Human papilloma virus in melanoma biopsy specimens and its relation to melanoma progression

Objectives To evaluate melanoma biopsy specimens for human papilloma virus (HPV) and d etermine the relation between the presence of HPV, in vitro growth, and cli nical progression of melanoma in the patients from whom the biopsy specimen s were derived. Summary Background Data Ultraviolet radiation from sun exposure appears to be the primary causal ag ent in the development of cutaneous melanoma, However, other agents, includ ing HPV, as observed in different epithelial carcinomas, may also play a ro le in melanoma development and progression. Methods Twelve melanoma biopsy specimens obtained from 12 patients with AJCC stage III and IV melanoma were stained with antibodies against gp-100 (HMB-45) an d S-100 protein to confirm melanoma diagnosis and with a polyclonal HPV ant ibody. After mechanical dissociation, the melanoma specimen cells' ability to grow in vitro was assessed. Patients were evaluated for melanoma progres sion with physical examination complete blood count, and liver function tes ts every 3 months and a chest radiograph every 6 months. Results All biopsy specimens were positive for S-100, and nine (75%) were positive for gp-100. Seven of 12 (58%) were positive for HPV by immunohistochemistry . in vitro, none of the HPV-negative tumor cells grew from the tumor biopsi es, whereas five of seven (71%) of the HPV-positive melanoma tumor cells gr ew very well, All patients with HPV-positive tumor cells had recurrences an d died of melanoma progression, whereas four of five (80%) patients with HP V-negative tumor cells remained alive and without melanoma recurrence. Conclusions The presence of HPV was found in 58% of the biopsy specimens obtained from patients with stage III and IV melanoma and correlated with rapid melanoma progression. HPV may serve as a cofactor in the development of melanoma and may modulate a more aggressive phenotype in HPV-containing melanoma cells.