Pattern of HPV infection in basal cell carcinoma and in perilesional skin biopsies from immunocompetent patients

Abstract

BackgroundThe association between human papillomavirus (HPV) infection and non-melanoma skin cancers (NMSCs) such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is not yet fully understood. We analysed the prevalence and spectrum of cutaneous beta-HPV types and mucosal/genital HPV types in paired biopsies (tumour and corresponding perilesional skin) obtained from 50 BCC immunocompetent patients. A small group of SCC patients (n=9) was also included. We also evaluated some previously postulated risk factors for HPV infection in NMSC patients.ResultsAll biopsies were negative for mucosal/genital HPV types. Overall, beta-HPV DNA was detected more often in SCC compared to BCC patients (78% vs 55% of total samples). The frequency of infection increased with the patient’s age [OR=4.88 (95% CI 1.29-18.39)]. There was no significant correlation between beta-HPV positivity and sex, skin type and UV exposure. The prevalence of beta-HPV species 1 types was significantly higher than those belonging to other beta-HPV species in biopsies from BCC (p=0.022) but not from SCC subjects (p=0.091). There was no significant difference in the overall prevalence of beta-HPV infection and the number of viral types between tumour lesions and perilesional skin. BCC samples were significantly more likely to be infected with beta-HPV species 1 types compared to perilesional skin (p=0.036) and showed a higher frequency of mixed infections (p=0.028).ConclusionsThese findings demonstrate that beta-HPV types belonging to species 1 are the most common HPV types detected in the skin of BCC patients. Moreover beta-1-HPV types and mixed infections are significantly more frequent in tumour samples than in healthy perilesional skin. Our results suggest that beta-1-HPVs as well as co-infection with more than one viral type could be important in NMSC and in particular in BCC.Further studies aimed to compare the biological activity of viral types in tumours and in healthy skin (viral replication and expression, interference of infection with cellular functions) are necessary to understand the role of HPV infection in skin cancer.

Human papilloma virus infection in basal cell carcinoma of the skin: a systematic review and meta-analysis study

“…In one study [14], α-HPV in BCC was positive in 35% of the cases that the high-risk HPV genotypes observed in these patients were HPV 16, 35, 58 and 59. The findings of a research [5] demonstrated that β1-HPVs were the most common HPV types detected in the skin of BCC patients. Moreover, these types and mixed infections are significantly more frequent in tumor samples than in healthy perilesional skin and the results suggested that the types as well as co-infection with more than one viral type could be important in BCC.…”

“…Out of 45 studies reported during 1991 to 2017; two studies were reported in Australia [12,13], one Romania [14], ten USA [15,16,17,18,19,20,21,22,23,24], one Argentina [1], four Netherlands [25,26,27,28], two Spain [8,11], one Brazil [29], one China [30], one UK [31], one Croatia [2], four Iran [9,32,33,34], one North Africa/France [35], one Germany/USA [36], two Greece [37,38], one Sweden/Austria [39], two Germany [40,41], five Italy [5,42,43,44,45], one Russia [46], one Germany/Poland [47], one Norway/Sweden [48] and two Sweden [49,50] (Table I). Fifteen studies were case-control and 30 studies were cross-sectional studies.…”

“…Fifteen studies were case-control and 30 studies were cross-sectional studies. Twenty-four studies did polymerase chain reaction (PCR) [1,2,12,14,19,20,21,25,28,29,31,32,35,36,37,39,40,41,42,43,44,46,47,49,50], 2 in situ hybridization (ISH) [15,18], 3 serology [16,48,24], 7 nested PCR [5,8,11,26,27,34,43], one loop-mediated isothermal amplification assay (LAMP)/PCR [30], 4 multiplex serology [17,22,38,45], 2 immunohistochemistry (IHC) [9,33] Meta-analysis Figure 2 shows the incidence of number of HPVs in the BCC patients and controls. Some studies reported this incidence in the BCC patients and controls (case-control studies) and other studies only reported in BCC patients (cross-sectional and cohort studies).…”

“…Four [5,21,22,48], five [23,28,45,49,50], seven [2,21,23,28,45,47,50], two [2,21], six [2,21,23,28,45,50], five [21,23,28,45,50], four [21,23,45,50] and three studies [21,23,45] reported the prevalence of β1-HPV, HPV 5 (β1), HPV 8 (β1), HPV 12 (β1), HPV 20 (β1), HPV 24 (β1), HPV 36 (β1), and HPV 93 (β1) in the BCC patients, respectively. In addition to, two [21,48], four [21,23,45,50], six [21,23,28,45,49,50], three [21,23,…”

“…More than 200 HPV types have been described and divided into five major genera: α-, β-, γ-, μ-and ν-papillomavirus [4]. HPVs can be divided into cutaneous types commonly found in common warts, mucosal types detected in genital condylomas and anogenital cancers and epidermodysplasia verruciformis (EV) types [5,6]. EV is a rare genodermatosis associated with infections with specific HPVs belonging to the β genus of HPV [7].…”