Anal cancer and human papillomaviruses

Abstract

Epidemiologic and clinical evidence has suggested a possible association between anal cancer and human papillomavirus (HPV) types that are known to be associated with cervical and other genital cancers. Using Southern blot and dot blot analysis, the authors examined 45 primary anal malignancies for HPV DNA types 6, 11, 16, and 18. HVP 16, DNA was detected in 23 of 41 (56 percent) anal squamous-cell carcinomas (SCC) and in the lymph-node metastases of two of these tumors. In addition, HPV 18 DNA was detected in 2/41 (5 percent) anal SCCs. Anal SCC contained no detectable HPV 6 or 11 DNA. The remaining four primary anal malignancies were not squamous carcinomas and did not contain any detectable HPV DNA. Nonmalignant anal epithelium and malignant rectal mucosa obtained from surgical patients undergoing hemorrhoidectomy and abdominoperineal excision of the rectum did not contain any detectable HPV DNA. HPV 16 DNA in anal cancer was predominantly integrated into the host cell DNA. In situ hybridization was used to demonstrate that HPV 16 DNA in anal SCC tissues is confined to the nuclei of carcinoma cells. The results of this investigation closely parallel similar studies of cervical cancer and lend support to the concept of the involvement of HPV 16 and 18 in the development of anal and genital squamous-cell carcinoma.

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

“…14 Nonsquamous malignancies of the anal canal, adenocarcinomas of the rectum, and benign anal mucosa have all tested negative for HPV. 3,[15][16][17] Our findings in this study are concordant with the literature. High-risk HPV was present in 89% of squamous cell carcinoma overall, 100% of cancers from immunodeficient individuals, and 86% of cancers in immunocompetent individuals.…”

Malignant transformation of high-grade anal intraepithelial neoplasia

“…The preinvasive condition known as anal intraepithelial neoplasia (AIN) is a relatively recently recognized condition, first described by McCance et al 1 . When human papillomavirus type 16 was identified as an important aetiological agent in anal squamous carcinoma it became apparent that there were parallels between anal and genital squamous carcinomas 2 . The identification of anal lesions that shared morphological features and histopathological parallels with cervical intraepithelial neoplasia (CIN) and vulval intraepithelial neoplasia (VIN) followed 3 .…”

The treatment of squamous anal carcinoma: guidelines of the Italian society of colo-rectal surgery

“…Screening should be performed with anal cytology and high-resolution anoscopy. HPV infection should be considered in the evaluation of the progression of precancerous lesions such as AIN to anal cancer [13]. Due to the close relationship of cervical cancer with HPV infection, a gynecological exam should be performed with the aim of screening for synchronous cervical cancer.…”