Human papillomavirus and colorectal cancer: evidences and pitfalls of published literature.
OBJECTIVE
The aim of this study is to review published literature regarding a possible role of human papillomavirus (HPV) infection in colorectal cancer in order to understand if HPV infection plays an active role in colorectal carcinogenesis and to highlight evidences and pitfalls of published studies.


METHODS
We reviewed literature by searching PubMed, Ovid, and the Cochrane databases for published series investigating HPV and colorectal cancer from 1988 to date.


RESULTS
Twenty-one studies investigating a possible correlation between HPV infection and colon cancer have been published. We reviewed 15 case-control studies and six studies investigating a possible role for HPV virus in colorectal carcinogenesis. HPV was detected in the majority of reported series with a significant difference in HPV infection between tumors and disease-free controls or tumor-adjacent tissue; the HPV mean detection rate within carcinomas was 41.7%, comparing to a mean detection rate of 32.8% in adjacent colic mucosae, and 5.8% in disease-free controls (Chi-square test, p = 0.001). The correlation between HPV infection and c-myc amplification, k-ras mutation, and p53 polymorphism or mutations has been investigated; however, the possible role of HPV in colorectal carcinogenesis was not defined.


CONCLUSIONS
HPV has been detected in the majority of reported series, but published literature lacks in definitive data regarding standard methods of investigation and stratification of groups and population. These data encourage further studies with the aim to investigate the presence of the virus in larger series, its possible role in oncogenesis, the integration in host genome, the expression of viral oncoproteins, the mutations in HPV positive cancers and routes of colon infection (hematologic/lymphatic spreading or perineal diffusion).
Lorenzon
Laura
L
II Faculty of Medicine and Surgery, University of Rome La Sapienza, St. Andrea Hospital, Rome, Italy. laura.lorenzon@uniroma1.it
Ferri
Mario
M
Pilozzi
Emanuela
E
Torrisi
Maria Rosaria
MR
Ziparo
Vincenzo
V
French
Deborah
D
D035843:Biomedical Research; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000821:virology*; D006801:Humans; D027383:Papillomaviridae / Q000302:isolation & purification / Q000502:physiology*; D011642:Publications
J Microbiol Immunol Infect. 2001 Jun;34(2):87-91
11456365
Yonsei Med J. 2006 Feb 28;47(1):1-14
16502480
J Surg Res. 1990 May;48(5):397-402
2161968
Proc R Soc Med. 1965 May;58:295-300
14283879
Eur J Surg Oncol. 2007 Jun;33(5):569-74
17321098
Front Biosci. 2006 Sep 01;11:2286-302
16720315
Eur J Surg Oncol. 1991 Oct;17(5):507-13
1657651
Br J Cancer. 2007 May 7;96(9):1320-3
17375045
J Clin Virol. 2001 May;21(2):129-34
11378493
World J Gastroenterol. 2006 Mar 7;12(9):1426-9
16552814
Clin Cancer Res. 2005 Apr 15;11(8):2862-7
15837733
Acta Virol. 1988 Jul;32(4):303-8
2903634
Gut. 1995 Jul;37(1):87-90
7672688
N Engl J Med. 2003 Mar 6;348(10):919-32
12621137
Oncol Rep. 2003 Nov-Dec;10(6):2089-92
14534749
Colorectal Dis. 2005 Sep;7(5):492-5
16108887
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):2970-9
18990738
Anticancer Res. 2005 Jul-Aug;25(4):2767-9
16080524
Arch Surg. 1995 Jan;130(1):73-6
7802580
Am J Surg. 1993 Dec;166(6):738-40; discussion 741-2
8273860
Res Commun Mol Pathol Pharmacol. 2001 Jul;109(1-2):25-34
11458982
Dis Colon Rectum. 1991 Jun;34(6):469-74
1645245
J BUON. 2009 Jul-Sep;14(3):495-9
19810144
J Surg Oncol. 1992 Sep;51(1):5-7
1325576
N Engl J Med. 2009 Dec 17;361(25):2449-60
20018966
J Pathol. 2007 Aug;212(4):356-67
17573670
Arch Surg. 1990 Jul;125(7):862-5
2164371
Med Oncol. 2011 Mar;28(1):127-32
20082157
BMC Cancer. 2006 May 04;6:115
16672071