Detection of Human Cytomegalovirus in Malignant and Benign Breast Tumors in Egyptian Women

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Abstract

Many studies have suggested that human cytomegalovirus (HCMV) is associated with several human malignancies, including breast cancer (BC). We assessed the presence of HCMV proteins (PP65 and early/immediate early [E/IE]) and DNA in blood and tissue samples and adjacent non-neoplastic tissues obtained from 61 BC patients and 20 patients with fibroadenoma (FA) cases. A significant difference was found in the index value of anti-CMV IgG antibodies between BC patients and the control group (P = .001). We found a significant association between the expression of CMV PP65 and E/IE proteins in the malignant and FA groups (P < .001). A statistically significant correlation was found between the expression of both viral proteins (PP65 and E/IE) and estrogen receptor–positive (ER+)/HER2neu−, progesterone receptor–positive (PR+)/HER2neu−, and ER+, PR+/HER2neu− BC cases. The concordance between the results obtained by the different assays was low.

Introduction:

Previous studies have reported a role for human cytomegalovirus (HCMV) in breast carcinogenesis. We sought to assess the role of HCMV infection in the development and/or progression of breast cancer (BC) among Egyptian patients.

Patients and Methods:

The study included 61 patients with BC cases. Of these 61 patients, 40 had been assessed for HCMV in the blood, BC tissue samples, and adjacent non-neoplastic tissue samples, and 21 had been assessed for HCMV in the tissue only. Tissue samples from 20 patients with fibroadenoma (FA) were also included. As a control group, 41 blood samples obtained from healthy women with no history of cancer were used as a blood control group. HCMV was assessed using enzyme-linked immunosorbent assay, real-time polymerase chain reaction (PCR), and immunohistochemistry (IHC).

Results:

A significant difference was found in the index value for the anti-CMV IgG antibodies between the BC patients and the control group (P = .001). Using real-time PCR, HCMV DNA was detected in 11 of 61 BC tissues (18%) compared with 1 of 20 FA tissues (5%). HCMV DNA was present in 8 of the 40 plasma samples (20%). Regarding the viral proteins, 21 of 61 samples (34.4%) were positive for early/immediate early (E/IE) and 49 (80.3%) were positive for PP65 expression by IHC. The concordance between the results obtained by the different assays was low. CMVPP65 expression was significantly associated with E/IE protein expression in the malignant and FA groups (P < .001).

Conclusion:

The presence of CMV proteins and DNA in BC tissues suggests a role for this virus. However, the basic criteria to support a causal association of HCMV with BC were not fulfilled.

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