Chiang An-Jen, Chen Di-Rong, Cheng Jiin-Tsuey, Chang Tsung-Hsien
Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Taiwan J Obstet Gynecol. 2015 Oct;54(5):559-66. doi: 10.1016/j.tjog.2015.08.008.
Primary squamous cell carcinoma (SCC) of the ovary in humans is rare. Most cases represent a malignant transformation of ovarian teratoma, Brenner tumor, or endometriosis. The etiology of this cancer remains largely unknown. Human papillomavirus (HPV) infection is a critical factor that induces tumor formation, particularly cervical cancer. Therefore, this study aimed to evaluate the association of HPV with malignant transformation of mature cystic teratoma (MCT) into SCC of the ovary.
The samples included four formalin-fixed paraffin-embedded SCC-MCT tissues and their adjacent tissues from the cervix to the ovaries, 12 cases of benign teratoma ovarian tissues (dermoid tissues), and 11 cases of benign nonteratoma ovarian tissues (nondermoid tissues). The two squamous carcinoma tissues of the cervix were used as control samples. HPV was detected by immunohistochemistry (IHC) with anti-HPV capsid or E6 (HPV type 16/18) antibodies and in situ hybridization (ISH) with three sets of genotyping probes, HPV types 6/11, 16/18, and 31/33.
IHC revealed HPV infection associated with the four cases of SCC-MCT and the two cases of control cervical cancer samples. Importantly, HPV was also detected in adjacent reproductive tissues of the SCC-MCT cases, which suggested that the viral particles might spread in an ascending route through the fallopian tubes, endometrium, endocervix, and cervix to the ovaries. ISH revealed HPV type 16/18 in all SCC-MCT cases and HPV type 31/33 in two, with no HPV type 6/11 in any SCC-MCT cases. However, compared with the SCC-MCT cases, the lower detection rates of HPV in dermoid cysts and nondermoid tissues suggested that HPV might not be associated with normal ovarian tissues or benign ovarian teratomas.
Our data suggest that high-risk HPV infection might be a causal factor that induces malignant transformation of MCT into SCC of the ovary, although further investigation is still required.
原发性卵巢鳞状细胞癌（SCC）在人类中较为罕见。大多数病例是卵巢畸胎瘤、布伦纳瘤或子宫内膜异位症的恶性转化。这种癌症的病因在很大程度上仍然未知。人乳头瘤病毒（HPV）感染是诱导肿瘤形成的关键因素，尤其是宫颈癌。因此，本研究旨在评估HPV与成熟囊性畸胎瘤（MCT）向卵巢SCC恶性转化之间的关联。
样本包括4例福尔马林固定石蜡包埋的SCC-MCT组织及其从宫颈到卵巢的相邻组织、12例良性畸胎瘤卵巢组织（皮样组织）和11例良性非畸胎瘤卵巢组织（非皮样组织）。2例宫颈鳞状癌组织用作对照样本。采用抗HPV衣壳或E6（HPV 16 / 18型）抗体的免疫组织化学（IHC）以及使用三组基因分型探针（HPV 6 / 11型、16 / 18型和31 / 33型）的原位杂交（ISH）检测HPV。
免疫组化显示HPV感染与4例SCC-MCT病例以及2例对照宫颈癌样本相关。重要的是，在SCC-MCT病例的相邻生殖组织中也检测到了HPV，这表明病毒颗粒可能通过输卵管、子宫内膜、子宫颈管和宫颈以上升途径扩散至卵巢。原位杂交显示所有SCC-MCT病例中均有HPV 16 / 18型，2例中有HPV
