Characterisation of anal intraepithelial neoplasia and anal cancer in HIV-positive men by immunohistochemical markers p16, Ki-67, HPV-E4 and DNA methylation markers.


Journal

International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124

Informations de publication

Date de publication:
15 11 2021
Historique:
revised: 07 06 2021
received: 12 04 2021
accepted: 05 07 2021
pubmed: 27 7 2021
medline: 23 11 2021
entrez: 26 7 2021
Statut: ppublish

Résumé

Human papillomavirus (HPV)-induced anal intraepithelial neoplasia (AIN, graded 1-3) is highly prevalent in HIV-positive (HIV+) men who have sex with men (MSM), but only a minority of lesions progresses to cancer. Our study aimed to characterise comprehensively anal tissue samples from a cross-sectional series (n = 104) of HIV+ MSM and longitudinal series (n = 40) of AIN2/3 progressing to cancer using different biomarkers. The cross-sectional series consisted of 8 normal, 26 AIN1, 45 AIN2, 15 AIN3 and 10 anal squamous cell carcinoma. Tissue sections were immunohistochemically (IHC) stained for p16 (viral transformation marker), Ki-67 (cellular proliferation marker) and HPV-E4 (viral production marker). We evaluated the expression of IHC markers and compared it with DNA methylation, a marker for malignant transformation. E4 positivity decreased, whereas p16 and Ki-67 scores and methylation marker positivity increased (P values < .001) with increasing severity of anal lesions. Within AIN2, a heterogeneous biomarker pattern was observed concerning E4, p16 and methylation status, reflecting the biological heterogeneity of these lesions. In the longitudinal series, all AIN2/3 and carcinomas showed high p16 and Ki-67 expression, strong methylation positivity and occasional E4 positivity. We earlier showed that high methylation levels are associated with progression to cancer. The observed E4 expression in some AIN2/3 during the course of progression to cancer and absence of E4 in a considerable number of AIN1 lesions make the potential clinical significance of E4 expression difficult to interpret. Our data show that IHC biomarkers can help to characterise AIN; however, their prognostic value for cancer risk stratification, next to objective methylation analysis, appears to be limited.

Identifiants

pubmed: 34310698
doi: 10.1002/ijc.33748
pmc: PMC9292283
doi:

Substances chimiques

Biomarkers, Tumor 0
Cyclin-Dependent Kinase Inhibitor p16 0
Ki-67 Antigen 0
Oncogene Proteins, Viral 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1833-1844

Informations de copyright

© 2021 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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Auteurs

Ramon P van der Zee (RP)

Department of Pathology, Cancer Center Amsterdam (CCA), Amsterdam University Medical Centers (Amsterdam UMC), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Chris J L M Meijer (CJLM)

Department of Pathology, Cancer Center Amsterdam (CCA), Amsterdam University Medical Centers (Amsterdam UMC), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Tamzin Cuming (T)

Anal Neoplasia Service, Homerton University Hospital, London, UK.

Alexander Kreuter (A)

Department of Dermatology, Venerology and Allergology, Helios St. Elisabeth Hospital Oberhausen, University Witten/Herdecke, Oberhausen, Germany.

Miekel M van de Sandt (MM)

DDL Diagnostic Laboratory, Rijswijk, The Netherlands.

Wim G V Quint (WGV)

DDL Diagnostic Laboratory, Rijswijk, The Netherlands.

Henry J C de Vries (HJC)

Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands.

Jan M Prins (JM)

Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Renske D M Steenbergen (RDM)

Department of Pathology, Cancer Center Amsterdam (CCA), Amsterdam University Medical Centers (Amsterdam UMC), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

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Classifications MeSH