Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY.
Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Clin Breast Cancer. 2021 Dec;21(6):e638-e646. doi: 10.1016/j.clbc.2021.04.006. Epub 2021 Apr 22.
This study explored human papillomavirus (HPV) amplification in breast benign and malignant lesions by chromogenic in situ hybridization (CISH) and the concordance of p16 expression by immunohistochemistry.
The presence of HPV6/11 and HPV16/18 in 33 cases of intraductal papilloma, 34 cases of ductal carcinoma in situ (DCIS), and 56 cases of invasive breast carcinoma (IBC) was evaluated using matched-background breast parenchyma and breast reduction as control groups. Association with clinicopathologic factors including prognosis was assessed.
HPV 6/11 was observed in 0 cases (0%) of breast reduction, one case (3%) of intraductal papilloma, 11 cases (32.4%) of DCIS, and eight cases (14.3%) of IBC. HPV 16/18 was detected in three cases of (9.1%) breast reduction, six cases (18.8%) of intraductal papillomas, 14 cases (41.2%) of DCIS, and 25 cases (44.6%) of IBC. There was no difference in the HPV status between intraductal papilloma and breast reduction. HPV amplification in intraductal papilloma did not associate with developing atypia or carcinoma after long-term follow-up. However, HPV 6/11 and HPV 16/18 amplification was significantly higher in both DCIS and IBC when compared with breast reduction (P < .05). Compared with background breast parenchyma, HPV 16/18 amplification was significantly higher in both DCIS and IBC (P = .003 and P = .013, respectively). No correlation between p16 immunohistochemical staining and either of the HPV CISH testing was found (P > .05).
HPV infection was detected in both breast lesions and background parenchyma. HPV infection may play a role in the pathogenesis of breast cancer but is not associated with intraductal papilloma. Immunohistochemical stain for p16 is not a good surrogate marker for HPV infection in breast lesions.
本研究通过显色原位杂交(CISH)检测人乳头瘤病毒(HPV)在乳腺良恶性病变中的扩增情况,并探讨免疫组化法检测 p16 表达的一致性。
以乳腺实质和乳腺缩小术作为对照,分析 33 例乳腺导管内乳头状瘤、34 例导管原位癌(DCIS)和 56 例浸润性乳腺癌(IBC)患者中 HPV6/11 和 HPV16/18 的存在情况。评估其与临床病理因素的相关性,包括预后。
乳腺缩小术组中 HPV6/11 未检出(0%),1 例(3%)乳腺导管内乳头状瘤、11 例(32.4%)DCIS 和 8 例(14.3%)IBC 中检出 HPV16/18。乳腺缩小术组中 HPV16/18 检出率为 3 例(9.1%)、6 例(18.8%)乳腺导管内乳头状瘤、14 例(41.2%)DCIS 和 25 例(44.6%)IBC。导管内乳头状瘤和乳腺缩小术之间 HPV 状态无差异。导管内乳头状瘤 HPV 扩增与长期随访后发生不典型增生或癌变无关。然而,与乳腺缩小术相比,DCIS 和 IBC 中 HPV6/11 和 HPV16/18 扩增明显更高(P<0.05)。与乳腺实质背景相比,DCIS 和 IBC 中 HPV16/18 扩增明显更高(P=0.003 和 P=0.013)。未发现 HPV CISH 检测与 p16 免疫组化染色之间存在相关性(P>0.05)。
在乳腺病变和背景实质中均检测到 HPV 感染。HPV 感染可能在乳腺癌的发病机制中起作用,但与导管内乳头状瘤无关。p16 免疫组化染色不是乳腺病变中 HPV 感染的良好替代标志物。