Difference between revisions of "Human papillomavirus"

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#redirect [[Viruses#Human_papillomavirus]]
[[Image:High grade squamous intraepithelial lesion - 2 - p16 -- high mag.jpg|thumb|Micrograph showing block positive [[p16]] immunostaining in [[high-grade squamous intraepithelial lesion]] of the cervix. ''p16'' is commonly used as a surrogate marker for human papillomavirus (HPV). (WC)]]
'''Human papillomavirus''', abbreviated '''HPV''', is virus implicated in a large number of [[cancer]]s.
 
==General==
*Sexually transmitted.
 
Note:
*Some tests can be done on formalin-fixed, paraffin-embedded tissue.<ref name=pmid21128780>{{Cite journal  | last1 = Black | first1 = CC. | last2 = Bentley | first2 = HA. | last3 = Davis | first3 = TH. | last4 = Tsongalis | first4 = GJ. | title = Use of a linear array for the detection of human papillomavirus genotypes in head and neck cancer. | journal = Arch Pathol Lab Med | volume = 134 | issue = 12 | pages = 1813-7 | month = Dec | year = 2010 | doi = 10.1043/2009-0592-OAR.1 | PMID = 21128780 }}</ref>
 
===Associated pathology===
*Benign:
**[[Verruca vulgaris]].
**[[Condyloma acuminatum]].
**[[Esophagus#Human_papilloma_virus_esophagitis|HPV esophagitis]].
*Malignant:
*#[[Uterine cervix|Cervical cancer]] and precursors ([[LSIL]], [[HSIL]]).
*#Anal cancer and precursors ([[Anus#Anal_intraepithelial_neoplasia|AIN]]).<ref name=pmid21616117>{{Cite journal  | last1 = Borget | first1 = I. | last2 = Abramowitz | first2 = L. | last3 = Mathevet | first3 = P. | title = Economic burden of HPV-related cancers in France. | journal = Vaccine | volume = 29 | issue = 32 | pages = 5245-9 | month = Jul | year = 2011 | doi = 10.1016/j.vaccine.2011.05.018 | PMID = 21616117 }}</ref>
*#[[Vulva|Vulvar cancer]].<ref name=pmid21616117/>
*#[[Vagina|Vaginal cancer]].<ref name=pmid21616117/>
*#[[Penis|Penile cancer]].<ref name=pmid21616117/>
*#[[HPV-associated head and neck squamous cell carcinoma]] - oropharynx (specifically - tonsils, base of tongue).
*#[[Human papillomavirus-related multiphenotypic sinonasal carcinoma]] (previously known as ''HPV-related carcinoma with adenoid cystic-like features'').
**Possibly esophageal carcinoma<ref name=pmid21130683>{{Cite journal  | last1 = Zhang | first1 = QY. | last2 = Zhang | first2 = DH. | last3 = Shen | first3 = ZY. | last4 = Xu | first4 = LY. | last5 = Li | first5 = EM. | last6 = Au | first6 = WW. | title = Infection and integration of human papillomavirus in esophageal carcinoma. | journal = Int J Hyg Environ Health | volume = 214 | issue = 2 | pages = 156-61 | month = Mar | year = 2011 | doi = 10.1016/j.ijheh.2010.11.001 | PMID = 21130683 }}</ref> - disputed.<ref name=pmid21169053>{{Cite journal  | last1 = Iyer | first1 = A. | last2 = Rajendran | first2 = V. | last3 = Adamson | first3 = CS. | last4 = Peng | first4 = Z. | last5 = Cooper | first5 = K. | last6 = Evans | first6 = MF. | title = Human papillomavirus is detectable in Barrett's esophagus and esophageal carcinoma but is unlikely to be of any etiologic significance. | journal = J Clin Virol | volume = 50 | issue = 3 | pages = 205-8 | month = Mar | year = 2011 | doi = 10.1016/j.jcv.2010.11.015 | PMID = 21169053 }}</ref>
 
