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Specific expression of Epstein-Barr virus in cutaneous squamous cell carcinomas from heart transplant recipients
A Ternesten-Bratel1, C Kjellström, A Ricksten
1Institute of Laboratory Medicine, Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden.
Background:
We investigated a Swedish group of 114 immunosuppressed cardiac allograft patients for the occurrence of posttransplant cutaneous squamous cell carcinomas. A total of 15 tumors were detected in specimens from 5 patients.
Methods:
The tumors were analyzed for the presence of Epstein-Barr virus (EBV) genomes as well as EBV-specific gene expression by using three different techniques; the polymerase chain reaction (PCR), in situ hybridization, and immunohistochemistry. The material was also tested by PCR for high-risk human papilloma virus genome.
Results:
EBV DNA could be detected by PCR in 10 of the investigated tumors, 7 of which also expressed EBV latent membrane protein 1 and/or EBV-encoded RNAs. No EBV genomes or EBV gene products could be detected in normal skin/resection margins, available from three of the tumors investigated. All tumors were negative for high-risk human papilloma virus DNA analyzed by PCR.
Conclusions:
In this study, we have found a high incidence of EBV-specific expression in posttransplant cutaneous squamous cell carcinomas. These results suggest that at least some of the skin cancers developing in immunocompromised heart transplant recipients are associated with EBV.