Human Papilloma Virus Infection and Skin Cancer in Renal Allograft Recipients

Barr, B. B.; McLaren, K M; Smith, I. P.; Benton, E. C.; Bunney, Mary H.; Blessing, K.; Hunter, John

doi:10.1016/s0140-6736(89)91143-4

Cited by 284 publications

(72 citation statements)

References 26 publications

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“…Moreover, we confirmed a significantly higher overall risk among patients transplanted at young age, among men compared with women, and following transplantation of organs other than a kidney (Kinlen, 1992;Penn, 2000). For specific cancer sites, the excess risk was most notable for nonmelanoma skin cancer, lip cancer and NHL, which is in accordance with other investigators (Hoover and Fraumeni, 1973;Kinlen et al, 1979;Blohme and Brynger, 1985;Barr et al, 1989;Kinlen, 1992;Opelz and Heneerson, 1993;Birkeland et al, 1995Birkeland et al, , 2000Bouwes Bavinck et al, 1997;Hoshida et al, 1997;Kyllonen et al, 2000;Lindelof et al, 2000;Penn, 2000). In the study by Lindelöf et al (2000), the SIRs included all incident cancers, whereas in our study, we only counted the first cancer.…”

Section: Discussionsupporting

confidence: 91%

“…Unknown HPV subtypes are hypothesised to play a role in the aetiology of nonmelanoma skin cancer (Blohme and Brynger, 1985;Barr et al, 1989;Bouwes Bavinck et al, 1997) and defined oncogenic types are clearly causally related to cancer of the cervix (IARC, 1995), anus (Frisch et al, 1997), vulva and vagina (Blohme and Brynger, 1985;Alloub et al, 1989). Although controversial, HPV has also been proposed as a risk factor for oesophageal cancer (Galloway and Daling, 1996) as well as for head and neck cancers (Mork et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

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Cancer risk following organ transplantation: a nationwide cohort study in Sweden

et al. 2003

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A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to assess the risk of cancer following organ transplantation. A nationwide cohort study comprising 5931 patients who underwent transplantation of kidney, liver or other organs during 1970 -1997 in Sweden was conducted. Complete follow-up was accomplished through linkage to nationwide databases. We used comparisons with the entire Swedish population to calculate standardised incidence ratios (SIRs), and Poisson regression for multivariate internal analyses of relative risks (RRs) with 95% confidence intervals (CI). Overall, we observed 692 incident first cancers vs 171 expected (SIR 4.0; 95% CI 3.7 -4.4). We confirmed marked excesses of nonmelanoma skin cancer (SIR 56.2; 95% CI 49.8 -63.2), lip cancer (SIR 53.3; 95% CI 38.0 -72.5) and of non-Hodgkin's lymphoma (NHL) (SIR 6.0; 95% CI 4.4 -8.0). Compared with patients who underwent kidney transplantation, those who received other organs were at substantially higher risk of NHL (RR 8.4; 95% CI 4.3 -16). Besides, we found, significantly, about 20-fold excess risk of cancer of the vulva and vagina, 10-fold of anal cancer, and five-fold of oral cavity and kidney cancer, as well as two-to four-fold excesses of cancer in the oesophagus, stomach, large bowel, urinary bladder, lung and thyroid gland. In conclusion, organ transplantation entails a persistent, about four-fold increased overall cancer risk. The complex pattern of excess risk at many sites challenges current understanding of oncogenic infections that might become activated by immunologic alterations.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Cancer risk following organ transplantation: a nationwide cohort study in Sweden

et al. 2003

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“…15 In a Scottish study of 202 renal allograft patients, 15 of 25 SCC contained HPV 5/8 DNA with the suggestion that these serotypes may contribute to the development of SCC in renal allograft patients. 13 Further studies have isolated HPV serotypes from premalignant and malignant lesions in both cardiac and renal transplant patients. Berkhout et al isolated HPV subtype DNA associated with EV in 80% of SCC from renal transplant patients using polymerase chain reaction.…”

