Agras Koray, Doluoglu Omer Gokhan, Acikgoz Ziya Cibali, Ener Kemal, Ocal Asli
Department of Urology, Clinic of Ankara Training and Research Hospital, University of Medical Sciences, Ankara, Turkey.
Department of Microbiology, Clinic of Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
J Pediatr Urol. 2020 Jun;16(3):388.e1-388.e6. doi: 10.1016/j.jpurol.2020.04.016. Epub 2020 Apr 25.
Human papillomavirus infection (HPV) is one of the most common sexually transmitted infections and can cause penile and anal cancer in men, and invasive cervical cancer in women.
To evaulate the colonization of 32 HPV subtypes in the foreskin of boys.
A prospective analysis was made of the data of 62 healthy boys who had undergone standard circumcision. Deoxyribonucleic acid (DNA) was isolated from the foreskin tissues, and the integrity of DNA was tested. The DNA of each patient was further assessed with real-time polymerase chain reaction (PCR) and the presence of 32 subtypes of HPV was explored. To confirm the results, melting curve analysis and agarose gel electrophoresis (AGE) were performed for all samples. Further analysis was made using LCD-array on six randomly selected samples to confirm the results together with negative and positive controls.
The mean age of the boys was 6.8 ± 2 years at the time of surgery. All positive controls and samples were positive, all negative controls were negative in the first HPV amplification assay. All positive controls had typical melting curve peaks, whereas all sample amplifications had non-specific, atypical melting curves not fitting with those of the positive controls. Two bands of expected sizes (124 and 405 bp) were only observed in positive controls, but not in negative controls or samples on AGE. The same results were observed on the 6 randomly selected samples using LCD-array. Consequently, all the foreskin samples were evaluated as negative for the 32 HPV types investigated in the study.
Literature shows a high prevalence of genital HPV in newborns, in early infancy, late adolescence and adulthood. However there is a lack of data in literature on the prevalence in early and late childhood. The negative results of HPV colonization on the foreskin in the current study may be attributed to the conservative and mostly monogamous nature of most family structures in Turkey.
The results of the present study have shown that foreskin tissue is not a natural reservoir for HPV and subclinical HPV infection is not likely in the absence of suspected sexual contact.
人乳头瘤病毒感染（HPV）是最常见的性传播感染之一，可导致男性阴茎癌和肛门癌，以及女性浸润性宫颈癌。
评估32种HPV亚型在男孩包皮中的定植情况。
对62名接受标准包皮环切术的健康男孩的数据进行前瞻性分析。从包皮组织中分离出脱氧核糖核酸（DNA），并检测DNA的完整性。使用实时聚合酶链反应（PCR）进一步评估每位患者的DNA，并探索32种HPV亚型的存在情况。为确认结果，对所有样本进行熔解曲线分析和琼脂糖凝胶电泳（AGE）。对六个随机选择的样本使用液晶芯片阵列进行进一步分析，以与阴性和阳性对照一起确认结果。
手术时男孩的平均年龄为6.8±2岁。在首次HPV扩增试验中，所有阳性对照和样本均为阳性，所有阴性对照均为阴性。所有阳性对照均有典型的熔解曲线峰，而所有样本扩增均有非特异性、不典型的熔解曲线，与阳性对照不符。在AGE上，仅在阳性对照中观察到预期大小的两条带（124和405 bp），而在阴性对照或样本中未观察到。使用液晶芯片阵列对六个随机选择的样本观察到相同结果。因此，所有包皮样本在该研究中所检测的32种HPV类型中均被评估为阴性。
文献显示新生儿、婴儿早期、青春期晚期和成年期生殖器HPV的患病率较高。然而，文献中缺乏关于儿童早期和晚期患病率的数据。本研究中HPV在包皮中定植的阴性结果可能归因于土耳其大多数家庭结构的保守性和大多为一夫一妻制的性质。
本研究结果表明，包皮组织不是HPV的天然储存库，在没有疑似性接触的情况下不太可能发生亚临床HPV感染。
