March 2, 2007

No Link Between Viral Findings In The Prostate And Subsequent Cancer Development Recently, mutations in genes associated with immune defense and a link to the development of prostate cancer (CaP) has been proposed by several scientific studies. In addition, epidemiologic reports suggest that men with prior history of sexually transmitted infections have an increased relative risk for development of CaP. Based upon these reports Dr. Bergh and associates from Umed University and Karolinska Institute, Sweden investigated whether the presence of genetic traces viral infections in the prostate correlated with histological inflammation and a subsequent diagnosis of CaP. They did not find an association and report this in the on-line version of the British Journal of Cancer.

The research was a case-control study of 402 patients with benign prostatic hyperplasia who underwent transurethral resection of the prostate. Median patient age was 64 years and specimens were paraffin-embedded. A total of 201 men developed CaP at least 6 months after the TURP. For each case, a control was randomly selected from a group of patients that did not develop CaP. The case-controls were matched for age, residence and year of surgery. TURP specimens were graded for degree of histological inflammation as mild or severe. DNA from prostate tissue was purified and checked for integrity. Tissue was examined for genetic traces of EBV, herpes simplex virus (HSV) 1 and 2, cytomegalovirus (CMV), adenovirus, HPV, polyoma viruses BKV and JCV and Candida albicans. Nested PCR assays were used for all except HPV and C. albicans. Positive PCR findings were verified by sequencing.

Of the 402 samples tested, 352 (87.6%) were positive for the human ОІ-globin gene. This suggested sufficient DNA quality. Of the 352 samples, 31 (8.8%) were positive for EBV and 10 (2.8%) for JCV. No other viral DNAs were detected. Of 240 samples that were available for C. albicans specific PCR, 2 (0.8%) were positive. The detection of EBV, JCV and C. albicans was then tested for correlation with subsequent CaP development. A total of 159 matched case-control pairs with complete information on EBV and JCV and 115 pairs with complete information for C. albicans were available. Of the 29 positive EBV samples, 15 (9.4%) were in the case group and progressed to CaP and 14 (8.8%) were in the control group. The two samples with C. albicans were found in the case group. There was no difference in the occurrence of severe inflammation in the EBV or JCV positive samples vs. virus-negative samples.

The outcomes of this study suggest that the examined viruses are unlikely to contribute to CaP development. However, the results are very methodology dependent and the incidence of samples with viral infection was less than 10% for every virus selected.

J Bergh, I Marklund, C Gustavsson, F Wiklund, H Grönberg, A Allard, O Alexeyev, F Elgh
British Journal of Cancer advance online publication 21 November 2006

Reviewed by Contributing Editor Christopher P. Evans, MD

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