Clonality analysis of synchronous lesions of cervical carcinoma based on X chromosome inactivation polymorphism, human papillomavirus type 16 genome mutations, and loss of heterozygosity.

One of the most common forms of carcinoma in women, cervical invasive squamous cell carcinoma (CIC), often coexists with multiple lesions of cervical intraepithelial neoplasia (CIN). CIC and CIN show heterogeneity with respect to both histopathology and biology. To understand the causes, origin, and model of progression of cervical carcinoma, we assessed the clonality of a case with multiple synchronous lesions by analyzing X chromosome inactivation polymorphism, human papillomavirus type 16 (HPV16) sequence variation/mutations, and loss of heterozygosity (LOH). Microdissection was performed on 24 samples from this case, representing the entire lesional situation. The combination of different X chromosome inactivation patterns, two HPV16 point mutations, and LOH at three genomic microsatellite loci, led to the identification of five different "monoclonal" lesions (CIN II, CIN III, and invasive carcinoma nests) and five different "polyclonal" areas (CIN II and normal squamous epithelium). This finding indicated that CIC can originate from multiple precursor cells, from which some clones might progress via multiple steps, namely via CIN II and CIN III, whereas others might develop independently and possibly directly from the carcinoma precursor cells. Our results also supported the view that HPV16 as a "field factor" causes cervical carcinoma, which is probably promoted by the loss of chromosomal material as indicated by the LOH.

Multiple variants of HPV16 E6 gene in cervical invasive squamous cell carcinoma.

BACKGROUND: HPV16 is the most commonly detected genotype in cervical squamous cell carcinoma. E6 of HPV16 is a viral oncogene and has frequent DNA sequence variations whose encoded proteins have been shown to have heterogeneity in biochemical and biological properties. This study tried to establish whether the E6 variants derive from the infection pool or from spontaneous mutation in the host. MATERIALS AND METHODS: We combined the use of microdissection of multiple areas of tumor tissue, PCR-sequencing of HPV16 E6 and E5 genes and allele-specific amplification of PCR to analyze the E6 variations in four cases of cervical cancer (M4, M12, M13 and M23). RESULTS: We isolated two common (350G and 350T) and three rare (310G, 374T and 459C) E6 variations corresponding to five different E6 variants. The common E6 variations were always co-segregated with specific E5 variations. Both common variants persisted in all the four cases. Of three cases each had one additional rare E6 variant. CONCLUSION: The common E6 variants would derive from the infection pool, whereas the rare E6 variants may evolve from the mutation of either of the common E6 variants. This finding might have implications for the future study of natural HPV evolution, the design of viral vaccine and the carcinogenesis of cervical cancer.