title: Role of human papillomavirus types 16, 18, and 52 in recurrent cystitis and urinary bladder cancer among Egyptian patients.
abstract: BACKGROUND
  Bladder cancer is a common malignancy in Egypt. Human papillomavirus (HPV) could have a possible etiologic role in bladder carcinogenesis. We aimed to estimate the prevalence of HPV-16, -18, and -52 in Egyptian patients with bladder cancer or recurrent cystitis, and to study the correlation of type-specific HPV-immunoglobulin (Ig)G with polymerase chain reaction (PCR) results and different clinicopathologic parameters.
  
  
  METHODS
  This study was conducted on 60 inpatients of the Urosurgery Department at the Theodor Bilharz Research Institute (TBRI), who were identified histopathologically and clinically as cancer bladder (group I, 20 patients), cystitis (group II, 24 patients), and cancer bladder with cystitis (group III, 16 patients), and a fourth group of 20 healthy control subjects (for serologic testing). Patients were subjected to detection of HPV-16 and -18 DNA by PCR on bladder tissue biopsies (BTB) and buffy coat cells (BCC) and serum IgG antibodies to L1 capsids of HPV-16 and -52 IgG by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  HPV-16 and -18 DNA were detected in BTB (30% and 10%, respectively) with significantly higher rates (44.4%) in bladder cancer than cystitis cases (11.11%), with significant association with schistosomal affection (78.6% and 25%, respectively) and recurrence (48%, HPV-16). There was a significant association of transitional cell carcinoma (TCC) with HPV-16 in 69.2% and 61.1% of BCC and BTB, respectively. Multiple HPV types 16, 18, and 52 were significantly higher than single types (79.2% and 20.8%, respectively). The observed absolute association between seropositivity of HPV-52 (11.7%) and HPV-16 (26.7%) was significantly associated with TCC in patient groups only.
  
  
  CONCLUSIONS
  Our study confirmed the significant association of HPV-16, -18 and -52 with bladder cancer in Egyptian patients, with the suggestion of viral synergistic action in bladder carcinogenesis. Such HPV types were significantly associated with TCC tumors of low grade and high stage, with schistosomal affection and recurrence tendency. HPV serology would pave the way for better management and follow-up of patients and for optimal design and evaluation of HPV vaccination.
authors.affiliation: Infection Control Unit, Theodor Bilharz Research Institute (TBRI), Giza, Egypt.
authors.forename: Hala
authors.initials: H
authors.lastname: Badawi
authors.forename: Hanem
authors.initials: H
authors.lastname: Ahmed
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ismail
authors.forename: Manal
authors.initials: M
authors.lastname: Diab
authors.forename: Magd
authors.initials: M
authors.lastname: Moubarak
authors.forename: Afkar
authors.initials: A
authors.lastname: Badawy
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003556:Cystitis / Q000821:virology*; D004534:Egypt; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections; D012008:Recurrence; D001749:Urinary Bladder Neoplasms / Q000821:virology*; D055815:Young Adult