Human papilloma virus infection and overexpression of p53 protein in bilharzial bladder cancer

Aims and background: An association between human papilloma virus (HPV) and bladder cancer has been reported. However, the role of HPV in bilharzial b ladder cancer and its prevalence have not yet been clarified. Study design: We investigated 50 cases for HPV types 16/18 by in situ hybri dization. Also, p53 protein expression by immunohistochemistry was evaluate d in 41 of the 50 cases, with correlation of these factors to clinicopathol ogic parameters and tumor relapse after primary treatment. Results: HPV was detected in 46% of Egyptian bladder carcinomas (23/50 case s). Positivity was 47.8% for squamous cell carcinoma and 36.4% for transiti onal cell carcinoma. There was a possible viral-bilharzial association as 5 2.8% of Bilharzial cases, whereas only 12.5% of non-Bilharzial cases were H PV positive (P < 0.05). P53 protein was found in 19/41 (46.3%) cases. There was a concordance between HPV and p53 in 58.5% of cases. Neither factor wa s related to tumor recurrence after primary treatment. Conclusions: HPV may thus be implicated in the etiology of bilharzial bladd er cancer, but a definite causal relationship remains to be demonstrated. H PV together with p53 alterations work in synergy to accelerate the carcinog enic process, as there was concordance in the results of both parameters in 24/41 (58.5%) cases.