J Korean Assoc Oral Maxillofac Surg.  2013 Oct;39(5):224-230.

Immunohistochemical study on the expression of matrix metalloproteinase 2 and high-risk human papilloma virus in the malignant progression of papillomas

• Lee HJ
• Kim JW

Abstract

OBJECTIVES
Papilloma frequently develops as a benign tumor of the head and neck area, but its potential for malignant transformation has yet to be studied. This study aims to provide basic information for papillomas using the immunohistochemical staining of matrix metalloproteinase 2 (MMP-2) and human papilloma virus (HPV) 16 and 18.
MATERIALS AND METHODS
To evaluate the malignant transformation of papillomas, the selected tissue samples were serially diagnosed with pre-cancerous papilloma (with epithelial dysplasia, pseudo-epitheliomatous hyperplasia) or malignant lesion (squamous cell carcinoma, SCC) after the first diagnosis (squamous papilloma, inverted papilloma). The selected tissues were stained with an antibody to MMP-2 and HPV 16-E7, HPV 18-L1. A statistical analysis was performed according to each transformation step.
RESULTS
The epithelial layer of papilloma and pre-cancerous papilloma lesions had a similar MMP-2 expression, but that of the malignant lesion had a significantly increased MMP-2 expression. HPV 16 and 18 infection rates were 28.6%, 33.3% and 63.6% in papillomas, pre-cancerous papilloma lesions, and SCC.
CONCLUSIONS
A relatively high MMP-2 expression and HPV 16 or 18 infection of papillomas may be associated with early events in the multistep processes of malignant transformation of papillomas.

Keyword

Matrix metalloproteinase 2; Papilloma; Immunohistochemistry; Squamous cell carcinoma; Human papilloma virus

MeSH Terms

Carcinoma, Squamous Cell
Head
Human papillomavirus 16
Humans*
Immunohistochemistry
Matrix Metalloproteinase 2*
Neck
Papilloma*
Papilloma, Inverted
Viruses*
Matrix Metalloproteinase 2

Figure

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  Fig. 1 Immunohistochemical staining of matrix metalloproteinase 2 (MMP-2). (A) shows negative staining of the control group except keratinized layer (×100). (B) illustrates weak immunoreaction to MMP-2 in the papilloma (×100). (C) shows moderate immunoreaction to MMP-2 in the papilloma with dysplasia (×100). (D) exhibits strong immunoreaction to MMP-2 in squamous cell carcinoma, transformed from the papilloma (×100).

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  Fig. 2 Koilocytosis is noted, with the epithelial layer showing positive immunoreactivity to human papilloma virus 16 (×400).

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  Fig. 3 Epithelial cells showing koilocytosis reacting positively to human papilloma virus 18 antibody (×400).

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  Fig. 4 MMP-2 expression score and HPV 16 and 18 infection for each lesion in the epithelium. *P<0.05. (MMP-2: matrix metalloproteinase 2, HPV: human papilloma virus, Pa: papilloma, PC: pre-cancer lesion, SCC: squamous cell carcinoma)

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  Fig. 5 MMP-2 expression score and HPV 16 and 18 infection for each lesion in connective tissue. (MMP-2: matrix metalloproteinase 2, HPV: human papilloma virus, Pa: papilloma, PC: pre-cancer lesion, SCC: squamous cell carcinoma)

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