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

• Published in: Clinical breast cancer 2018-08, Vol.18 (4), p.e629-e642
• Main Authors: El Shazly, Dalia F., Bahnassey, Abeer A., Omar, Omar S., Elsayed, Elsayed T., Al-Hindawi, Ali, El-Desouky, Eman, Youssef, Hend, Zekri, Abdel-Rahman N.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Viral - analysis; Biomarkers, Tumor - metabolism; Breast Neoplasms - epidemiology; Breast Neoplasms - pathology; Breast Neoplasms - virology; CMV PP65; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - epidemiology; DNA, Viral - blood; Egypt - epidemiology; Enzyme-linked immunosorbent assay; Female; Fibroadenoma - epidemiology; Fibroadenoma - pathology; Fibroadenoma - virology; HCMV DNA; Humans; Immunohistochemistry; Middle Aged; Real-time PCR; Real-Time Polymerase Chain Reaction; Viral Proteins - analysis; Young Adult
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2017.10.018

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. 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. 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). 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). The presence of CMV proteins and DNA in BC tissues suggests a role for this virus. How