Human Papillomavirus Infection in Anal Carcinoma, Anal Condylomata and Rectal

Kim, Toung Jin; Joo, Jae Hwan; Kim, Hyung Rok; Kim, Dong Yi

Abstract

In order to examine the association of human papilloma virus(HPV) infection with anal carcinoma, the authors used polymerase chain reaction(PCR) and in situ hybridization technique to detect HPV DNA in formalin fixed, paraffin-embedded tissues from 46 anal carcinoma patients. At the same time, 28 condyloma accuminata specimens and 25 rectal adecarcinomas were examined for HPV DNA with in situ hybridization(ISH). By PCR analysis, using type specific primers and probes for HPV 6, 11, 16, 18 and 33, HPV type 16 DNA was demonstrated in 30(65.2%) of 46 anal carcinoma specimens, but HPV type 6, 11, 18 or HPV type 33 was not identified. HPV DNA Positivity was different according to the site of the anal carcinoma. In anal marginal squamous celt carcinoma, 3(27.3%) of 11 contained HPV DNA but 27(77.1%) of 35 anal canal carcinoma contained HPV DNA. Among the anal canal carcinomas, the cloacogenic carcinoma contained HPV DNA in 11(84.6%) of 13 and squamous cell carcinoma contained in 16(72.7%) of 22 specimens. Two of six local recurrences and three of nine lymph node metastases had HPV-16 DNA. When the anal carcinomas were analysed using ISH technique for HPV type 6, 11, 16, 18, the frequency of Positivity decreased to 4(11.4%) of 35 and stained only for HPV type 16/18. Among the 28 condyloma accuminata specimens, 24(85.7%) contained HPV DNA type 6/11 and only 2(7.1%) contained type 16/18 by ISH technique. In contrast to anal carcinoma, male was predominent in condyloma accuminata patient(82.1% of 28) and 6 patients were homosexual man. HPV DNA was not demonstrated in all the cases of rectal adenocarcinoma by ISH. We conclude that HPV infections are associated with the development of anal canal carcinoma but are not associated with adenocarcinoma of the rectum. In anal carcinomas, anal canal carcinoma is more closely associated with HPV infection than anal marginal carcinoma. Among the HPV types studied, type 16, 18 are more closely linked with malignant transformation.