Specific expression of Epstein-Barr virus in cutaneous squamous cell carcinomas from heart transplant recipients

Background We investigated a Swedish group of 114 immunosuppressed cardiac allograft patients for the occurrence of posttransplant cutaneous squamous cell carcinomas; A total of 15 tumors were detected in specimens from 5 pat ients. Methods. The tumors were analyzed for the presence of Epstein-Barr virus (E BV) genomes as well as EBV-specific gene expression by using three differen t techniques; the polymerase chain reaction (PCR), in situ hybridization, a nd immunohistochemistry, The material was also tested by PCR for high-risk human papilloma virus genome. Results. EBV DNA could be detected by PCR in 10 of the investigated tumors, 7 of which also expressed EBV latent membrane protein 1 and/or EBV-encoded RNAs. No EBV genomes or EBV gene products could be detected in normal skin /resection margins, available from three of the tumors investigated. All tu mors were negative for high-risk human papilloma virus DNA analyzed by PCR. Conclusions. In this study, we have found a high incidence of EBV-specific expression in posttransplant cutaneous squamous cell carcinomas. These resu lts suggest that at least some of the skin cancers developing in immunocomp romised heart transplant recipients are associated with EBV.