Maloney K E, Wiener J S, Walther P J
Department of Surgery (Division of Urology), Duke University Medical Center, Durham, North Carolina.
J Urol. 1994 Feb;151(2):360-4. doi: 10.1016/s0022-5347(17)34949-2.
While a strong association between oncogenic human papillomaviruses and squamous cell cancers of the genital tract (penis, urethra and cervix) is known to exist, there is substantial controversy regarding the association of human papillomaviruses and cancers of the bladder. Technical issues regarding assay technique and concern about potential contamination have marred interpretation of previous work. Moreover, because human papillomavirus has been associated predominantly with squamous cell cancers at other sites, any involvement of human papillomavirus and bladder epithelial carcinogenesis must address whether any association between human papillomavirus and squamous cell carcinoma of the bladder exists. Differential polymerase chain reaction and a rigorous protocol to avoid crossover contamination were used to analyze archival bladder carcinoma specimens (22 squamous cell carcinomas and 20 transitional cell carcinomas). Type specific primers for human papillomavirus types 16 and 18 were used as were general primers to detect types 6b, 11, 13, 16, 18, 31, 32, 33, 35, 45 and 51. Only 1 of 22 squamous cell carcinoma specimens (4.4%) was positive (human papillomavirus type 18)--a cadaveric renal transplant patient on chronic immunosuppression. Cervical specimens were human papillomavirus negative in this patient. No human papillomavirus deoxyribonucleic acid was detected in the 20 transitional cell carcinoma cohort. Our results confirm that these human papillomavirus types appear to have little association with invasive transitional cell cancers. Of greater significance, despite this (to our knowledge) first reported case of human papillomavirus type 18 detected in squamous cell carcinoma of the bladder (seen in an immunocompromised patient), we conclude that these oncogenic human papillomavirus types do not have a significant role in squamous cell carcinogenesis of the bladder.
虽然已知致癌性人乳头瘤病毒与生殖道（阴茎、尿道和子宫颈）的鳞状细胞癌之间存在密切关联，但关于人乳头瘤病毒与膀胱癌的关联仍存在大量争议。检测技术的技术问题以及对潜在污染的担忧影响了对先前研究结果的解读。此外，由于人乳头瘤病毒主要与其他部位的鳞状细胞癌相关，因此人乳头瘤病毒与膀胱上皮致癌作用的任何关联都必须探讨人乳头瘤病毒与膀胱鳞状细胞癌之间是否存在关联。采用差异聚合酶链反应和严格的方案以避免交叉污染，对存档的膀胱癌标本（22例鳞状细胞癌和20例移行细胞癌）进行分析。使用了人乳头瘤病毒16型和18型的型特异性引物以及用于检测6b、11、13、16、18、31、32、33、35、45和51型的通用引物。22例鳞状细胞癌标本中仅1例（4.4%）呈阳性（人乳头瘤病毒18型）——一名接受慢性免疫抑制的尸体肾移植患者。该患者的宫颈标本人乳头瘤病毒呈阴性。在20例移行细胞癌队列中未检测到人乳头瘤病毒脱氧核糖核酸。我们的结果证实，这些人乳头瘤病毒类型似乎与浸润性移行细胞癌几乎没有关联。更重要的是，尽管这是（据我们所知）首次报道在膀胱鳞状细胞癌中检测到人乳头瘤病毒18型（见于一名免疫功能低下的患者），但我们得出结论，这些致癌性人乳头瘤病毒类型在膀胱鳞状细胞癌发生过程中不起重要作用。
