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Die Detektion von Papillomavirus-DNA in der Prostata

Ein Virus mit unterschätzter klinischer Relevanz?

Detection of papillomavirus DNA in the prostate

A virus with underestimated clinical relevance?

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Zusammenfassung

Hintergrund

Humane Papillomaviren (HPV) sind die am häufigsten sexuell übertragenen Krankheitserreger. Sie werden mit der steigenden Inzidenz verschiedener anogenitaler Tumoren in Zusammenhang gebracht. Die Präsenz von HPV in der Prostata und der Stellenwert des Virus in der Karzinogenese des Prostatakarzinoms (PCA) sind Gegenstand kontroverser Diskussionen. Den Hintergrund der Untersuchung bildet die Frage, ob eine Assoziation zwischen dem Nachweis von intraprostatischen HPV und dem PCA besteht.

Material und Methode

Die Daten von 213 konsekutiven Patienten wurden ausgewertet (mittleres Alter: 65,7±8,4 Jahre), bei denen im Rahmen der transrektalen ultraschallgestützten Multibiopsie der Prostata ein zusätzlicher Stanzzylinder mittels PCR auf Bakterien-, Pilze- und Viren-DNA (unter Einschluss von HPV) mit anschließender Sequenzierung untersucht wurde. Die so erhobenen Daten wurden neben dem histologischen Ergebnis mit diversen klinischen Parametern korreliert. Mit dem binären logistischen Regressionsmodell wurde der Einfluss der vorliegenden Erreger auf die Existenz des PCA geprüft.

Ergebnisse

Der Nachweis von allgemeiner Bakterien-DNA (16S rDNA) gelang nicht. 145 der 213 Patienten (68,1%) wiesen HPV-DNA in der PCR auf. In 64% (n=137) wurde High-risk-HPV-DNA beschrieben, bei jeweils 18% waren es die HPV-Genotypen 16 und 18. In unserer Untersuchung bestand kein signifikant positives Verhältnis zwischen dem HPV-Nachweis und einem histologisch verifizierten PCA, das bei 23,5% der Patienten (n=50) gefunden wurde (Odds-Ratio=1,45; 95%-Konfidenzintervall=0,71–2,91). Der BK-Virus war in keinem der Stanzzylinder durch die PCR nachweisbar.

Schlussfolgerungen

Trotz fehlender positiver Korrelation zwischen HPV-DNA und PCA in der vorliegenden Untersuchung weisen Daten aus der Literatur auf einen Einfluss der Papillomaviren auf die Karzinogenese des PCA hin. Zukünftige Studien müssen klären, inwieweit die HPV-DNA in das Erbgut der Prostatazellen eingebaut wird und dann über einzelne Gene in der Lage ist, eine maligne Transformation zu bewirken.

Abstract

Background

Human papillomaviruses (HPV) are the most frequent pathogens of sexually transmitted diseases. They have been associated with an increased incidence of several anogenital tumors. Whether oncogenic HPV are involved in the pathogenesis of prostate cancer has been a subject of great controversy. This study’s purpose was to investigate the association between HPV infection and prostate cancer (PCA).

Material and methods

The study included 213 consecutive patients with an average age of 65.7 (±8.4) years. Within the framework of transrectal, ultrasonic-guided multibiopsy of the prostate, one additional core was examined by means of polymerase chain reaction (PCR) in relation to bacterial, fungal, and viral (including HPV) DNA, with subsequent DNA sequencing. The collected data were correlated with the histological results and with diverse clinical variables. The influence of several predictors for the existence of PCA was verified with a logistic regression model.

Results

No general bacterial DNA (16S rDNA) was detected. Of the 213 patients, 145 (68.1%) showed HPV DNA. In 64% (n=137), high-risk HPV DNA were depicted; these were 18% of the total in each case of HPV genotypes 16 and 18. From our examinations, no significant positive correlation existed between the HPV evidence and the histologically verified PCA that was found in 23.5% of the patients (n=50; odds ratio 1.45; 95% confidence interval 0.71–2.91). The BK virus was not found in any of the cores confirmed through PCR.

Conclusion

Although no positive correlation between HPV infection and PCA existed in our study, data from the literature suggest an influence of the papillomavirus on PCA oncogenesis. Future studies should highlight to what extent HPV DNA is inserted in the genome of prostate cells and is able to cause subsequent malignant transformation of particular genes.

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Danksagung

Diese Forschungsstudie wurde von der Bayer Vital GmbH und der Brandenburgischen Gesellschaft für Urologie unterstützt. Die Autoren danken beiden Institutionen für ihren Anteil an der Finanzierung der Untersuchungen. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Urologische Klinik, Carl-Thiem-Klinikum Cottbus, Lehrkrankenhaus der Universitätsklinik Charité zu Berlin, Thiemstraße 111, 03048, Cottbus, Deutschland

    M. May, B. Hoschke, S. Brookman-Amissah, K.-P. Braun & C. Helke

  2. Institut für Medizinische Mikrobiologie, Carl-Thiem-Klinikum, Cottbus, Deutschland

    R. Kalisch, T. Juretzek, I. Spivak & W. Bär

  3. Klinik für Urologie und Kinderurologie, Justus-Liebig-Universität, Gießen, Deutschland

    F. Wagenlehner

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  1. M. May
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  2. R. Kalisch
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  3. B. Hoschke
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Correspondence to M. May.

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May, M., Kalisch, R., Hoschke, B. et al. Die Detektion von Papillomavirus-DNA in der Prostata. Urologe 47, 846–852 (2008). https://doi.org/10.1007/s00120-008-1694-5

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