Detection of human cytomegalovirus in patients with epithelial ovarian cancer and its impacts on survival

• Published in: Infectious agents and cancer Vol. 15; no. 1; pp. 23 - 8
• Main Authors: Yin, Min, Chen, Aiping, Zhao, Fei, Ji, Xuechao, Li, Chuan, Wang, Guangning
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.04.2020; BioMed Central; BMC
• Subjects: Adjuvant chemotherapy; Age; Benign; Cancer patients; Cancer therapies; Carcinogenesis; Care and treatment; Cell proliferation; Chemotherapy; Chronic infection; Clinical outcomes; Cytomegalovirus; Cytomegalovirus infections; Deoxyribonucleic acid; Development and progression; DNA; Epithelial ovarian cancer; Hospitals; Human cytomegalovirus; Human papillomavirus; Immunohistochemistry; Immunology; Infection; Infections; Inflammation; Medical ethics; Medical prognosis; Medical research; Multivariate analysis; Ovarian cancer; Paraffin; Pathology; Patient outcomes; Patients; Pp65 protein; Protein expression; Proteins; Risk factors; Studies; Surgery; Survival; Survival analysis; Tegument; Tumors; Vascular diseases; Viral carcinogenesis; Virus diseases; China; United States > US; Epithelial ovarian cancer; Survival; Viral carcinogenesis; Human cytomegalovirus
• ISSN: 1750-9378; 1750-9378
• DOI: 10.1186/s13027-020-00289-5

The cause of epithelial ovarian cancer (EOC) is not elucidated. Viral infection may induce chronic inflammatory infection and play a role in the pathogenesis of cancers. Some viruses are considered to be oncomodulatory, modulating cellular pathways such as cell proliferation, tumor progression, vascular disease development, and immune evasion. Human cytomegalovirus (HCMV) has been detected in several types of cancers including ovarian cancer. However, the role of HCMV in ovarian carcinogenesis remains controversial. To investigate the potential role of HCMV infection in EOC, we evaluated the prevalence of HCMV proteins in EOC tissue and its impacts on patients' survival. Formalin-fixed paraffin-embedded tissues from 66 patients with EOC and 30 patients with benign ovarian cystadenoma were studied. Specimens were analyzed for expression of HCMV immediate early protein (IE) and HCMV tegument protein (pp65) by immunohistochemistry. HCMV-IE protein expression was detected in 82% of EOC and 36% of benign tumors; pp65 was detected in 97% of EOC and 63% of benign tumors. Extensive HCMV-IE protein expression was associated with higher stage of EOC. Reactivation of latent HCMV within the tumor at interval debulking surgery may be induced by neoadjuvant chemotherapy before surgery. Extensive HCMV-IE expression was associated with shorter median overall survival than focal or negative expression (39 versus 41 months,  = 0.03). Multivariate analysis indicated that HCMV-IE expression was an independent prognostic factor for overall survival (  = 0.034). This study demonstrate a high prevalence of HCMV proteins in tissue sections from patients with EOC. HCMV infection can be potential risk factor for EOC development. Extensive HCMV-IE expression indicated a poor prognosis. The relationship between HCMV and clinical outcomes highlight the need for further researches on the oncomodulatory role of HCMV in ovarian cancer.