Association between human Papillomavirus and colorectal adenocarcinoma and its influence on tumor staging and degree of cell differentiation

Abstract

BackgroundColorectal cancer is one of the most common types of neoplasia among the worldwide adult population. Among neoplasms of the gastrointestinal tract, it is ranked second in relation to prevalence and mortality, but its etiology is only known in around 5% of the cases. It is believed that 15% of malignant diseases are related to viral oncogenesis.AimTo correlate the presence of HPV with the staging and degree of cell differentiation among patients with colorectal adenocarcinoma.MethodsA retrospective case-control study was conducted on 144 patients divided between a test group of 79 cases of colorectal cancer and a control group to analyze 144 patients aged 25 to 85 years (mean, 57.85 years; standard deviation, 15.27 years and median, 58 years). Eighty-six patients (59.7%) were male. For both groups, tissue samples from paraffin blocks were subjected to DNA extraction followed by the polymerase chain reaction using generic and specific primers for HPV 16 and 18. Dot blot hybridization was also performed with the aim of identifying HPV DNA.ResultsThe groups were shown to be homogenous regarding sex, age and site of HPV findings in the samples analyzed. Out of the 41 patients with HPV, 36 (45.6%) were in the cases and five (7.7%) were in the control group (p<0.001). All the HPV cases observed comprised HPV 16, and HPV 18 was not shown in any of the cases studied. There were no significant differences in comparisons of sex, age and site regarding the presence of HPV in either of the groups. It was not observe any significant difference in relation to staging or degree of cell differentiation among the patients with colorectal cancer.ConclusionHuman papillomavirus type 16 is present in individuals with colorectal carcinoma. However, its presence was unrelated to staging or degree of differentiation.

Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise

“…This phenomenon has been extensively investigated by various authors, above all regarding colorectal cancer, whose model is considered ideal for the comprehension of the carcinogenic process, due to the progression from pre-malignancy to malignancy. However, Picanço-Júnior et al 30 did not find a correlation between staging and cellular differentiation with the presence of HPV 16, despite being evident in other systematic studies that HPV infection can be a risk factor for the increase of colorectal cancer prevalence. It is possible that the discrepancy in the results found by Picanço-Júnior et al 30 is linked to the use of different techniques or inadequate material, which causes the lack of evidence in these studies.…”

“…From the 18 eligible studies [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] , 7 (38.9%) were conducted in the United States (1), in Brazil (3), in Argentina (2), in Peru (1), 5 (27.8%) in Europe, and 6 (33.3%) in Asia.…”

“…Figure 2 presents the total prevalence of colorectal cancer due to HPV with an estimate of 51.8% (CI95% 35.7 -66.0). When comparing cases and controls (98/262; 28/224, respectively), in 4 of the 18 studies 22,30,32,35 , the estimate of the difference of colorectal cancer risk due to HPV was 24.3% (CI95% 4.5 -44.0), with odds ratio values of 4.661 (CI95% 2.500 -8.688) (Figure 2).…”

“…Meanwhile, for the estimate of prevalence due to HPV 16 and 18, 16 of the 18 eligible papers were assessed (Figure 3), from the total of 598 samples, presenting very similar In the assessment of the estimate of colorectal cancer prevalence by region, eight of the 18 papers 21,[23][24][25][26]29,30,32 , from the total of 411 samples, presented relatively expressive values for the cervical area, 253 (61.3%; CI95% 50.4 -72.3) and for the rectal area, 158 (38.7%; CI95% 27.7 -49.6).…”

“…Based on the complete reading of the 18 eligible papers for the systematic study [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] , it was found that the location where HPV is most predominant is the cervical area, the vulva, the vagina, and the anus, since they are associated with chronic infections, preceded by non-malignant precursor lesions, like the cervical squamous intraepithelial lesion (CSIL) and the anal squamous intraepithelial lesions (ASIL), with predilection being shown for the zone of cellular transition of glandular squamous cells, seeing that both have common biological characteristics, including histopathological aspects.…”