Observational Study
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World J Gastroenterol. Jun 7, 2014; 20(21): 6632-6637
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6632
Potential role of human papilloma virus in the pathogenesis of gastric cancer
Miroslaw Snietura, Dariusz Waniczek, Wojciech Piglowski, Agnieszka Kopec, Ewa Nowakowska-Zajdel, Zbigniew Lorenc, Malgorzata Muc-Wierzgon
Miroslaw Snietura, Wojciech Piglowski, Agnieszka Kopec, Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
Dariusz Waniczek, Zbigniew Lorenc, Clinical Department of General, Colorectal and Trauma Surgery, Silesian Medical University, 41-200 Sosnowiec, Poland
Ewa Nowakowska-Zajdel, Malgorzata Muc-Wierzgon, Department of Internal Diseases, Silesian Medical University, 41-902 Bytom, Poland
Author contributions: Snietura M and Waniczek D designed the study, directed its implementation and contributed to the analysis and interpretation of the data as well as to the redaction of the manuscript; Piglowski W and Kopec A performed the experiments and contributed to the collection of the materials and patient data; Nowakowska-Zajdel E, Lorenc Z and Muc-Wierzgon M contributed to the analysis and interpretation of the data.
Supported by Internal Research Grant of Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch
Correspondence to: Miroslaw Snietura, MD, PhD, Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, ul. Wybrzeze Armii Krajowej 15, 44-101 Gliwice, Poland. mirek@snietura.net
Telephone: +48-32-2789408 Fax: +48-32-2789415
Received: October 15, 2013
Revised: February 11, 2014
Accepted: March 8, 2014
Published online: June 7, 2014
Processing time: 234 Days and 9.8 Hours
Abstract

AIM: To demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric cancer (GAC) tissues.

METHODS: The study involved 84 surgically treated patients with gastric adenocarcinoma, regardless of the clinical stage of the disease. The presence of HPV DNA of high oncogenic risk types in formalin-fixed, paraffin-embedded tumor samples was determined using quantitative polymerase chain reaction analysis. A stringent protocol of prevention of cross- and environmental contamination was applied during DNA isolation, and amplification, as well as confirmation of the biological activity of the virus in tumor cells, was implemented. The study utilized the Real-time High Risk HPV test, which detects the DNA of 14 HPV subtypes that are considered to have high oncogenic potential. The overexpression of the p16INK4a protein assessed immunohistochemically was considered confirmation of the HPV infection.

RESULTS: Among the 89 patients initially included in the study group, diagnostic results were obtained for 84 individuals. In five cases, either the histopathological material was too scant to isolate the necessary amount of DNA, or the isolated DNA was significantly degraded, resulting in the failure of internal control amplification within the predefined number of 35 cycles. Those patients were excluded from further analysis. The amplification of HPV DNA was demonstrated in none of the 84 tissue samples; thus, all cases were considered to have a negative DNA status of highly oncogenic HPV subtypes. Immunohistochemical staining provided diagnostic results for all of the examined tissue samples, and excluded the accumulation of the p16INK4a protein in tumor cells, thus confirming the lack of active HPV infection in all of the individuals.

CONCLUSION: The study does not confirm the presence or biological activity of HPV in tumor tissues. Thus, the relationship between GAC and HPV infection, in the Central European population seems doubtful.

Keywords: Gastric cancer; Human papilloma virus; Quantitative polymerase chain reaction; P16INK4a expression

Core tip: The study aimed to demonstrate the presence and biological activity of human papilloma virus (HPV) in gastric cancer tissues. The genomes of 14 HPV subtypes of high oncogenic potential were assessed using quantitative polymerase chain reaction in 84 tumor samples. A stringent protocol for preventing sample contamination, and confirming the biological activity of the virus in the tumor cells, was applied. The study did not confirm either the presence of the HPV genome or viral activity in the examined tumor tissues.