoplastic epithelium, resulting in a total of 21 positive cases (88%). In adenosquamous carcinoma, HPV-DNA was detected in 12 cases (75%) and and the HPV-DNA localization of each component was pure adenocarcinoma, 28.6%; mixed, 54.5%; and pure squamous cell carcinoma, 83.3%. In the underlying non-neoplastic epithelium, HPV-DNA was found more frequently in the squamous epithelium (73.3%) than the cervical glands (6.3%). In conclusion, HPV-DNA was detected in 54% of adenocarcinoma, and the rate was elevated by HPV localization in the underlying non-neoplastic epithelium. HPV infection in the underlying squamous epithelium might be related to the carcinogenesis, even in cervical adenocarcinoma. HPV-DNA localization was different in each component of adenosquamous carcinoma.     

Human papillomavirus infection among sexual partners attending a Sexually Transmitted Disease Clinic in Rio de Janeiro, Brazil

Cervical cancer is a major source of illness and death among women worldwide and genital infection with oncogenic human papillomavirus (HPV) its principal cause. There is evidence of the influence of the male factor in the development of cervical neoplasia. Nevertheless, the pathogenic processes of HPV in men are still poorly understood. It has been observed that different HPV types can be found among couples. The objective of the present study was to investigate HPV infections in female patients (n = 60 females/group) as well as in their sexual partners and to identify the concordance of HPV genotypes among them. By using the polymerase chain reaction, we detected a 95% prevalence of HPV DNA in women with cervical intraepithelial neoplasia (CIN) compared to 18.3% in women with normal cervical epithelium, with a statistically significant difference (P < 0.001). The HPV DNA prevalence was 50% in male partners of women with CIN and 16.6% in partners of healthy women. In the control group (healthy women), only 9 couples were simultaneously infected with HPV, and only 22.2% of them had the same virus type, showing a weak agreement rate (kappa index = 0.2). Finally, we observed that HPV DNA was present in both partners in 30 couples if the women had CIN, and among them, 53.3% shared the same HPV type, showing moderate agreement, with a kappa index of 0.5. This finding supports the idea of circulation and recirculation of HPV among couples, perpetuating HPV in the sexually active population, rather than true recurrences of latent infections.     

喉癌p16、p15基因纯合性缺失的研究

目的 研究p16、p15基因缺失状态与喉癌发生、发展的关系。方法 提取喉癌新鲜组织中基因组DNA，采用聚合酶链反应技术，分别对80例喉癌进行p16基因第2外显子（p16E2）和67例喉癌进行p15基因第2外显子(p15E2）纯合性缺失研究。结果 检测p16E2弛合性缺失率为12.5%(10/80)，p15E2纯合性缺失率为11.94%（8／67），p16E2、p15E2共同缺失率为5.97%（4／67）。结论 p16E2和p15E2纯合缺失以及二者共同缺失与喉癌发生有相关性，可能在喉癌发生及恶性进展中起一定作用。     

宫颈脱落细胞标本中人乳头瘤病毒16、18型E6基因的检测

观察宫颈脱落细胞标本是否能替代宫颈组织标检测HPV16、18型的感染。通过聚合酶链反应－限制性片段多态性分析。比较127例宫颈患者的单、双份宫颈脱落细胞和宫颈病变组织中HPV16、18型E6基因的检出率。发现单、双份宫颈脱落细胞标本中HPV16型E6基因的检出率分别为34．64％和40．73％;HPV18型的检出率为17．32和22．04％,存在差异。组织标本中HPV16、18型的检出率分别为41．73％和22．83％,与双份脱落细胞本的检出率无明显,表明双宫颈脱落细胞标本可替代宫颈组织标本检测患者宫颈组织中HPV16、18型感染情况。