Section: Discussionmentioning

confidence: 99%

Aggressive cutaneous malignancies following cardiothoracic transplantation

Veness¹,

Quinn²,

Ong³

et al. 1999

Cancer

121

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“…In such patients the high prevalence of infection by a spectrum of human papilloma virus (HPV) types together with a high incidence of other neoplasms associated with a viral pathogenesis has suggested a role for virus during NMSC development (Barr et al, 1989). However, in skin, unlike cervical carcinoma, compelling evidence that HPVs play a causative role, rather than being mere passengers, is lacking.…”

mentioning

confidence: 99%

Low frequency of allelic loss in skin tumours from immunosuppressed individuals

Rehman

Quinn²,

Takata³

et al. 1997

Br J Cancer

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Summary Organ transplant recipients receiving immunosuppression show a dramatically increased risk of non-melanoma skin cancer. The cause of this increase is not known. We report that the rate of loss of heterozygosity (at all the loci we examined) was significantly lower in tumours from immunosuppressed individuals than in tumours from immunocompetent subjects [20 out of 148 (14%) vs 157 out of 428 (37%); P < 0.0001]. These results suggest that tumours in immunosuppressed individuals have a different molecular pathogenesis.Keywords: loss of heterozygosity; non-melanoma skin cancer; immunosuppression; tumour suppressor; human papilloma virus; squamous cell carcinoma Patients receiving immunosuppressive therapy after organ transplantation show up to a 250-fold increase in the incidence of nonmelanoma skin cancers (NMSCs) and their precursor lesions (Abel, 1989; Hartevelt et al, 1990; Espana et al, 1995; Glover et al, 1997). In such patients the high prevalence of infection by a spectrum of human papilloma virus (HPV) types together with a high incidence of other neoplasms associated with a viral pathogenesis has suggested a role for virus during NMSC development (Barr et al, 1989). However, in skin, unlike cervical carcinoma, compelling evidence that HPVs play a causative role, rather than being mere passengers, is lacking. It is also possible that other viruses such as the recently described Kaposi's sarcoma herpes-like virus (KSHV) (Boshoff et al, 1996) or as yet unidentified viruses may be important. We therefore sought indirect evidence for a different molecular pathogenesis in these tumours that would provide support for a causal role for one or more types of virus, including viruses that had not yet been identified.Tumour-suppressor gene inactivation commonly occurs by mutation of one allele accompanied by chromosome loss of the wild-type allele (Knudson, 1991). Other mechanisms of tumoursuppressor gene activation can occur, including binding of the products of virally encoded oncogenes or changes in methylation status of tumour-suppressor genes (Vousden, 1993;Kinzler and Vogelstein, 1996). If, in tumours from immunosuppressed individuals, tumour-suppressor genes are being inactivated by alternative means, then the rate or pattern of loss of heterozygosity might be expected to differ from those in immunocompetent individuals. We examined this hypothesis. Ten-micrometre tissue sections were carefully microdissected to separate tumour from adjacent normal epithelium, and the DNA was extracted using phenol-chloroform (Jackson et al, 1995). In all cases, control DNA from either adjacent normal skin or blood was used. Tumour and control DNA was subject to polymerase chain reaction (PCR) amplification using one [y-32P]ATP (Life Sciences, Amersham, UK) end-labelled primer as previously described (Rehman et al, 1996), using microsatellite markers 3p (D3S1293), 9p (D9S162, D9S171), 9q (D9S197), 13q (D13S170), 17p (D17S796) and 17q (D17S785) (Research Genetics, Huntsville, AL, USA). PCR products were resolved on a ...

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Human Papilloma Virus Infection and Skin Cancer in Renal Allograft Recipients

Cited by 284 publications

References 26 publications

Cancer risk following organ transplantation: a nationwide cohort study in Sweden

Cancer risk following organ transplantation: a nationwide cohort study in Sweden

Aggressive cutaneous malignancies following cardiothoracic transplantation

Low frequency of allelic loss in skin tumours from immunosuppressed individuals

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