===Oncocytic types===
Known as "high risk" types; this grouping includes:<ref name=pmid22312235>{{Cite journal  | last1 = Ntova | first1 = CK. | last2 = Kottaridi | first2 = C. | last3 = Chranioti | first3 = A. | last4 = Spathis | first4 = A. | last5 = Kassanos | first5 = D. | last6 = Paraskevaidis | first6 = E. | last7 = Karakitsos | first7 = P. | title = Genetic Variability and Phylogeny of High Risk HPV Type 16, 18, 31, 33 and 45 L1 Gene in Greek Women. | journal = Int J Mol Sci | volume = 13 | issue = 1 | pages = 1-17 | month =  | year = 2012 | doi = 10.3390/ijms13010001 | PMID = 22312235 }}</ref>
*HPV 18 - predominantly adenocarcinoma.<ref name=pmid15551313>{{Cite journal  | last1 = De Boer | first1 = MA. | last2 = Peters | first2 = LA. | last3 = Aziz | first3 = MF. | last4 = Siregar | first4 = B. | last5 = Cornain | first5 = S. | last6 = Vrede | first6 = MA. | last7 = Jordanova | first7 = ES. | last8 = Fleuren | first8 = GJ. | title = Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries. | journal = Int J Cancer | volume = 114 | issue = 3 | pages = 422-5 | month = Apr | year = 2005 | doi = 10.1002/ijc.20727 | PMID = 15551313 }}</ref>
**'''Eigh'''teen = '''a'''denocarcinoma.
*HPV 16 - predominantly squamous cell carcinoma.<ref name=pmid15551313/>
**'''S'''ixteen = '''s'''quamous.
*HPV 31.
*HPV 33.
*HPV 45.
 
===Oncogenesis===
Quick & dirty explanation of pathogenesis:<ref name=pmid12445661>{{Cite journal  | last1 = Münger | first1 = K. | last2 = Howley | first2 = PM. | title = Human papillomavirus immortalization and transformation functions. | journal = Virus Res | volume = 89 | issue = 2 | pages = 213-28 | month = Nov | year = 2002 | doi =  | PMID = 12445661 }}</ref><ref name=Ref_PCPBoD8_169>{{Ref PCPBoD8|169}}</ref>
*Virus integrates into host genome.
**This is accompanied by loss of ''viral gene E2'' (which suppresses function of E6 & E7).
*''Viral gene E6'' dysregulates ''p53''.
*''Viral gene E7'' dysregulates ''RB''.
 
===Vaccine===
Recombinant vaccine (Gardasil, Silgard) - covers:<ref name=pmid21942919>{{Cite journal  | last1 = McCormack | first1 = PL. | last2 = Joura | first2 = EA. | title = Spotlight on Quadrivalent Human Papillomavirus(Types 6, 11, 16, 18) Recombinant Vaccine(Gardasil®) in the Prevention of PremalignantGenital Lesions, Genital Cancer, and Genital Warts in Women†. | journal = BioDrugs | volume = 25 | issue = 5 | pages = 339-43 | month = Oct | year = 2011 | doi = 10.2165/11205060-000000000-00000 | PMID = 21942919 }}</ref>
*HPV 6.
*HPV 11.
*HPV 16.
*HPV 18.
 
==Microscopic==
Features:
*Koilocytes:
** Perinuclear clearing.
** Nuclear changes.
*** Size similar (or larger) to those in the basal layer of the epithelium.
*** Nuclear enlargement should be evident on low power, i.e. 25x.
*** Central location - nucleus should be smack in the middle of the cell.
 
===Images===
<gallery>
Image:Low-grade_squamous_intraepithelial_lesion.jpg | LSIL (WC).
Image:Low-grade_sil_and_endocx.jpg | LSIL & endocervix (WC).
</gallery>
 
==IHC==
*[[p16]] +ve -- stains most cells infected by HPV.
 
 
===Images===
<gallery>
Image: High grade squamous intraepithelial lesion - 2 - p16 -- high mag.jpg | Block positive p16 staining in [[HSIL]]. (WC)
Image:Consistent with HPV-associated SCC - p16 -- intermed mag.jpg | c/w [[Human papillomavirus-associated head and neck squamous cell carcinoma|HPV-assoc. SCC]] - p16 - intermed. mag. (WC/Nephron)
Image:Consistent with HPV-associated SCC - p16 -- high mag.jpg | c/w HPV-assoc. SCC - p16 - high mag. (WC/Nephron)
</gallery>
 
==See also==
*[[Virus]].
*[[Viruses and cancer]].
 
==References==
{{Reflist|2}}


[[Category:Viruses]]
[[Category:Viruses]]

Latest revision as of 15:35, 9 December 2021

Micrograph showing block positive p16 immunostaining in high-grade squamous intraepithelial lesion of the cervix. p16 is commonly used as a surrogate marker for human papillomavirus (HPV). (WC)

Human papillomavirus, abbreviated HPV, is virus implicated in a large number of cancers.

General

  • Sexually transmitted.

