Humane Papillomaviren in Harnblasenkarzinomen: Epiphänomen oder Subentität?

Zusammenfassung

Fragestellung: Die humanen Papillomaviren 16 und 18 sind die am häufigsten nachgewiesenen Genotypen in genitalen Malignomen. Eine strenge Assoziation zwischen dem Nachweis von HPV 16 und 18 und dem Auftreten von Zervixkarzinomen ist bekannt, eine mögliche Assoziation beim Karzinom der Harnblase hingegen wird kontrovers diskutiert. Die geringe Inzidenz der HPV Typen 6 und 11 und die geringe Progression HPV 6 und 11positiver, benigner Tumoren hat dazugeführt, diese als „low risk virus” zu klassifizieren. In der vorliegenden Studie wurde die Prävalenz von HPV 16, 18 sowie von 6 und 11analysiert. Material und Methode: Um die Inzidenz der HPV Typen 6,11 und 16 und 18 in histologischen Schnittpräparaten zu bestimmen, wurden 48 formalin-fixierte und Paraffin-eingebettete Harnblasenkarzinome unterschiedlichen Stagings und Gradings auf das Vorhandensein von HPV DNA 6,11 sowie von 16 und 18 mit der Polymerasekettenreaktion untersucht. Ergebnisse: Interessanterweise konnte in 4 Harnblasenkarzinomen und in 4 nicht neoplastischen Harnblasengeweben HPV 6/11 nachgewiesen werden. Ein Nachweis von HPV 16 oder 18 konnte dagegen nicht erbracht werden. Schlussfolgerung: Zusammenfassend scheinen HPV 16 und 18 bei der untersuchten Patientengruppe keine Rolle in der Entstehung des Harnblasenkarzinoms zu spielen. Der Nachweis von HPV6/11-Infektionen zeigt allerdings, dass das Blasenepithel von Papillomaviren infiziert werden kann. Die Bedeutung der nachgewiesenen HPV 6/11 in einem Mehrschrittmechanismus einer Karzinomentstehung zur möglichen Abgrenzung einer Subentität muss in weiteren Studien abgeklärt werden.

Abstract

Purpose: Human papillomavirus types 16 and 18 are the most frequent genotypes identified in genital malignancies. A strong association between the detection of human papillomavirus (HPV) and cervical Cancer is known to exist, but there is substantial controversy regarding the association of HPV and cancers of the bladder.The low incidence of HPV 6 and 11 in carcinomas and the rare progression of benign, HPV 6 and 11 positive tumors has led to the classification of low risk virus. In the present study the prevalence of the HPV 16,18 and 6 and 11 was analyzed in human bladder cancer. Material and Methods: To determinate the incidence of HPV 6,11 and 16 and 18 in histological section of human bladder cancer, 48 formalin fixed and paraffin embedded bladder tumor specimens with different staging and grading were analyzed for the presence of HPV DNA using the polymerase chain reaction (PCR). These results were confirmed by southern blot hybridization using radiolabbeled probes for HPV DNA types 6/11 and 16 and 18. Results: Interestinctly four carcinoms of the bladder and four non neoplastic bladder tissue specimens were positive for HPV 6/11. No HPV 16 and 18 DNA was detected in any specimens. Conclusions: We conclude that these HPV 16 and 18 seem not to have a significant role in the development of bladder cancer in the analysed population. However, the detection of HPV6/11 infections show, that the bladder epithelium can be infected by HPVs. Therefore the relevance of these HPV 6/11 in the multistep process of bladder carcinogenesis should be examined in further studies.

Humane Papillomaviren - Harnblasenkarzinom - Polymerasekettenreaktion

Papillomavirus, human - Bladder cancer - Polymerase chain reaction

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