Is There any Association between Urothelial Carcinoma of the Bladder and Human Papillomavirus? A Case-Control Study

Abstract

<b><i>Objectives:</i></b> Human papillomavirus (HPV) is a well-known oncogenic virus associated with anogenital carcinomas. Despite the anatomical proximity of the bladder and the anogenital region, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is still a controversial issue. This study aimed to test the urethral swabs and first-void urine samples of patients with UCB for HPV-Deoxyribonucleic acid (DNA) using polymerase chain reaction (PCR) assay and to compare the results with a control group. <b><i>Materials and Methods:</i></b> Sixty-nine patients who were diagnosed with UCB between January and December 2018 were included in this case-control study. Sixty-nine patients who visited the urology outpatient clinic for non-oncological reasons within the study period were designated as the control group. Urethral swab and first-void morning urine samples were collected from each patient. HPV-DNA presence was investigated using a PCR kit that can detect a total of 22 HPV genotypes, of which 18 are high-risk and 3 are low-risk genotypes. <b><i>Results:</i></b> The mean age of the patients included in the study was 63.2 ± 12.6 years and the male to female ratio was 5.3. HPV-DNA was detected in 28.9% (20/69) of the patients in the case group and in 8.7% (6/69) of the patients in the control group. HPV-DNA positivity was significantly higher in the case group (OR 4.24; 95% CI 1.63–12.34). No statistically significant relationship was found between HPV-DNA positivity and tumor grade (<i>p</i> = 0.36). <b><i>Conclusion:</i></b> A statistically significant relationship exists between HPV infection and UCB, regardless of the tumor grade.

Association of human papilloma virus (HPV) infection with oncological outcomes in urothelial bladder cancer

“…The results of a previous study suggested an association between the high-risk types of HPV and low-grade bladder cancer [6]. However, a recent study that used fresh tissue samples for detecting HPV refuted a relationship between this virus and bladder tumor grade [27].…”

“…Quality of PCR might be slightly higher in FFT samples compared to FFPE; however, the difference is trivial and non-significant in many cases [35,36]. For instance a previous study declared the superiority of fresh tissue samples over FFPE [27]. However, difficulties in acquiring and maintaining FFT samples results in much more common use of FFPE [37].…”

Detection of HPV infection in urothelial carcinoma using RNAscope: Clinicopathological characterization

“…It is implicated in about 90% of anogenital cancers 7 . Although several case–control studies suggested the potential involvement of HPV in UC, 8‐10 the causality of HPV in UC was not established. Previous studies reported contrasting HPV detection rates of 0%–81% in UC 10,11 .…”

Genetic variation of E6 and E7 genes of human papillomavirus 52 from Central China

“…1 Unlike most other viruses, the classification of HPVs is based on their genomic sequence homology instead of their antigenic structure. 2 In recent years, hundreds of different HPV types have been found. According to the malignant progression of the disease, HPV is mainly divided into high-risk and low-risk types.…”

“…1,3 The high-risk types, such as HPV-16, 18, 52, and 58, are closely associated with cervical cancer. 2,4 HPV imposes a substantial socioeconomic burden mainly due to its oncogenic potential. 5 HPV-16 and HPV-18 are found to be the most common HPV infection types in the world.…”