Integrated hepatitis B virus (HBV) DNA is almost invariably found in hepatocellular carcinomas (HCC) which develop in HBV carriers. Integrated HBV DNAs from two single-integration HCCs (C3 and C4) have been cloned, and the cellular integration sites have been analyzed. Integrated HBV DNA of C3 is present in chromosome 6 and contains a nearly complete linear HBV genome. The HBV DNA integration in tumor C3 was not associated with major rearrangements of cellular DNA. In contrast, the integrated HBV DNA in C4 contains a large inverted repeat of HBV DNA, in which each repeat consists of a linear HBV DNA segment similar to that present in C3. The C4 integration was also accompanied by a cellular DNA translocation at the HBV integration site. The translocation occurred between chromosomes 17 and 18, along with a deletion of at least 1. HCC (2,5,8). This is consistent with their potential action as tumor initiators (9). Hepadnaviruses so far have not been shown to contain a viral oncogene per se, nor has a common cellular integration site been identified in HCCs (7,(10)(11)(12). In addition, some human and woodchuck HCCs from carriers do not contain any integrated or free viral DNA (6, 7, 13). These findings raise the possibility that viral antigens are not required for the maintenance of HCC and may function only as tumor initiators. Additional studies are necessary to identify a unifying molecular mechanism to explain the strong epidemiological data linking chronic infection with HCC.Factors that stimulate the incidence of chromosome aberrations are associated with increased risk of neoplasia (9,14). In the case of chemical hepatocarcinogenesis in the mouse and rat, agents that damage DNA stimulate the occurrence of HCC (15-18). The ability of oncogenic viruses to damage DNA through integration and by increasing the mutation rate of cellular genes is probably an important factor in virusmediated multistage carcinogenesis (19). To investigate the possible role of HBV integrations in a general mechanism involving host DNA rearrangements, we have studied the structure of cellular DNA sequences at HBV integration sites. A previous study (20) reported a large deletion of cellular DNA at chromosome position 11p13 in association with an HBV integration. In this report we describe an HBV-induced translocation between chromosomes 17 and 18. We believe it is the first translocation to be directly linked to any viral DNA integration. The ability of HBV integrations to generate chromosome defects may be part of a multistep mechanism in the development of fully malignant HCC.
METHODSPrimary HCCs were obtained from two HBV carriers at autopsy. The first tumor, C3, was obtained from a 62-year-old Japanese man and the second, C4, was obtained from a 37-year-old Japanese man. Both were HBsAg-positive, and both tumors had a trabecular phenotype.DNA was extracted from the tumors, and restriction endonuclease fragments containing integrated HBV DNA were identified by Southern blot analysis as previously reported (3). Tumors C3 ...