PREVAILING PAPILLOMAVIRUS TYPES IN NONMELANOMA CARCINOMAS OF THE SKININ RENAL-ALLOGRAFT RECIPIENTS

The role of human papillomavirus (HPV) in the aetiology of in site and invasive carcinoma of the genital tract is well established. In the r are disorder epidermodysplasia verruciformis (EV), in which patients d evelop extensive warts of unusual types and multiple cutaneous squamou s cancers on light-exposed skin, current evidence suggests a probable role for a specific group-of EV HPVs in the carcinogenic process. Dete rmination of the possible role of HPV in the aetiology of non-melanoma skin cancers (NMSCs), which occur frequently in immunosuppressed orga n allograft recipients, has been limited, until recently, by the lack of availability of a sensitive detection system for a wide range of cu taneous HPV types, We have used a combination of 2 sets of PCR primers to examine 68 benign and malignant tumours collected over a 12-year p eriod from 25 renal allograft recipients. Cloning and sequencing of th e PCR products were carried out to distinguish HPV DNA from cellular s equences. A combination of these techniques revealed HPV DNA in all vi ral warts, 65% of keratoses, 91 % of intra-epidermal cancers and 91% o f invasive squamous cancers. Both cutaneous and EV HPV types were dete cted, including 18 novel types. In 4 patients with multiple cancers, t he most prevalent types were in the EV group: HPV 20, 23, 38 and 2 nov el types, DL40 and DL267 (related to HPV IO and 38, respectively). The se 5 HPV types were present in a total of 73% of all malignant lesions tested. The technique described represents a reliable method of HPV D NA detection in NMSC. The EV group of HPVs predominate in the cancers, but the multiplicity of HPV types detected with double infection in s ome lesions suggests virus/virus in addition to virus/host interaction in the carcinogenic process. (C) 1997 Wiley-Liss, Inc.