Failure to Demonstrate Human Papillomavirus DNA in Epithelial Ovarian Cancer by General Primer PCR

abstract & commentary

Source: Anttila M, et al. Gynecol Oncol 1999; 72:337-341.

Synopsis: Human papillomavirus DNA was not found in 98 ovarian cancer samples.

Scattered reports throughout the available literature have suggested that human papillomavirus (HPV) DNA can be found in a small percentage of ovarian cancers. However, more recent reports using the most modern techniques have failed to detect HPV DNA in ovarian cancer.

Anttila and colleagues randomly selected 98 cases of epithelial ovarian cancer from a series of 445 patients. Using the most stringent conditions and modern techniques, Anttila et al failed to identify HPV DNA in any of the ovarian cancer samples.

This study, performed by a team of experienced HPV investigators, is the largest series reported in the literature to date. Based on their results and those of most recent investigators, it is unlikely that HPV DNA plays a role in the development of epithelial ovarian cancer.

Comment by Kenneth Noller, MD

Those of us in gynecology have become so focused on the fact that the presence of an HPV infection seems to be necessary for the development of significant cervical neoplasia that we often forget the virus has been linked to many other epithelial cancers. Most of the head and neck squamous cancers have now been linked to prior HPV infections; most cases of esophageal cancer have demonstrable HPV DNA; anal cancers almost always show HPV DNA incorporated into the cancer cell nuclei. It is not surprising that other epithelial cancers have been studied for the presence of HPV. Because so much of the interest in this virus has been a result of its role in cervical cancer, it is not surprising that all gynecologic malignancies have been investigated. Of course, vaginal and vulvar cancers are usually HPV DNA positive. But what about ovarian cancer? So little is known about its origin that any clue would be helpful.

Many investigators have studied at least a few cases of ovarian cancer. About one in four of the analyzed tumors has shown evidence of HPV DNA. However, most of those reports are old and used suboptimal technology.

The current report is particularly interesting because it has been written by one of the leading teams of HPV investigators in the world. The fact that Anttila et al found no traces of HPV DNA in 98 epithelial ovarian cancers strongly suggests that the virus does not play a role in the development of this disease.

As an aside, whenever I see an article published by Anttila et al, I make time to read it in detail. They continue to be one of the best sources for reliable information concerning HPV.

Anttila et al studied 98 epithelial ovarian cancers for the presence of HPV DNA. What percentage of the cases were positive for HPV 33?

    a. 0%
    b. 12%
    c. 23%
    d. 46%
    e. 91%