Note:

  • Some tests can be done on formalin-fixed, paraffin-embedded tissue.[1]

Associated pathology

Oncocytic types

Known as "high risk" types; this grouping includes:[5]

  • HPV 18 - predominantly adenocarcinoma.[6]
    • Eighteen = adenocarcinoma.
  • HPV 16 - predominantly squamous cell carcinoma.[6]
    • Sixteen = squamous.
  • HPV 31.
  • HPV 33.
  • HPV 45.

Oncogenesis

Quick & dirty explanation of pathogenesis:[7][8]

  • Virus integrates into host genome.
    • This is accompanied by loss of viral gene E2 (which suppresses function of E6 & E7).
  • Viral gene E6 dysregulates p53.
  • Viral gene E7 dysregulates RB.

Vaccine

Recombinant vaccine (Gardasil, Silgard) - covers:[9]

  • HPV 6.
  • HPV 11.
  • HPV 16.
  • HPV 18.

Microscopic

Features:

  • Koilocytes:
    • Perinuclear clearing.
    • Nuclear changes.
      • Size similar (or larger) to those in the basal layer of the epithelium.
      • Nuclear enlargement should be evident on low power, i.e. 25x.
      • Central location - nucleus should be smack in the middle of the cell.

Images

  • LSIL (WC).

  • LSIL & endocervix (WC).

IHC

  • p16 +ve -- stains most cells infected by HPV.


Images

  • Block positive p16 staining in HSIL. (WC)

  • c/w HPV-assoc. SCC - p16 - intermed. mag. (WC/Nephron)

  • c/w HPV-assoc. SCC - p16 - high mag. (WC/Nephron)

See also

References

  1. ↑ Black, CC.; Bentley, HA.; Davis, TH.; Tsongalis, GJ. (Dec 2010). "Use of a linear array for the detection of human papillomavirus genotypes in head and neck cancer.". Arch Pathol Lab Med 134 (12): 1813-7. doi:10.1043/2009-0592-OAR.1. PMID 21128780.
  2. ↑ 2.0 2.1 2.2 2.3 Borget, I.; Abramowitz, L.; Mathevet, P. (Jul 2011). "Economic burden of HPV-related cancers in France.". Vaccine 29 (32): 5245-9. doi:10.1016/j.vaccine.2011.05.018. PMID 21616117.
  3. ↑ Zhang, QY.; Zhang, DH.; Shen, ZY.; Xu, LY.; Li, EM.; Au, WW. (Mar 2011). "Infection and integration of human papillomavirus in esophageal carcinoma.". Int J Hyg Environ Health 214 (2): 156-61. doi:10.1016/j.ijheh.2010.11.001. PMID 21130683.
  4. ↑ Iyer, A.; Rajendran, V.; Adamson, CS.; Peng, Z.; Cooper, K.; Evans, MF. (Mar 2011). "Human papillomavirus is detectable in Barrett's esophagus and esophageal carcinoma but is unlikely to be of any etiologic significance.". J Clin Virol 50 (3): 205-8. doi:10.1016/j.jcv.2010.11.015. PMID 21169053.
  5. ↑ Ntova, CK.; Kottaridi, C.; Chranioti, A.; Spathis, A.; Kassanos, D.; Paraskevaidis, E.; Karakitsos, P. (2012). "Genetic Variability and Phylogeny of High Risk HPV Type 16, 18, 31, 33 and 45 L1 Gene in Greek Women.". Int J Mol Sci 13 (1): 1-17. doi:10.3390/ijms13010001. PMID 22312235.
  6. ↑ 6.0 6.1 De Boer, MA.; Peters, LA.; Aziz, MF.; Siregar, B.; Cornain, S.; Vrede, MA.; Jordanova, ES.; Fleuren, GJ. (Apr 2005). "Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries.". Int J Cancer 114 (3): 422-5. doi:10.1002/ijc.20727. PMID 15551313.
  7. ↑ Münger, K.; Howley, PM. (Nov 2002). "Human papillomavirus immortalization and transformation functions.". Virus Res 89 (2): 213-28. PMID 12445661.
  8. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 169. ISBN 978-1416054542.
  9. ↑ McCormack, PL.; Joura, EA. (Oct 2011). "Spotlight on Quadrivalent Human Papillomavirus(Types 6, 11, 16, 18) Recombinant Vaccine(Gardasil®) in the Prevention of PremalignantGenital Lesions, Genital Cancer, and Genital Warts in Women†.". BioDrugs 25 (5): 339-43. doi:10.2165/11205060-000000000-00000. PMID 21942919.
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