title: Detection of human papillomavirus infection and p16 immunohistochemistry expression in bladder cancer with squamous differentiation.
abstract: OBJECTIVE
  To determine the potential association between HPV infection and the squamous cell component of urothelial carcinoma (UC) of the bladder and to validate p16 overexpression as a surrogate marker for HPV infection in these cancers among Koreans.
  
  
  METHODS
  We analyzed the presence of HPV infection using an HPV-DNA chip and the expression of p16 using immunohistochemistry in 47 subjects between July 2001 and March 2011. The study group (n = 35) included patients with squamous differentiation of UC of the bladder. The control group (n = 12) included patients with squamous metaplasia of the bladder.
  
  
  RESULTS
  Baseline characteristics of control and study groups were similar. HPV DNA detection rates were approximately 2-fold higher in the study than the control group (17.1% [6/35] versus 8.3% [1/12], respectively), but the difference was not statistically significant. P16 overexpression was detected in 16/35 (45.7%) study group and 1/12 (8.3%) control group samples (p = 0.034). Both HPV-positivity and p16 overexpression were present in 3/35 (8.8%) study group samples, but none of the control group (p = 0.295). In the study group, the percentage of HPV-positive cases who were non-smokers was 2-fold higher than the percentage of HPV-negative cases who were non-smokers (66.7% [4/6] versus 31.0% [9/29], respectively); however, statistical significance was not achieved due to the small sample size.
  
  
  CONCLUSIONS
  HPV infection may be associated with UC of the bladder with squamous differentiation, especially in non-smokers. However, p16 expression does not appear to be a strong surrogate marker for evidence of HPV infection in this type of cancer.
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Sung Han
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000821:virology; D002454:Cell Differentiation; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D015870:Gene Expression; D052162:Human papillomavirus 16 / Q000235:genetics*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000821:virology; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery / Q000821:virology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000821:virology
chemical_list: D004279:DNA, Viral