title: Human papilloma virus is not detectable in samples of urothelial bladder cancer in a central European population: a prospective translational study.
abstract: BACKGROUND
  Previous investigations on the association of human papillomavirus (HPV) and human bladder cancer have led to conflicting results. The aim of this study was to determine if low and high risk HPV play a role in the etiology of superficial low grade and invasive high grade urothelial carcinoma of the bladder.
  
  
  METHODS
  We prospectively collected tumor samples of urothelial carcinoma of the bladder from 109 patients treated with transurethral resection or cystectomy, with bladder tissue from transurethral resection of the prostate serving as control. Unfixed, frozen tumor samples were analyzed for the presence of 14 high risk HPV types using real time PCR. Additionally, all specimens were tested for 35 low risk HPV types with a conventional PCR using degenerate primers located in the L1 region. Six frozen samples of cervical carcinoma served as positive controls.
  
  
  RESULTS
  We included 109 cases of bladder cancer with 41 superficial (pTa low grade) tumors, 56 invasive (pT1-T4) high grade tumors and 12 others (pTa high grade + pTis). We have not detected HPV-DNA in any sample (95 % Confidence Interval [CI] 0-3.3 %), superficial tumors (95 % CI 0-6.4 %) or in invasive tumors (95 % CI 0-8.6 %) with correct positive controls.
  
  
  CONCLUSIONS
  Using a broad, sensitive assay with prospectively collected specimens of a Central European population we could not detect HPV-DNA in any of the cases. Our results suggest that it is unlikely that HPV infections play a major role in the development of urothelial bladder cancer.
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.|http://www.mriu.de.
authors.forename: Sebastian C
authors.initials: SC
authors.lastname: Schmid
authors.affiliation: Department of Virology, Technische Universität/Helmholtz Zentrum München, Munich, Germany.
authors.forename: Leonore
authors.initials: L
authors.lastname: Thümer
authors.affiliation: Institute of Medical Statistics and Epidemiology, Technische Universität München, Munich, Germany.
authors.forename: Tibor
authors.initials: T
authors.lastname: Schuster
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Horn
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Kurtz
authors.affiliation: Institute of Pathology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Slotta-Huspenina
authors.affiliation: Department of Virology, Technische Universität/Helmholtz Zentrum München, Munich, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Seebach
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Straub
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Autenrieth
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Kübler
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Margitta
authors.initials: M
authors.lastname: Retz
authors.affiliation: Department of Virology, Technische Universität/Helmholtz Zentrum München, Munich, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Protzer
authors.affiliation: Department of Urology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
authors.forename: Jürgen E
authors.initials: JE
authors.lastname: Gschwend
authors.affiliation: Department of Virology, Technische Universität/Helmholtz Zentrum München, Munich, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoffmann
keywords: Bladder cancer; HPV; PCR; Papillomavirus; Polymerase chain reaction; Urothelial carcinoma