Elsevier

Seminars in Oncology

Volume 36, Issue 6, December 2009, Pages 542-552
Seminars in Oncology

Lung cancer in women
Human Papilloma Virus and Female Lung Adenocarcinoma

https://doi.org/10.1053/j.seminoncol.2009.10.002Get rights and content

Lung cancer is the leading cause of cancer among women worldwide, and adenocarcinoma is the most common histological subtype among non-smoking women. Previous studies showed that human papillomavirus (HPV) infection may relate to the tumorigenesis of pulmonary adenocarcinoma. Women with anogenital malignancy have a higher risk of lung cancer, which raises the possibility of HPV transmission from the cervix to the lung. Two postulated pathways are discussed in this work. First, HPV may infect the female cervix and then move to the lung by blood circulation. The second transmission route is the HPV infection of oral cavity resulting from dangerous sexual contacts, and subsequently transmitted to the lung. This chapter also reviews the techniques for detecting the existence, subtypes, and viral load of HPV. Future studies are needed to demonstrate the causal inference between HPV infection and the risk of female lung adenocarcinoma.

Section snippets

Human Papillomavirus

To date, more than 200 HPV subtypes have been identified. HPV is a circular double-strand DNA lasting for 8 kilobase pairs and containing three main regions: early (E genes), late (L genes), and the long control region (LCR).40 E1 and E2 proteins modulate viral replication and transcription. The function of E3 protein is not clear and it is present in only a few HPVs.40 E4 binds to cytoskeletal protein40 and manages the maturation and replication of the virus.41 The E4 protein also interacts

Postulated Mechanisms of HPV Infection and Lung Adenocarcinoma

Previous studies have shown that HPV infection may be a risk factor of lung adenocarcinoma, which is more prevalent among nonsmokers. Two possible transmission routes establish the link between HPV infection and the risk of lung adenocarcinoma (Figure 1). To unravel the etiology of lung adenocarcinoma among females, it is important to elucidate how HPV is transmitted into the lung. Two major transmission pathways are discussed below.

Molecular Approaches for Detecting HPV

Several techniques have been developed and applied to detect the existence of HPV DNA in human biospecimens. These techniques mainly fall into two categories: direct hybridization and PCR amplification methods, and are tabulated in Table 1.

Conclusions

HPV is difficult to culture in vitro. Due to its weak systemic antigenicity, serological testing is insensitive and nonspecific for HPV detection. Current techniques for HPV identification rely on the detection of its DNA. Therefore, hybridization and PCR-based techniques have been used to detect the existence of HPV and its subtypes. The hybridization approach has the limitations of low sensitivity, is time-consuming, and requires a large amount of DNA samples. In contrast, the PCR-based

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