Analysis of human papillomavirus type-16 variants in Italian women with cervical intraepithelial neoplasia and cervical cancer.
Human papillomavirus type 16 (HPV-16) classes (E, AA, As, Af1, Af2) and their variants have different geographic distribution and different degrees of association with cervical lesions. This study was designed to examine HPV-16 variants among Italian women and their prevalence in case patients (affected by invasive cervical carcinoma or cervical intraepithelial neoplasia grade 2-3 and cervical intraepithelial neoplasia grade 1), versus control subjects with normal cervical epithelium (controls). A total of 90 HPV-16 positive cervical samples from women of Italian Caucasian descent have been tested, including 36 invasive cervical carcinomas, 21 with cervical intraepithelial neoplasias grade 2-3, 17 with cervical intraepithelial neoplasia grade 1 and 16 controls. HPV-16 was detected with an E6/E7 gene-specific polymerase chain reaction, and variant HPV-16 classes and subclasses were identified by direct nucleotide sequencing of the region coding for the E6 and the E7 oncoproteins, the MY09/11-amplified highly conserved L1 region, and the long control region (LCR). Among the 90 HPV-16 samples, nine viral variants have been identified belonging to the European (Ep-T350 and E-G350) and non-European (AA and Af-1) branches. The E-G350 is the prevalent variant in all analyzed different disease stages being present in 55.5% of ICC, 52.4% of cervical intraepithelial neoplasias 2-3, 47.1% of cervical intraepithelial neoplasia grade 1, and 50.0% of control samples. The non-European variants AA and Af1, rarely detected in control samples, represent 33.3% of all HPV-16 infections in invasive cervical carcinoma (with a peak of 19.4% and 13.9%, respectively), showing a statistically significant increase in frequency in more advanced lesions (chi(2) trend = 7.2; P < 0.05). The prevalence of HPV-16 Ep-T350, however, is higher in controls (43.7%) and in of cervical intraepithelial neoplasia grade 1 (41.2%) than in cervical intraepithelial neoplasia grade 2-3 (28.6%) and in invasive cervical carcinoma (11.1%) cases strongly suggesting lack of progression for pre-neoplastic lesions associated with such variant. The increased frequency of non-European variants in invasive lesions suggests that they are more oncogenic than European variants. This could have implications for future diagnostic and therapeutic strategies.
Tornesello
Maria Lina
ML
Viral Oncology and AIDS Reference Centre, National Cancer Institute, Fond. Pascale, Naples, Italy.
Duraturo
Maria Luisa
ML
Salatiello
Immacolata
I
Buonaguro
Luigi
L
Losito
Simona
S
Botti
Gerardo
G
Stellato
Giovanni
G
Greggi
Stefano
S
Piccoli
Roberto
R
Pilotti
Silvana
S
Stefanon
Bernardina
B
De Palo
Giuseppe
G
Franceschi
Silvia
S
Buonaguro
Franco M
FM
D000328:Adult; D000368:Aged; D036022:Capsid Proteins / Q000235:genetics; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D005814:Genes, Viral; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D017720:Molecular Epidemiology; D009856:Oncogene Proteins, Viral / Q000235:genetics; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D050725:Papillomavirus E7 Proteins; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology*; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012097:Repressor Proteins / Q000235:genetics; D017422:Sequence Analysis, DNA; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*
D036022:Capsid Proteins; C068651:E6 protein, Human papillomavirus type 16; D009856:Oncogene Proteins, Viral; D050725:Papillomavirus E7 Proteins; D012097:Repressor Proteins; C059731:oncogene protein E7, Human papillomavirus type 16; C063317:L1 protein, Human papillomavirus type 16